Glioblastoma multiforme, or GBM, is a malignant glioma that is a deadly type of cancerous brain tumor.
It was reported that Teddy Kennedy's seizure on May 16, 2088, was diagnosed to be caused by a brain tumor of GBM kind. At the time, he was 76 years old. Even with the best medical resources available to him, he could not escape cancer's ravaging effect, and passed away just over one year later, on August 26, 2009.
Even today, medical experts cannot explain why this particular brain cell starts to grow uncontrollably and burrows deep into the complex neural network. No surgery, radiation, and/or chemotherapy can weed it out completely. When the person is young, the body can withstand repeated medical intrusions to keep resurging cancer at bay for a longer period of time. My friend was 74 when he was diagnosed with GBM. The following is an account of his final odyssey on Earth.
One day in May 2009, my friend suddenly collapsed in the living room, hitting his head on the floor and knocking him unconscious. He was rushed to the local emergency hospital.
An MRI revealed a large tumor two inches above the right temple inside the brain. Surgery was performed in the brain under the scalp to remove the tumor and relieve the pressure it caused.
The operation went smoothly. While he was recuperating in the hospital, the laboratory test came back indicating that the tumor was a malignant glioma, an uncontrollable growth of the glial cell that supports the neuron in the brain. It was further classified as a type 4 cancer called GBM in terms of severity. Worst yet, the doctor's prognosis was 12 to 18 months to live if the prescribed medical therapies were followed. Obviously, it was quite a shock to the system to realize that his 74-year journey on Earth was about to end.
The Power of Attorney
After consulting a lawyer on the matter, my friend signed a power of attorney to a person whom he could trust to help him spend the possible final days of his life in peace and reasonable comfort. The tasks included the handling of all his assets and making all the medical decisions if he was no longer in control of his faculties.
My friend, with help from relatives and friends, started to research the subject extensively on the Internet. Together with the recent demise of Senator Kennedy at age 77 after battling a similar brain tumor for around 18 months, convinced to follow through with the standard radiation and chemotherapies. The alternatives of relying on faith and a different lifestyle alone were just too subjective to be promising as a long-term cure.
The radiation treatment started two weeks after the recovery from the surgery. It was going to take five weeks, five times a week, and a few minutes at a time. The machine used was based on the latest technology called Gamma Knife. A specially fashioned head frame was positioned over the scalp for protection as well as to guide the gamma beam to the precise location inside the brain.
The only immediate side effect was scorched skin where the beam struck and physical fatigue. The radiation regimen was intended to kill the cancerous cells that were missed during surgery. In the process, the normal and healthy cells would be destroyed also. After two weeks, an MRI was taken to reveal no new growth. However, the long-term damage to the brain's functions was not known.
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Two weeks after starting the radiation therapy, my friend started to take the chemo drug, Temodar. It was an effective and proven drug against most cancers with tolerable side effects. It killed fast-growing cells that are made up of cancer, stomach linings, hair, etc. So the side effects were hair loss, nausea, and loss of appetite.
My friend's one-year chemotherapy regimen consisted of a cycle of taking this drug for five consecutive days followed by 23 days of rest. At the end of the eighth week, my friend not only lost 40 pounds but also his strength and balance, progressively. So much so that he needed assistance going to and from the bathroom, not to mention driving a car. The doctor could only console him by saying that those were the effects of radiation and chemotherapy. The good news was that the cancer had not grown any larger and that my friend was not feeling any discomfort that could not be masked by painkillers.
The Nursing Home
After six months, my friend was bedridden with a fading memory. After consultations with the doctor and lawyer, my friend's condition could best be taken care of in a nursing home with round-the-clock medical and physical attention. Quick research and visitation to some of the local nursing homes concluded that:
- The average yearly cost was $60,000.
- The average size was 100 beds with two full-time nurses and 10 staffers/therapists.
- All had vacancies and were eager to admit new patients. If the cost was a consideration, they would take the patient’s savings and assets with the deficits covered by Medicaid.
Since my friend was also a veteran of the Korean War, he could also enter the nursing home administrated by the federal government. The veteran facility had a much better reputation and would take only the patient's pension and federal benefits. However, there was a waiting list due to high demand and limited facilities. To the relief of everyone, my friend was admitted to the local veteran nursing home in November 2009.
After two weeks of observation, this facility was deemed as good as its reputation and could be trusted to take care of my friend's remaining days. After a total of eight months, the doctor discontinued my friend's chemotherapy. He was getting weaker, barely able to recognize the face of friends and relatives, and needed to be force-fed.
He spent most of his daytimes sitting in the wheelchair motionless in the recreation room. Finally, in July 2010, my friend had difficulty swallowing food and breathing. The recommended steps would be to insert tubes to keep him alive with machines. Since my friend had signed a letter of no tubes and DNR (do not resuscitate) if there was no hope of ever getting better, It was accepted by all parties to inject my friend with pain relief medication and let Nature take its course. He passed away peacefully the next day with friends and relatives at his side.
The Two Evils
My friend had survived 14 months against this dreadful cancer. He was full of hope and energy right after the surgery and four weeks into the radiation and chemotherapy.
Four months later, he could no longer walk, had a diminished appetite, and had a fading memory. Once in the nursing home, even with professional care, his deteriorating condition could no longer be reversed. On the internet, many similar cases for GBM patients above age 70 were posted.
It may be concluded that the chemo drug, Temodar, can be effective in stopping the growth of the brain tumor. But, it can also cause the body to weaken to such a degree that the patient can no longer recover from the collateral damages. It is a choice between two evils. The good news is that new drugs are in the pipeline that can target the specific cancer cell with minimal effect on the surrounding tissues.
- About Glioblastoma - National Brain Tumor Society
Glioblastoma (GBM) is a disease that all Americans should care about. It can strike men, women, and children of any age, background, and walk of life.
- Living with Glioblastoma - American Brain Foundation
Read the story of a woman who turned a life-changing glioblastoma diagnosis into a passion for patient advocacy.
- Glioblastoma Multiforme – Symptoms, Diagnosis and Treatment Options
Written by board-certified neurosurgeons, read a guide to the symptoms, diagnosis and treatments of glioblastoma multiforme.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.