I’ve read a few studies that say PC (PCV without vincristine) has almost all of the benefits of PCV but with far fewer side effects. Only good for oligodendroglioma though.

TMZ is the chemo of choice for astrocytoma. It is easier to tolerate but less useful unless you have MGMT promoter methylation.

There are practically zero drugs on trial for low-grade gliomas but a few for glioblastoma.

The only trial that shows promise is one for a targetted therapy if you have the (rare) BRAF v600 mutation but it’s not yet available in the UK.

If they want to they can assume a diagnosis- it is a bit like they were doing with your epilepsy diagnosis.
Some centres are better than others – my Torbay oncologist told me that I was the only patient she saw annually for a
check-up that required no treatment.
I think some parts of NHS are more regimental than others.

To be fair to my oncologist, she didn’t actually say she couldn’t take me on without a biopsy and I never really asked her anyway.

NHS policy is to assign you to a surgeon initially and then assign you to an oncologist after you have had surgery (most people with brain tumours have surgery). I am in a weird spot since I am not having surgery.

I’d guess that, if I really wanted, I could transfer to the oncologist but there is very little that she can do for me without a biopsy anyway.

From Guys and Dolls, Frank Loesser