Expert: Claes-Gustaf Nordquist, M.D. - 4/27/2008

Question
Dear Doctor:
My mother who is 75 years of age was diagnosed in April of 2007 with a Glioblastoma Multiforme Grade IV tumor, had surgery and the surgeon (who is world renowned)said he removed all the tumor. 4/25/08 she had an MRI and according to the surgeon she is cancer free.  she took 33 treatments of radiation in May thru July, 2007. She took very little Chemo (Temador tablets)in May and June, 2007. Platelets got as low as 11,000 and she had 2 platelet transfusions. Platelets as of March, 2008 are at 88,000 (which I know is below normal) red blood count is normal and white blood count is below at around 2.4. I am taking her to therapy, but she has a lot of confusion,  severe fatigue, sleepiness, dizziness, left leg drags, and she is very unstable on her feet. The surgeon says it could still be after effects of the radiation, but the oncologist, neurologist, or PCP can't seem to give us any answers as to why she has all these symptoms after 1 year. I know surviving something like this is a miracle itself and recovery takes a long time if you do survive, but their seems to be no improvement whatsoever even with therapy twice a week. The only medications she is currently taking are glipizide for Diabetes Type II, Levothyroxine for Thryroid, Celexa for Depression, and the PCP just changed her blood pressure medicine to Norvasc about a month ago.  She had been taking Aricept to help her thinking (she doesn't have Alzheimer's or dementia according to the neurologist),but he changed it to Namenda as of Friday to see if the Aricept could be causing her symptoms. Do you think the Norvasc could be inneracting with any of these other medicines she is taking?  I've asked the PCP if we could stop it a few days to see, but he said no.  Her blood pressures to me seem normal, usually running 130's over 70's & lower 80's. We check it twice daily, morning and night. Do you have any suggestions?

Answer
It is extremely remarkable that she is tumor free one year after treatment. If you had not stated that MRI shows her to be tumor free I would say that her symptoms may indicate a return of her tumor. I'm sorry, I have no idea why she has these symptoms if not connected to her tumor. But since no one seems to be able to come up with anything I suggest that you have a second opinion including full examinations etc. done on and for her. Good luck!