Expert: Claes-Gustaf Nordquist, M.D. - 11/29/2008

Question
My friend was diagnosed with GBM STAGE 4 in May of 2007.  They removed 95% of the tumor, and did the routine radiation treatments and also temedor.  He has now stopped the treatments. He was under the care of NY doctors, and then went to Duke...now back at Sloan Kettering in NYC.  It's been now about 7 months and unfortunately, he's addicted to pain killer as he had a drug abuse problem in the past. He is on very strong painkillers such as OXYCONDONE/OXYCONDTIN and now morphine.  His 'pain management doctor' is prescribing this to him. We (family)although believe he is in somewhat of pain ...(headaches) he does not need to be on such strong medication.  Is this true? We cannot tell if he's 'doped up' or high...or just dying and sleeping alot due to his illness.  
Yes, I know the prognosis is not good and he may not live much longer. However, we believe that the very strong medications he is on is not what he needs and could be limiting his very short life.  He is in bed all day-and very weak. Again, not sure if this is from cancer or being addicted from his pain medication. Please let me know your thoughts!!!
thanks, emily

Answer
Brain tumor patients usually and normally do sleep a lot and more and more as the tumor progresses. When they sleep all the time the end is near. They then slip into a coma and then pass away. So neither do I know if this is due to his tumor only or at least in part due to his medication. It may be either way. Normally brain tumor patient do not suffer that much pain that strong pain killers are necessary. However based on the actually hopeless prognosis of a GBM GRADE 4 tumor (brain tumors do not normally have stages) where all and every patient is killed by his or her tumor normally within a year or so regardless of treatment I do not consider any medicine addiction of such a patient a big deal, since he/she WILL NOT live much longer anyway. These tumors do have a 100% mortality rate. It is his tumor that will kill him not his medication anyway. Maybe he needed the medication in the beginning due to anxiety due to his situation. I do not know. To try to change anything now is most probably quite useless and meaningless. His tumor makes him weak anyway. I'm sorry I have nothing better to tell you!