Death from glioblastoma can often come suddenly and unexpectedly. In some cases, death may be preceded by a few hours or days in which the patient has noticeable signs and symptoms.
Glioblastoma gets the highest grade in its family — grade IV — in part because of its high growth rate. These cancers can grow 1.4 percent in a single day. The growth is happening on a microscopic level, but a glioblastoma tumor can double in size within seven weeks (median time).
If you have a glioblastoma headache, you will likely start experiencing pain shortly after waking up. The pain is persistent and tends to get worse whenever you cough, change positions or exercise. You may also experience throbbing—although this depends on where the tumor is located—as well as vomiting.
Sudden death from an undiagnosed primary intracranial neoplasm is an exceptionally rare event, with reported frequencies in the range of 0.02% to 2.1% in medico-legal autopsy series and only 12% of all cases of sudden, unexpected death due to primary intracranial tumors are due to glioblastomas.
Both before and after treatment, glioblastoma often causes problems with speech, cognition, and mobility. Physical and occupational therapy can help your loved one manage these problems and restore a better quality of life.
Growth of the tumor and swelling can disturb areas of the brain, manifesting as several clinical symptoms such as weakness, a decrease in consciousness, difficulty swallowing, seizures, and headache.
The personality changes often encountered by people with glioblastoma include: Intense anger and irritation. Emotional ups and downs. Hostile, aggressive behavior.
Drowsiness or loss of consciousness is one of the most frequently reported symptoms in the final weeks of a brain tumor patient's life. Lethargy, confusion, and night/day reversal are often early signs of decreasing level of consciousness.
GBM is a devastating brain cancer that can result in death in six months or less, if untreated; hence, it is imperative to seek expert neuro-oncological and neurosurgical care immediately, as this can impact overall survival.
Part of the reason why glioblastomas are so deadly is that they arise from a type of brain cell called astrocytes. These cells are shaped like a star, so when the tumors form they develop tentacles, which makes them difficult to remove surgically. Additionally, the tumors advance rapidly.
Although the average life expectancy after diagnosis is 14 to 16 months, approximately 1% of patients survive at least 10 years. Currently, the longest anyone has survived a glioblastoma is more than 20 years and counting.
According to the National Brain Tumor Society, the average survival of glioblastoma patients is eight months after diagnosis; only 6.8% are alive after five years. Most gliomas are sporadic and seem to have no clear genetic cause. Only about 5% of gliomas are familial, afflicting two or more members of the same family.
Like stages, brain cancer grades range from 1 to 4. The higher the grade, the more aggressive the cancer. However, glioblastomas are always classified as grade 4 brain cancer. That's because this type of cancer is an aggressive form of astrocytoma.
In the final stages of the disease, end-of-life signs may become more apparent. These can include decreased appetite, withdrawal, changes in behavior, increased fatigue, difficulty speaking or swallowing, and labored breathing.
Headaches: These are often the first symptoms of glioblastoma. Brain tumor headaches can differ from normal headaches. They typically become more frequent over time and may not respond to over-the-counter pain medicine.
The average glioblastoma survival time is 12-18 months – only 25% of patients survive more than one year, and only 5% of patients survive more than five years.
The EOL may range from days to weeks, generally within three months from death [12]. In this phase, medical therapy and cares are aimed to reduce the symptom burden and to maintain the patient's Quality Of Life (QOL) [9].
Glioblastoma often grows into the healthy brain tissue, so it might not be possible to remove all of the cancer cells. Most people have other treatments after surgery to get to the cancer cells that are left.
People who have undergone radiation therapy as a treatment for leukemia, fungal infections of the scalp or previous cancers of the brain have an elevated risk of developing glioblastoma. Other risk factors include being male, being 50 years of age or older and having chromosomal abnormalities on chromosome 10 or 17.
Some people don't have pain. But if a person is in pain, it can usually be well controlled, and people can be kept very comfortable. The doctors and nurses looking after the dying person will do all they can. Sometimes restlessness is a sign of being in pain.
The average life expectancy for glioblastoma patients who undergo treatment is 12-15 months and only four months for those who do not receive treatment.
Poor sleep can be particularly bothersome, especially when patients with brain tumors also report hypersomnia. Hypersomnia was reported in more than 90% of primary brain-tumor patients undergoing cranial radiation therapy.
Key points about glioblastoma multiforme
It's a fast-growing cancer that spreads within the brain. Symptoms include headaches, seizures, nausea and vomiting, and vision, speech, hearing, and thinking problems. You'll see many medical specialists for treatment. Be sure to ask them questions.
Usually, primary GBMs present overexpression and gene amplification of epidermal growth factor receptor (EGFR) and mutations in cyclin-dependent kinase inhibitor 2A (CDKN2A/p16INK4A) and phosphatase tensin homologue (PTEN) genes.
Causes of Glioblastoma Multiforme
In most cases, the exact underlying cause of glioblastoma multiforme is unknown. In rare cases, it can occur in people with certain genetic syndromes, such as neurofibromatosis type 1, Turcot syndrome and Li Fraumeni syndrome.