Expert: Claes-Gustaf Nordquist, M.D. - 8/6/2011

Question
My 67 year old husband was diagnosed with GBM IV July 3, 2010.  He had surgery which removed about 50% of the tumor.  He went through several weeks of daily Proton Radiation treatments with low dose temodar and decadron, then after a month break, was given strong temodar on 5 and off 28 days for 6 months.  After he completed that phase of treatment, he started having breathing problems.  Upon a scan of his lungs, a blood clot was found.  He was put on blood thinners but continued to decline.  Another scan found a large Abdominal Aorta Aneurysm.  That was repaired, then his stools were black and a trip to the hospital found a bleed in his stomach.  That was repaired and he was off the blood thinners for a while.  Then, his right leg and foot swelled and started to discolor.  A trip to the hospital showed blood clots down his right leg.  After a few days of drip blood thinner, he returned home, then his doctor ordered a scan of his pelvic area and found his inferior vena cava was blocked from his stomach down both legs.  He is showing blood veins in his sides and stomach area where the doctor said the blood was trying to make a different route to get the blood from his lower body back to his heart since the Inferior Vena Cava was not sending the blood back to the heart as it should. The doctor told him of a treatment he could have they call the roto rooter.  My husband decided against that treatment.  He currently is taking Lovanox injections for thinner twice a day.  His right leg, foot and right hip is still swollen but seems to be slowly getting better.  The bottom line of this story, is that his Brain Tumor has been stable since his surgery and radiation.  I firmly believe all the clotting problems he keeps having is somewhat due to Temodar.  I realize people say tumors can cause blood clotting, but I believe Temodar caused him more problems than it helped him.

Answer
I honestly disagree! I do not even know how many times I have discussed temodar treatment cases here and your case is the very first of its kind that I have ever heard of. If this was a known side effect of any significant probability there would be plenty of warnings on this matter. But there are no such warnings. Temodar is used in most brain tumor cases all over the world. So this SHOULD be a known side effect if it exists. It is far more probable that your husband has another condition at the same time. Yes blood clots are associated with tumors - mainly in the abdominal and pelvic areas - but hardly with any brain tumors.


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