Expert: Claes-Gustaf Nordquist, M.D. - 7/13/2009

Question
This is my husbands 2nd brain tumor it was told that it is a anaplastic astrocytoma stage 4 an it measures 7x5 cm effecting the whole brain with a fluid sack underneath the tumor causing pressure on the memory,personality and mobility nerves. 5 years ago he had the same tumor but a stage 3 and most of it but the lower lining was removed because it sat on top of the main artery of the brain. He had chemotherapy(temador)and radiation.
we were turned down this time for surgery. said it was too dangerous and he would be a vegetable. The tumor is effecting his memory causing him to have short term memory loss,slow mobility. He is child like and it is very hard to focus.
He is not sleeping well even with medication. HE is more aggressive and short tempered.
We are currently awaiting a clinical trial to be excepted but I feel like they will also turn us down.
He had been in remission for 5 years and from October of 2008 until June 25 2009 he has a massive tumor. Should we seek out the clinical trial and put him through the test or should we enjoy what time we have and we are unsure what time we have I feel like 6 months to a year, but I have not been told a spec time frame.
I have two children ages 10 and 7 and they are begging for him to not go through treatment in fear it will kill him and make him to sick to be around them.
I am scared and afraid because the doctors are not talking to me and telling me what to expect. Will he have seizures,will he get to the point of wanting to do nothing but sleep? How long does a patient have when told he has this type tumor?

Answer
I'm sorry to read of his - and your - problems! I think it is the same tumor that has come back. I also think its GRADE (brain tumors usually do not have any stages) at that time was not evaluated correctly. If it had been a grade 3 then he would not be alive now. It was probably only at most a grade 2. However it is far more likely that it is a grade 4 now. Brain tumors have sometimes a bad habit of getting worse over time. And I think that is what has happened here. Yes after previous surgery and radiation therapy there is no room available now for either surgery or radiation therapy unfortunately. So the ONLY possibility that remains for him is some sort of clinical trial. If that will be of any help is impossible to tell (that is why it is a trial) but it is his only available chance! So you can not let your children decide this since this is a decision for grown ups. Besides if nothing is done he will anyway pass away. So as I see it there is not much of a choice. His remaining survival without surgery and radiation is probably as you wrote around 6 months to a year. There may be stroke like symptoms and even epileptic fits. He will become more and more confused and sleep more and more. When he sleeps all the time his end will be near. He will then drift into a coma and then pass away. There will be little pain - if any.  The personality changes you describe are not uncommon in situations like this. I'm sorry I have nothing better to tell you!