Expert: Claes-Gustaf Nordquist, M.D. - 3/7/2010

Question
My mother was recently diagnosed with GBM. She underwent a craniotomy to debulk two tumors on January 20 and, following an an amazingly-fast regrowth of the remaining tumors, a second craniotomy on January 29. She has recovered from her surgeries very well, and she was slated to start radiation therapy/temodar next Tuesday.

Nevertheless, her radiation oncologist called on Friday, informing us that an MRI showed the tumors had grown again and that radiation/chemotherapy might not do much. He raised the possibility of a third craniotomy, but I am worried that before we get to radio/chemo, the tumor will have grown back again. My mom lives in a developing nation, and we are wondering if perhaps there are other options (e.g., gamma knife) that are not available here that would help her.

Please help me, please help her. She is too young and full of life to die.

Answer
The so called "GammaKnife" is also a form of radiation therapy but can only take care of rather small lesions. In this case not much bigger than an inch in size. I do not know how big your mother's remaining lesions are but if there are problems in getting her to ordinary radiation therapy after surgery the same problems may happen with the GammaKnife too. Unfortunately GBM tumors all have a very bad prognosis everywhere regardless of therapy.
I'm very sorry I have nothing better to tell you!



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