Expert: Claes-Gustaf Nordquist, M.D. - 12/6/2007

Question
My Nana was diagnosed with a brain tumor about 3 weeks ago.  They originally suspected a stroke.  She had previously been fighting ovarian cancer as well and they felt she could no longer handle the chemo and she was not a candidate for surgery for the tumor. They told us 6 to 8 months but she has taken a turn for the worse in the past few days.  Last week, although her speech made little sense, she was awake and knew us and tried to talk to us.  Now, she sleeps mostly, hasn't eaten in 4 days.  Sometimes she opens her eyes.  I was hoping you could tell me what goes on with tumors at this stage.  Does she see us and know who we are?  can she hear us?  Is she aware of what's going on around her and she just cannot communicate?
They did not do a biopsy of the tumor so we don't know what kind it is, but any information you could provide on the stages of brain tumors and what the patient sees, hears, feels, knows until the end would be very much appreciated.
Thank you,
Megan

Answer
Many of your questions are impossible to answer because nobody knows! The only thing I can tell you is that when patients reach the state you describe the end is not far off. She will sleep more and more, drift into a coma and then pass away. You have yourself noted that she can not communicate. This is typical of this stage of the process, but it also means that no one can get those answers from the patients you ask for so nobody knows. And therefore there are no answers to those questions. Recent advances in neurophysiology may give us some insights on this in the future but we are not there yet, sorry!