GBM Cancer

Glioblastoma Multiforme Brain Cancer

What is it: Glioblastoma Multiforme (GBM) is a very aggressive form of brain cancer that can occur on the brain or spinal cord. It can occur at any age, but is more common in older adults. GBMs are very difficult to treat and can cause death.

Symptoms:

  • Persistent headaches
  • Double or blurred vision
  • Nausea
  • Vomiting
  • Loss of appetite
  • Changes in mood or personality
  • Changes in ability to think and learn
  • Memory loss
  • New onset of seizures
  • Muscle weakness
  • Speech difficulty

MRI images from July 2017 upon first diagnosis

Treatments:

Surgery: Surgical resections is typically the first stage of treatment for patients with glioblastomas. Surgery can be quite intense and requires a well trained Neurosurgeon. Removal of the tumor tissue can relieve pressure in the brain as well as some of the symptoms of the tumor. This surgery can take days or weeks to recover from, typically in a NeuroICU unit. Surgery can be very challanging and high risk depending on where the tumor is located on the brain.

Radiation therapy: Radiation is typically the next step in treating a GBM post surgery (with chemotherapy). In our experience we did one round of radiation treatment (once a week for a 6 week period).

  • Targeted radiation therapy is the new focus for brain tumors. This is typically performed by creating a head mask designed specifically for each individual patient. This allows for the radiation beams to directly hit the tumor region of the brain instead of the entire brain itself.

Chemotherapy: Several chemotherapy drugs taken orally or through IV infusion are available to manage the symptoms of glioblastoma. Chemotherapy are the next step in treating a GBM tumor and several different treatments may be perscribed by your NeuroOncologist.

-Chemotherapies we explored:

      • Avastin: Infusion Chemotherapy which can be taken through an IV every other week. The intention of the Avastin is to cut off the blood supply that feeds the tumor and helps the tumor to grow. The main side effects for this chemo would be the potental for internal bleeding,
      • Temozolomide: Oral Chemotherapy which can be taken either in small doses every day or in larger dose in a 6 week period. The intention of the Temozolomide is to attack the tumor tissue itself. It is the #1 choice for fighting brain tumors among doctors. Main side effect: may cause a significant drop in blood platelet levels as well.
      • Lomustine: Infusion Chemotherapy which can be taken through an IV once every six weeks. The intention of the Lomustine was to attack the tumor tissue. The main side effects for this chemo would be fatigue, vomiting and a NADIR period the forth week which means an intense amount of fatigue.

Targeted therapy: New therapies such as Optune, Clinical trials and Virus injections are new forms of treatment that can be explored for the patient. These treatments may have the potential to prolong the life of GBM patients by several months. However, these may also be higher risk as they are trials more than definite treatments. Consult with your doctor on the best resources and options avalible for you.

Other helpful medications we explore:

    • Dexamethasone: Steroid that helps relieve inflamation in the brain
    • Constipation Medication and Smooth Move Tea: Constipation is a common side effect from most chemotherapies. In order to keep regular, constipation medication such as laxatives and/or smooth move tea is commonly recommended by doctors to help with this.
    • Keppra: Anti-seziure medications
    • Trazodone: Anti-depressant and Anti-anxiety medication used to help patients sleep.
    • Zofran: Anti-Nausea and vomiting medication

Novocure Optune:

  • Optune is a new form of treatment that may help prolong the life of a GBM patient. It is a head set of arrays and a electronic battery pack that can be worn throughout the day and used as a treatment alongside radiation and chemotherapy. Review the link below and concult your doctor to see if Optune is right for you. (Doctors may not allow you to take clinical trials and Optune at the same time).
    • We explored Optune for several months and we are unsure of how it helped or did not help Stacey in her fight with GBM. Some things to know, you have to shave your head, head electrons are changed every other day or every day, you carry around a battery pack, you wear it at least 18 hours a day. Doctors supported the idea behind it but in our opinion you have to weigh the hassle of everything with how it mught be helping you. We chose to end our trial after the MRI scans showed regrowth and we moved onto a different treatment.
  • https://www.optune.com


*This website is not lisenced to diagnose or treat patients with cancer, please consult a trained profession if you believe that you or another person may have cancer. This website only supplies information relevant to the treatment we experience, this may not be the case for all other treatments or cases of GBM brain cancer.

FAQ:

Is GBM considered a terminal cancer?

-Yes, GBM cancers tend to be a form of brain cancer that has treatments which can help prolong the life of the patient and minimize some symptoms of the brain tumor. However, as of 2018 no treatment has been created that can cure patients from this cancer.

Determining the Grade of the GBM

Grade I: Least malignant GBM tumor, they tend to grow the slowest of the GBM tumors causing longer suvival

Grade II: Slow growing GBM tumor, looks more abnormal than the Grade I, but may reoccur as a higher grade

Grade III: A malignant form of GBM which are more actively reproducing than Grade II GBM and grow more into nearby brain tissues. They tend to reoccur as Grade IV GBM tumors.

Grade IV: The most aggressive and fastest reproducing form of GBM tumors, grows significantly into nearby brain tissue and forms blood vessels as to help feed the growth of the tumor.

Helpful Resources:

University of Colorado Hospital - Cancer treatment center (everything from infusions, doctor's appointments, health clinics, and more.)

MD Anderson (Houston, TX) - Cancer research institute in Texas

Imerman - Support volunteers who have gone through this and can help family members in the process

Denver Hospice Center - End of life care

Novel: When Breath Becomes Air by Paul Kalanithi, Admissions by Henry Marsh, Like a Hole in the Head by Ivan Noble, Pear Shaped by Adam Blaine

*These books are all novels which discuss cancer and patient experiences while undergoing treatment. These books can be quite emotional if you or a loved one is undergoing treatment so just be aware that these books can hit the heart a little bit, but there are all great novels.