Expert: Claes-Gustaf Nordquist, M.D. - 10/22/2009

Question
QUESTION: You answered a question from Sarah about what to expect as Glioblastoma progress.  I was wondering if you could give me more info, you stated "When the patient sleeps all the time the end is near".  My husband was diagnosed and had the tumor removed in May 09, He did 6 weeks of radiation, 1 year of Temodar, %26 Enzastaurin.  After 14 months the MRI showed the tumor was back.  He has had 2 treatments of Avastin.  He has had occasional focal motor seizures and headaches for the last couple of month but other than that his health has been fine and he has been active everyday. The last few days he is sleeping more than awake and complains of headache. When you say the end is near, I don't know if near is months, or days.  I am very worried.  Thanks

ANSWER: Well, what I meant was the fact that when these patients do sleep 24/7 ALL THE TIME then their deaths are not far off (no more than weeks usually). They then drift into a coma and then pass away. As far as I can understand your husband is not yet in that state.


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

QUESTION: Thanks for your quick response.  I hope he is just tired from treatments and will bounce back.  It is so difficult to ask and to get answers when you feel lost.  Your service is greatly appreciated.

Answer
That is of course possible. However all GBM patients follow more or less the same pattern so far. Avastin is a new drug here. Some progress has been reported after its introduction but we have yet to see any cure. Personally I believe that we still do not understand the biology of these tumors well enough for an effective treatment to be devised.