Expert: Claes-Gustaf Nordquist, M.D. - 10/9/2008

Question
On March 5th of this year, my father was diagnosed with an astrocytoma on    the right frontal lobe of his brain. Before this, my wonderful 61 yr old father was a healthy, vibrant, hardworking man who never missed a day of work. I noticed that he was sleeping more frequently, forgetting to get up for or go to work, and forgetting most of his normal duties. (i.e. pay the bills, shower, etc). His medical doctor broke the news to he and my mom sending him to UAB for treatment. UAB confirmed and started planning his treatment. Surgeons went in to remove the tumor but were only able to obtain a portion for a biopsy to see what type/grade tumor they were dealing with. The grade 4 GBM, which we soon found out, was so deeply woven into his brain that there was no need to operate. Oncologists began what they call paliative treatment to try to try to give him the longest and best quality of life possible. The affects of the chemo, radiation, and steroids were heartbreaking. After 1 round of treatment my father refused anymore. (Accept for the steroids which my mom, an RN of at least 30 years, refused to stop giving him). Now, 7 months later, he is mostly immoble and is under hospice care. my mother cares for him and keeps vigil 24/7. He seems to be in a lot of pain but can't or won't say what's hurting, screaming out in agony. Dad still has a good (too good) appetite. (thanks to the steroids) But he is very weak, fatigued, confused, hallucinating, and often times having moments of vagal responses where he seems to be having a seizure but according to drs are not seizures. He is incontinent and needs to be fed. There are days when he sleeps a lot and others where he hardly sleeps at all. I miss my dad already. This horrible disease has taken away the onle man besides my 5 year old son who has ever truly loved me and whom I have ever truly loved. Even though he's still alive I feel that I lost him months ago. I too would like to know what to look for in the end. Its not that I want him to die, or that im waiting on death to come. But how much longer does his suffering last and how will my family and I  know that the end is approaching?
Daddy's Little Girl
Brandi


Answer
I'm sorry to read about his and your problems! Glioblastoma multiforme grade 4 is a type of tumor that is still truly incurable and 100% fatal unfortunately. While it is impossible to exactly predict survival times the average survival times in cases like this are around one year or a little more. Unfortunately I have to agree. You have already lost him. When the end approaches the patients with this kind of tumor usually sleep more and more, then drift into a coma and then pass away. I'm sorry I have nothing better to tell you!