Anaplastic Oligodendroglioma: Impacts Of Aerobic And Flexibility Training On Physiological, Psychosocial, And Cognitive Function

HISTORY: A 44-year old female diagnosed with class III anaplastic oligodendroglioma with 1p19q genetic co-deletion who underwent a left-frontal craniotomy, chemotherapy, and radiation prior to starting an exercise-based cancer rehabilitation program. During initial assessments, she qualified and was enrolled in an ongoing research study examining the impacts of aerobic and flexibility training on cognitive function. CLINICAL EXAMINATION: Comprehensive physical, psychosocial, and cognitive assessments were completed pre and post training (36-session intervention). DIFFERENTIAL DIAGNOSIS: 1. Brain Metastases 2. Seizure Disorders 3. Glioblastoma Multiforme TESTS AND RESULTS: Sought medical assistance following grand mal seizures. Magnetic resonance images (01/15/2013) revealed infiltrative lesions on the anterolateral aspect of the left frontal lobe which measured at approximately 4.6cm x 3.3cm in the axial plane - involved cortex and subcortical white matter Patient underwent craniotomy (01/24/2013) Pathology confirmed grade III anaplastic oligodendroglioma - positive: 1p36 and 19q13 sequence deletions - negative: epidermal growth factor receptor sequences, tumor suppressor gene phosphatase - negative for the loss of the tumor suppressor gene phosphatase and tensin homolog sequences Follow-up (02/12/2013) the patient was awake, alert, and oriented, but physically fatigued New presentations: - blurred visual acuity (left eye), ambulation and postural difficulty, lower right extremity weakness, continual word aphasia with speech interruption FINAL/WORKING DIAGNOSIS: Class III anaplastic oligodendroglioma with 1p19q genetic co-deletion; referred to the University of Northern Colorado Cancer Rehabilitation Institute and recommended participation in study TREATMENT AND OUTCOMES: 1. Procarbazine, Lomustine, and Vincristine Sulfate (PCV) chemotherapeutic (6x) with ionized radiation (46Gy followed by 14Gy boost to resection site and G2/FLAIR regions) - temozolomide added as adjuvant to radiation 2. Patient completed 36 sessions of aerobic and flexibility training 3. Improvements observed in physiological, psychosocial, and cognitive variables 4. Patient then made a positive transfer into a standard exercise-based cancer rehabilitation program