Glioblastoma - treatment or no treatment?

FormerMember
FormerMember
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Hi all,

I wanted some advice about caring for my brother who has incurable glioblastoma stage 4.


My younger brother who is only 29 was disagnosed with GMB stage 4 on Oct 17th after having a seizure. Since then he has had a biopsy which showed he his tumour is incurable and debulking surugry wasn’t an option as the tumour has started of in the thalmas moved to the left side. Instead a chemo-radio combo would be given to prolong the his life expectancy for upto 12-14months. 


His tumour is on the left side and pretty big when it was diagnosed so his right side is affected with some weakness and sight impairment and as of recently suffers from seizures on a daily basis and severe headaches.


He started his treatment on 5th December for only 5 days where he suffered from multiple focal, absent and tonic-clinic seizures several times a day. After 5days of treatment he went into a coma for 4days because of the swelling in the Brain - there was no more room in his brain so his brain shut down and the tumour had also grown since the MRI the previous week. We were told treatment was no longer an option and he would need to move to a hospice for end of life care. We were given days and possibly a week. 


However, they gave some dex (24mg for 48hrs) and menatol to reduce the swelling and this has worked wonders and he is now conscious and eating and drinking..he was discharged from hospital last Wednesday in time for Xmas as there weren’t any spaces at the hospice. So we bought him home after 10days. Since coming home, he is walking independently and able to wash and shower on his own, eating well and is so much better at managing his seizures and tells us when is feeling dizzy or losing his balance. I feel that he does need to be ‘watched’ just in case of any dizziness or seizures as it happens at any time and during a seizure he is not aware of what’s happening around him. 


My brother is aware of everything and knows treatment is no longer an option and we have to let the disease takes it course. Today we went to see his oncologist, who was amazed at my brothers recovery, after his recent admission. My brother is going out and meeting friends, drinking and just making the of it now, as we know the inevitable. He obviously needs to be watched and picked up/dropped to places but at least he is doing what he wants and just enjoying his life.

 

Today we were told he could start a short course of radiotherapy - 6 sessions at high intensity over 2 weeks. But would need to reduce the dex to 12mg from 16mg before start anything. 


I would like some advice as to whether we should even try to attempt any treatment at this point or should he just continue to enjoy the quality of life that he currently has for as long as possible. My thinking is that if 5days of chemo-radio put him into a coma, as the tumour is very large, and he was bed ridden and spent almost 2weeks in hospital, wouldnt the same happen again? Although a very positive person, he was fed up from all the headaches, seisures and hospital appointments/admissions and didn’t want to go out or watch tv or anything, he was sad and depressed and just kept going. Right now it’s like he has been given a new lifeline, where is just making the most of each day.


In my brothers case, we know his cancer is not curable and life expectancy was 12months with treatment. It’s been 3months since the diagnosis and we haven’t had any treatment as such. 


We started off fighting and gave every option available to us a go... Now however, having seen what it can do to a person first hand, Isn’t it better having a few weeks/months of quality life than those extra few months where he could be back in hospital / not so mobile and suffering from more headaches and seizures as results of treatment? 





  • FormerMember
    FormerMember

    Hello Bub

    I am really sorry about your brother. I shall not try to suggest whether he should have treatment or not. That is for your brother to decide. Everyone is an individual, a statistic of only one. Predictions of timescales can be wrong too. In his position, I personally would try everything. My prognosis and age adjusted was only a year and here I am 21 months later. This will be a hard time for the family but I do wish you well in the decision making. As a thought, if he had treatment he can have anti seizure medication simultaneously and not necessarily have additional headaches.

    Best wishes

    Brian 

  • FormerMember
    FormerMember in reply to FormerMember

    Thanks for your response Brian and it’s really good to hear some good and positive stories, as so far the information we have heard and statistics presented to us in particular to my brothers case where, debulking wasn’t even an option, the end result hasn’t been what we’re expecting. 

    You are absolutely right in that it is solely my brother descison. I am keen to know how others found the treatment? As my brother hasn’t had a proper go and the treatment he had was not tolerated and just caused too much swelling within days and went into a coma.


    With this short term radiotherapy treatment the doctor did say we are only prolonging the life expectancy by a couple of months, and this is why I was keen to know if it was worth it, as my brothers quality of life deteriorated after the reducing the dex prior to treatment to 10mg with more seizures, headaches, tiredness, reduced mobility. Right now he is on 16mg of dex which has to be reduced before he can begin any treatment.


