My friend, aged 38, is suffering from glioblastoma multiforme for the past 2 years. He has undergone surgery, but the cancer in the brain could not be totally removed. Recently, he was diagnosed as having fluid accumulation in the brain and had another operation to remove the fluid. X-ray could not find the tumor anymore. The doctor has told my friend that the fluid in the brain is probably due to the "empty space" which was originally occupied by the tumor. The doctor mentioned that the fluid will go away and her husband should be all right. Lately, however, the fluid came back and the doctor could not explain why the fluid accumulated in the "empty space". My friend has to go to the hospital to "drain" out the fluid. This needs to be carried out every 2 months. Our questions are:
Li Liu, MD, OncoLink Editorial Assistant, responds:
Thank you for your question and interest.
Glioblastoma multiforme (GBM) is a very serious brain cancer. Unfortunately, very few adult patients with this condition are cured. Treatment usually consists of surgical resection, followed by adjuvant radiation therapy with the addition of chemotherapy in selected patients. If the tumor is completely removed prior to radiation, survival is prolonged compared to patients who have incomplete removal (International Journal of Radiation Oncology Biology and Physics, 26:239-244, 1993). Even after 2 years, it is possible for the tumor to return.
Without a detailed history, physical exam, and reviewing diagnostic studies, it is impossible to assess the reason for the fluid accumulation in your friend's brain. There can be many causes for this problem including cancer, infection, vascular disorder, and/or post surgical and radiation changes. Microscopic and chemical evaluation of the fluid itself would be helpful. The fluid accumulation in itself could be serious, for instance, if it causes an increase in pressure on the brain, or is infectious. You should discuss these questions with your friend's physicians who may be able to provide a more direct response.
Sep 2, 2014 - Combined postoperative treatment of glioblastoma patients with radiation and temozolomide improves five-year survival over radiation alone, though most patients still eventually die of the disease, according to an article published online Mar. 9 in The Lancet Oncology.