Expert: Claes-Gustaf Nordquist, M.D. - 4/29/2009

Question
Generally speaking, how long would a patient have to live if diagnosed with Grade IV primary brain cancer?  What would their remaining time left be like if they decided not to get any kind of treatment (surgery, chemo, radiation, etc.)?  Are there medications that could help prolong their life?  

I'm mostly interested in knowing how that person would function on a day to day basis.  Would there be headaches, mood swings, visual disturbances, etc.?  

Also, what would the very end be like?

Thank you so much for taking the time to answer these questions for me.

Answer
Grade IV (4) primary brain cancer like glioblastoma multiforme (GBM) grade IV has a very limited survival time of around one year or a little longer from primary treatment even if full treatment (surgery, radiation therapy & chemotherapy in combination) is given. Without such treatment the survival time will be even shorter - how much shorter depends on individual factors so I can not give a precise general answer. Apart from the treatments mentioned above NO medication or other treatments exist at present that can prolong survival. Many symptoms also depend on the location of the tumor in the brain (= which brain centers are affected) so again no general answer can be given. However some general symptoms do exist. The patient will in general get worse over time. The patient will become more and more confused, may complain of head ache, may show stroke like symptoms and even epileptic seizures. the patient will sleep more and more, have bigger and bigger difficulties in taking care of him-/herself - dressing, eating, hygiene etc. Actually quite messy! When the patient sleeps all the time the end is near. The patient will drift into a coma and then pass away. There will not be much pain.
I do hope this has explained it.