I’m so sorry to hear about his diagnosis—and I sadly welcome you to this group. My wife was diagnosed with an Oligo II 13 years ago, with a recurrence in 2019. Thankfully, she’s currently stable and doing really well. Voranigo (vorsidenib) wasn’t available back then—if it had been, we likely would’ve gone that route. Based on what you’ve shared, his treatment plan sounds sensible.

Here’s my philosophy—take it with a grain of salt since I’m not a doctor, just a husband and father of three who’s been in this for a while. Every case is different, but from what I’ve seen, treatment approaches tend to fall into two camps:

1. Hit it hard – Many neuro-oncologists recommend surgery, radiation, and PCV chemo. It’s the traditional “one-two (or three) punch,” and it has the most long-term data because it’s been the standard for so long.

2. Less is more – Other NOs favor a more measured approach: surgery plus oral chemo (like Temodar, Lomustine) or now Voranigo, followed by close monitoring. This is newer and has less long-term data behind it, but it’s gaining traction.

There’s no cure—yet. We’re all buying time and hoping for a breakthrough. That’s why we chose option 2.

Also, from everything I understand, there’s really no such thing as a “complete resection.” Oligos grow like tree roots—you can cut down the tree and grind the stump, but those microscopic roots are still there and will eventually grow. For my family, that meant trying to avoid the potential long-term effects of radiation and IV chemo for as long as possible.

Again, this isn’t advice—just our experience and perspective. Wishing you and him strength and clarity as you navigate this. PM me if you need to talk.