Expert: Claes-Gustaf Nordquist, M.D. - 10/12/2009

Question
March 24th, 2009, my husband had 2 tumors removed from his right temproal lobe and was they were found to be stage 4 gmb. Afterwards his treatment has been 7 weeks of radiation and follow up of temdor once daily every 3 weeks.  In june we found out that the tumors have returned and 2 more small ones have developed.  the last scan showed that they have stayed the same size  in a suspended state. My husband though has memeory changes, his mobility is getting more and more limited. He will lose the function of his right leg and his arms and hands will often get numb. Personality hasa changed but only towards direct family me in paticular, anger is a big issue whether his steriod dosage is lowered or not. He also gets paranoid and has become increasingly selfish, taking out huge loans and cashing out life insurance policies so he can purchase what he wishes, he is even building a house that is to his excat design. I am used as a scapegoat for everything, yet when I have told him that I will just leave and be gone, I am threatened with all sorts of things from legal action to even more violent threats.  Is this normal?? And what are the signs that he is gettting worse that i should be looking for. He is very good at showing another side of his personality to his doctors so they have a hard time believing what I tell them. He sleeps very little at night but naps during the day , the cold really affects him and he has gained alot of weight. Please help, right now he has no follow up appointments scheduled and I am not sure if what I see is something that should be mentioned to his dr's or not.

Answer
What you report does happen now and then - though certainly not always. Thinking and personality are after all functions of an organ, the brain, and his brain is severely disturbed and damaged by his illness and its treatment. These symptoms should not come as a great surprise to his drs.  Sometimes these patients react like your husband with apparently little sleep. However a more normal pattern is to become more and more confused and sleep more and more. As here stroke like symptoms can happen and even epileptic fits. When the patient sleeps all the time the end is near. The patient will then drift into a coma and then pass away. There is normally little pain - if any. You should report these changes to his drs.! His weight gain is caused by his cortisone treatment against brain swelling. That treatment too may have psychological/psychiatric side effects and may at least partly be responsible for his behavior!