Expert: Claes-Gustaf Nordquist, M.D. - 2/3/2008

Question
QUESTION: MY DAD DX 2/06 WITH GBM.IMEDIATLEY LOST SBILITY TO MOVE LEFT SIDE. TUMOR IN RT FRONTAL LOBE.HAD SURGERY RAD. CHEMO ETC. MANY CT & MRI OVER THE PAST 2 YRS NOT MUCH GROWTH. SOME EDEMA. WAS ORIGINALLY GIVEN 6-9 MTH PROGNOSIS. ALMOST 2 YRS TO DATE. HAS  HAD CONFUSION SHORT TERM MEMORY LOSS, OUTBURSTS, MOOD CHANGE PERSONALITY CHANGE ETC.I WEEK AGO DEVELOPED PNEMONIA, ADMITTED TO HOSPITAL.HAS BEEN ON HOSPICE 8 MTHS.HE SLEEPS ALOT HAS GOOD VITALS,DOESN'T SPEAK MUCH.NOW CAN ONLT EAT PURRIED FOOD.LOST SWALLOW REFLEX. HE STARTS TO EAT TAKES 2 BITES AND THAT IS IT. SO NOW BASICALLY NOT EATING ONLY IV.HE DOES NOT WANT FEEDING TUBE OR ANYTHING TO PROLONG.NO ONE WILL GIVE ME A TIME FRAME.HE SPEAKS OF HIS BROTHER THAT HAS BEEN GONE 20 YRS. I KNOW THESE ARE NOT GOOD SIGNS I JUST WISH I COULD HAVE AN IDEA WEEKS MTHS??? ANY ANSWER DUE TO WHAT I EXPLAINED?

ANSWER: It is always hard or impossible to predict survival times with any precision!  This long survival time makes me think that his tumor was not quite as malignant as thought when it was diagnosed! But brain tumors are often difficult to assess and evaluate! It is clear however that he is approaching the end of the road now. Even so it is not easy to predict how long time he may have left. Complications may kill him at any time! But anything from a few weeks to a couple of months seems probable! I'm sorry it is impossible to be more precise!


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QUESTION: NOT QUITE AS MALIGNANT? WHAT DOES THAT MEAN? THEY SAID IT WAS STAGE 4 GBM. THERE ARE DIFFERENT TYPES OF MALIGNAMCY?

Answer
They said that it was a GRADE 4 GBM I think. So there are grades 1,2,3,4 where grade 4 is the worst, the most malignant! It is however quite hard to put some tumors in the right grade. If he was a grade 3 and not far from grade 2 then this long survival time would be more understandable.