Expert: Claes-Gustaf Nordquist, M.D. - 1/28/2008

Question
My brother has completed his 5th week of Radiation, he has 1 week to go.  He is also receiving 160mg of Chemo (starts with a T).  We had a very difficult time getting him to radiation treatments on time, (he seems 'disconnected', can't get going and then started soiling himself because he could not make it to the restroom and would fall) so we were told to take him to the hospital (New Years Eve) where he remains to this day.  He is getting increasingly very weak, and now doesn't even want to get out of bed, plus his appetite is getting worse.  He does not talk much, just mumbles.  His short term memory is very bad, but his long term memory is good.  His GBM was a 'butterfly' and he had to undergo 2 surgeries, one on Oct 31, the other Dec 7.  After he finishes the radiation I understand they will take another MRI to see if it has grown or shrank.  My question is, "Is it normal for him to deteriorate so bad during this treatment protocol?"  And more important: "After this treatment will he be restored to his normal self or 95%, 90%, ect...Because his quality of life right now is 'next to nothing'?"  And I'm wondering if we should even continue...  Thank you for your response...

Answer
Unfortunately I have bad news for you. Glioblastoma multiforme (GBM)is a malignant brain tumor with a hopeless prognosis. All what surgery, radiation therapy and chemo therapy can do is to prolong survival time somewhat and hopefully decrease symptoms somewhat and for some time - hardly the case here it seems (but radiation can also cause some temporary brain swelling that may make his symptoms worse for a time). Even with full therapy survival times rarely are longer than a year from surgery, often shorter and never much longer. I'm sorry I have nothing better to tell you! Have his drs. really not discussed this situation with you? Later on he will become more and more confused, may show stroke like symptoms and even epileptic fits, sleep more and more, drift into a coma and then pass away. There will be little pain - if indeed any.