Expert: Claes-Gustaf Nordquist, M.D. - 9/19/2009

Question
QUESTION: My 57 year old father presented with some memory loss and had been lethargic over a 3 week period with this getting worse each week (we contributed to his high glucose level). One Saturday he presented with a headache and pain to his right eye, the following Monday we brought him to the E.R concerned this was more than just a diabetic issue. It was found he had a fairly large (8mm) mass (stage 4) on his right front lobe, moving over to the left. He had surgery yesterday and the neurosurgeon stated they had to remove a large portion of his right frontal lobe, there were blood vessels matted into the tumor. My father is still currently "out of it" they are giving him insulin, morphine, a form of heperin (he also tested positive for factor V liden, which runs rampid in my family)and I am not sure of what else. My father is moving his left extremeties with prompts. I am concerned with so much of the frontal lobe removed will he be my Dad? They are planning chemo and radiation after 2 weeks, daily for 6 weeks. The doctor said we would have a year to 5 years but from what I am reading it doesn't sound like this could be a fair estimate. I am very confused. I am tring very hard to see the reality of this but have gotten too much information and am not sure how much is misinformation. Any help is greatly appreciated.

ANSWER: Do you mean GRADE 4? Brain tumors do not usually have stages but they do have grades. In order to answer with any kind of precision I would need to read his full pathology report as well as his full CT brain scan & MRI brain scan reports. If that is possible you can copy them here.


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

QUESTION: I apologize, I did mean grade 4 astrocytoma (GBM). I am unable at this time to get reports. Right now I am very concerned that he has not come out of it yet and wondering how much time we will have with him.

Answer
A glioblastoma multiforme (astrocytoma) grade 4 has normally a survival time of around one (1) year or a little more after primary treatment (surgery, radiation therapy & chemotherapy). In your father's case his tumor was rather small actually (8 mm = less than 1/3 of an inch, 1 inch = 25.4 mm). So his survival time may be somewhat longer but 5 years is unfortunately very improbable in my opinion. I'm sorry I have nothing better to tell you!