    He does take anti-seizure medication - keppra. Was on phenytoin at the start then before his treatment we introduced keppra and clobazam, but it didn’t really help after as the swelling was just too much and causing seisures frequently. 


    My worry is if he starts to reduce the dex, he will  start to get more seisures and weakness and even if this is tolerated and begins treatment, he make go back into a coma, and this he may not even come out. I want my brother to enjoy his life like he is now and not suffer like he was before.

  • FormerMember
    FormerMember in reply to FormerMember

    Hello Bub

    For some, sadly, surgery is not possible. Usually informed by overall health and more especially by the site of tumour/tumours. They may be unsafe to access. Radiotherapy and chemotherapy can be well tolerated although little fun particularly chemotherapy which has its own side effects, and not everyone can complete the multiple cycles. Possibly a reduction in dex will not induce seizures as the Keppra should hold them back. Everyone is different though and best to seek a clinical opinion on any meds.


    Best wishes


    Brian

  • FormerMember
    FormerMember in reply to FormerMember

    Hi Bub,  I empathize with you and your younger brother.  Sounds like you and he have gotten the best results with the dex at the present level. 

    What an awful journey you've been through with his pain and coma, etc. I'll keep you both in my prayers to find your comfort a day at a time


  • FormerMember
    FormerMember

    My sister in her 70 s diagnosed with glioblastoma, given 6 mths to live came to live with us after 10 days of chemo/radiation treatment, with a bag full of pills and in coma like state.

    She chose to cut out most of her pills , of which there were MANY and to have no more treatments of any kind

    Then she began to be human again , living life thru spring and summer.,it was great.

    She had no pain, no headaches, no nausea ,no sleeping thru the day, good appetite.

    She is now in hospice and slowly deteriating, but i look back and am happy that we had what we had.

    This is just our personal journey.

  • FormerMember
    FormerMember in reply to FormerMember

    Hi

    So sorry to read about your brother, he is so young too, which somehow always seems even less fair. 

    As others have said, this is such a personal decision. My dad has undergone de-bulking surgery, 6weejs if radii and Chemo and 2 rounds of chemo after that. As Brian says, there are side effects that have really changed him. The radiotherapy does cause intense fatigue for weeks and months after it has been administered. He sleeps a lot and has little appetite. He is often like a duller version of himself. 

    He has been resolved to do everything he can to extend his life and so his choice has been treatment. That said, his situation is very different from your brothers. 


    Just yesterday at the chemo clinic we were advised to have no more chemo as the side effects are affecting him too greatly and he needs to get busy living, which it sounds like your brother is doing. The radiotherapy has shrunk what part of the tumour was left behind though for which we are truly grateful and very happy - the furst positive piece of news since July - and I believe that this will extend dad’s life from the initial prognosis. 

    He is also taking as many immune boosting supplements and diet as he can. I was surprised at how elated I felt that there is to be no more chemo. Hopefully onwards to a gradual recovery from the side effects. 


    I wish you all the best in this tough decision and as we say up here in Glasgow, I hope your brother kicks the arse right out of it with whatever time he has left x

  • FormerMember
    FormerMember in reply to FormerMember

    Hi Millie I hope you don't mind I've dropped you a friend request.  I am in West Lothian so not yo faraway from you. The reason I got in touch though was that my dad is on this journey too and is just about to start treatment following surgery.  Was just wondering what immune boosting supplements your dad taking.  I have been helping my dad look at diet too although the medics don't seem to advise any drastic changes just avoid too much sugar.  Just wondered what everyone else thinks or does.

    I hope your dad is able to get some time recovering from the effects of chemo soon.


    Best

    Mands 

  • FormerMember
    FormerMember in reply to FormerMember

    Hi. Mands.

    Have accepted your friend request. Really happy to talk to you. I am having a problem sending a pm to you on here. Do you want to pm me your email address? 

  • FormerMember
    FormerMember in reply to FormerMember

    Thank you TrailWalker. 

  • FormerMember
    FormerMember in reply to FormerMember

    Very sorry to hear about your sister. I pray that your sister does not suffer anymore. 

    I think you are right in that stopping a lot of the medications have made a difference even for my brother. 


    I also think sometimes when you let go mentally about what could be / what will happen etc, you begin to be free and just happier... My brother is in a good place at the moment, in that he able to have some quality of life - he is not oblivious to what will happen, but is just making the most of now and making plans for everything he wants to do over the coming months. I am very proud that he is still so positive and happy.