Expert: Claes-Gustaf Nordquist, M.D. - 6/27/2008

Question
QUESTION: My son in law suffered a seizure on Xmas day 2007.  He was diagnosed with Stage 3 Glioma. He has undergone surgery to remove the tumor.  They said they got everything they could see.  He has undergone 6 1/2 weeks of radiation and has started Temodor treatment.  He has had to have 3 more surgeries for swelling and necrotic debris (they called it).  He gets horrible headaches and loses function on his left side therefore the other surgeries.  As soon as his steroids are tapered off his symptoms of swelling return and has to go back on the steroids.  His most recent surgery they implanted a shunt.  This was only a week ago and so far it hasn't had to used. However, as mentioned, once steroid is tapered it all comes back.  I know his prognosis is not good.  He is only 37, my daughter is only 33 trying to cope with this and their two babies aged 5 and 4.  Our question is..What symptoms should we expect, how long before we start seeing them and in your opinion, what amount of time does he have left.  I know his current doctor at Cedar Sinai has an idea of all of these, but he does not tell us.  He is supposed to start a clinical trial with them in a few weeks using his platelets and part of the tumor to boost his own immune system.  What have you heard on this and does it really help?  From my understanding it will only give him a few months.  Does this affect his quality of life at that point?

ANSWER: A lot of research is going on with brain tumors since their prognosis is so bad. I have not heard of this before but I'm not surprised. If it will help I do not know He will over time be more confused, may show more stroke like symptoms and more epileptic fits. He will sleep more and more, eventually drift into a coma and then pass away. Usually there is not much pain. Survival time probably around a couple of years but it may be shorter. Even just months.
I'm sorry I have nothing better to tell you!


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QUESTION: At what point would he be hospitalized.  How much of the disease will he suffer at home.  Will he need to be placed in an assisted living home?  I sincerely thank you for your information.

Answer
I'm a Swede living in Sweden. At what point he would be admitted to a hospital is more a matter of local habits, resources and policies than of medical opinion so unfortunately I can not answer that with any certainty. The same applies to how much he has to stay at home. I do strongly suggest that you discuss this with his drs. as they are in a position where they should be better able to provide this information.
If by "an assisted living home" you mean a hospice then yes that is most probable and probably best.