Expert: Claes-Gustaf Nordquist, M.D. - 10/17/2010

Question
My mother was recently diagnosed with a GBM grade 4 after going to hosptial with severe headaches and vomitting. The initial MRI showed a mass 6cm x 2cm x 2cm. About 2-3 weeks later another scan showed that the tumour had already grown another cm. Due to cardiac concerns and the rate of growth the doctors chose not to attempt to debulk the tumour, but took a biopsy only.

The plan now is for radiation and oral chemotherapy only, with no surgery. All of the information I can find talks of survival times WITH surgery. How much difference will this make in terms of time I have left with my mother? With a tumour that is growing this rapidly is her survival time less? What symptoms should I expect as the tumour worsens? The tumour is mainly in the occipital area of the brain. My mother already has difficulty with vision, or perhaps more accurately processing what she is seeing and making sense of it.

Thanks for your time in answering

David

Answer
Well as you probably know by now the prognosis even with surgery of these tumors is very bad. So the absence of surgery will not make it any better. Even with surgery survival time after primary treatment (usually surgery but here radiation therapy) is usually only around one year. Here it may be somewhat shorter. Unfortunately it is impossible to be more precise. The fact that it is growing so rapidly may make survival time even shorter BUT may also make the tumor more radiation sensitive. That will unfortunately not make any cure possible but may give a somewhat longer survival time. More can not be said on that subject. Unfortunately due to the location of the tumor in the back of her brain her vision will be severely impaired. Over time she will be more and more confused and sleep more and more. Stroke like symptoms and epileptic fits may also develop. She will become unable to take care of herself. When she sleeps all the time her end will be near. She will then drift into a coma and then pass away. There will not be much pain. I'm sorry I have nothing better to tell you!




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