Expert: Claes-Gustaf Nordquist, M.D. - 9/6/2007

Question
Good Afternoon Doctor,

My husband is 26 years old and was diagnosed with Glioblastoma Multiforme Grade 4 cancer in his left temporal lobe of his brain at the end of December 2006.  He got a craniotomy two days after they found the cancer (about the size of an egg) and he began chemotherapy (temodar) and radiation for six weeks.  Because the tumor that was resected (almost the whole thing was removed) began to grow back slowly under treatment, in April they did the gamma knife radiation.  That same month, they started the intra-arterial chemotherapy.  The doctors said that the cancer has been stable since April and has not grown at all.  My husband will get these treatments until April of 2008 and then they will stop them to see if his cancer is dead or still growing.  Based on what I have told you, what do you believe the prognosis to be?  I just don't see how he could die before that because the tumor has stayed stable and has not grown a single bit.  After treatment stops, do you know how quickly the cancer could grow back or how likely that is to happen?  What is usually the cause of death with this type of cancer?

Thank you,
Ashley

Answer
Based on previous experience all patients with GBM grade 4 die of their tumour usually not much more than a year after initial treatment regardless of what therapy that they have received. In your husband's case some rather new and experimental therapy has been given. So here there is a new and uncertain situation for which we do not have experience. But based on old experience I can unfortunately not offer much hope.