Expert: Claes-Gustaf Nordquist, M.D. - 1/30/2008

Question
My mother was diagnosed with an Astrocytoma which the doctors believed to
be a Glioblastoma multiforme  (right frontal lobe) in Sept. 2007.  I took her to
every Doctor's appointment and she moved in with me so I could care for her.
My mother was 78 years old and in very good health for a person her age.
Every doctor we saw told her she had a year to live or maybe more. She had
side effect on the left side with loss of strength, balance and some movement
She had surgery on Oct. 3 2007 and the surgeon believed he removed about
90 of the tumor. She recovered very well from surgery and was in good
spirits. She began Temodar daily the first of Nov. and began Radiation on
Nov.
27.  (Doctors said they were waiting on her head to heal). When she began
Radation she was using a walker, could most things for her self and had a
very
positive attitude! She did Radiation and Temador (along with Keppra and
Decadron). Three weeks -into the the 7.5 weeks -after she began radation
she could not walk, sit up and slept a lot - also was somewhat gazed and
confused - just not herself.   The Doctors contributed these symptoms to the
radiation. They did an MRI (Dec. 27) and did not see any significant growth in
the tumor. She continued to get worse, could barely move had difficulty
talking
and after 5 weeks of radiation called it quits - stopped the temporary also.  
The
doctors hoped she would regain some energy in the weeks following her
radiation. Instead, she  declined at a fast rate. We started Hospice on Jan. 4th
and she died on January 17th. Exactly as you described - went into a coma
and then passed away.  I was shocked that she only lived 4 months.  I had
expected at least a year (we had things planned for after radiation!) A year is
what we heard. My mom is a fighter and has always beat the odds! I am
confused as to what happened. She got bad very quickly and I thought it was
side effects of radiation and then she was gone. The Oncologist believes that
there was most likely cancer somewhere else in the brain that could not be
seen - is that common?  Why can't they see it - did they do the right tests?
The Radiologist offered little explanation to the fast decline and cancer
growth
in spite of aggressive treatment.  What are your thoughts on this short time
frame? Is cancer growth commonly mistaken for side effects of radiation?
And, is
radiation successful with glioblastomas? Four months was too short!

Answer
Well I may have said around one year but some pass away MUCH quicker. Even so this process was rather unusual. Was not an autopsy performed? Such an autopsy could probably answer your questions. The reason may have been a vascular accident in her head. Irradiation may cause some brain swelling and under some unfortunate circumstances that in turn may cause vascular problems. Otherwise I have difficulties in believing that her radiation caused this. Radiation or surgery or chemo therapy or all of them together can not cure a glioblastoma multiforme! NOTHING at present can! ALL such cases so far are fatal! What these therapies can do - and usually do - is to prolong survival time to some extent (with individual variations) and to decrease symptoms somewhat and for some time (also with individual variations) that is all. But this was NOT a typical process. If no autopsy was done that is most unfortunate too because then we have lost the chance of answering your very adequate and just questions! Unfortunately that is all I can tell you!