Expert: Claes-Gustaf Nordquist, M.D. - 12/15/2007

Question
Hello.  My 33 year old brother was diagnosed with a Glioblastoma in August 2007.  He had surgery and the Oncologist removed almost all of it.  6 weeks after surgery, he started a very aggressive treatment of Radiation for 30 days and has also completed Chemotherapy 2x for 5 days each time.  The first round of Chemo dosage was 130, the second was 410.  He's had Meningitis.  He had a permanent shunt placed in November 2007 and has been taking large doses of Decadron "on and off" per doctor's orders since August.  He had been on Decadron continuously since November 2 (24 mg per day).  Last week his Oncologist ordered that his Decadron be reduced from 24 mg a day to 4 mg a day.  On 12/8 he started to become very confused.  His wife was worried and took him to his Oncologist.  He was admitted to the hospital on 12/9.  He was told that he was suffering from Dementia r/t the sudden decrease in Decadron.  His Oncologlist upped his Decadron dosage back up to 24 mg per day.  He told my brother's wife that it will take several weeks for the Dementia to go away.  Is this correct?  Could the Dementia be related to his Brain Cancer?  He had a recent MRI...there are no new tumors.  From what I've read...when one has Brain Cancer with a Glioblastoma Multiforme...it is fatal.  One usually lives < 2 years?  Is this correct?  Thank you so much for your time!  I truly appreciate it.

Answer
Radiation therapy can cause swelling of the brain and that causes confusion (not real dementia). The swelling can be countered with Decadron. Yes unfortunately glioblastoma multiforme is always (100%) fatal. Therapy can prolong survival but that is at present all. Survival time mostly depends on the grade of the tumor. A low grade tumor (I to II - 1 to 2)case survives longer than a high grade case (III to IV - 3 to 4). You have not mentioned the grade of his tumor so I can not evaluate his situation. I'm sorry I have nothing better to tell you!