Expert: Claes-Gustaf Nordquist, M.D. - 12/27/2008

Question
QUESTION: Hi. My father was just diagnosed with GBM IV in his right parietal lobe.  He had surgery on 12/23 to remove most of the tumor, but now I want to know what the progression of this disease will take on his body.  What I need to know is what should I expect to happen to him to prepare myself and my family? My mother is a small person and can't really do much lifting whatsoever.  My father is 6' 1" tall and probably 160 pounds. He's tall but not big but she is the only one left at the house. My brothers and I are close by, but not there all the time and we all have small children (all under 2) so we are tied up as well. I don't need to know when and how long he will live....no one can give us that information, but I just need to know what to expect.  Can you help?

Thanks.

ANSWER: If this truly is a GBM IV his prognosis is bad and fatal. His survival time may be extended and his symptoms relieved to some extent by radiation therapy and chemotherapy. But his prognosis will not be changed. Expected lifetime will then be around one year or a little more (some uncertainty here). He will over time though be more and more confused. He may develop stroke like symptoms and even epileptic fits. He will sleep more and more. When he sleeps all the time the end is near. He will then drift into a coma and then pass away. There will be little pain if any. I'm sorry I have nothing better to tell you! Your mother will most probably NOT be able to cope with this on her own. Hospice is recommended. If at home other additional nursing help as well. But best probably in a nursing home or hospice facility if possible. If anything is unclear please just ask!


---------- FOLLOW-UP ----------

QUESTION: I am just unclear as to why you stated "if this truely is GBM IV". Do GBM IV's not originate in the parietal lobes? We go to see the doctor in a few days for confirmation on the biopsy, but he had the surgery at one of the best hospitals in the world with one of the best neurologists and after the surgery he stated that his best guess was GBM.  We are hoping for a miracle at this point, but I would like some clarity as to your statement.  Thanks.

Answer
No. They can originate more or less anywhere in the brain. But brain tumor pathology is hard and difficult. It is a job for very talented and experienced neuropathologists. Usually it is a teamwork where several pathologists have to examine the material and discuss the matter until a diagnosis conclusion can be reached. So it is not an easy matter!