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Thread: Glioblastoma cognitive effects worse, MRI says it's better.

  1. #1
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    Glioblastoma cognitive effects worse, MRI says it's better.

    Hi,

    My 74 yo mom was diagnosed with glioblastoma back at the end of June 2017. Her symptoms were problems remembering words. They did a biopsy and removed some of the old dead tissue from her brain which reduced the pressure. The put her on decadron at this point. She then had a combination of chemo and radiation which ended in September. At that point she was doing pretty well cognitively. She had an MRI at this point. I think it showed slight improvement over the one she had when she had the biopsy.

    Since then they've increased the dosage of the chemo drug, I think it's five days on 25 days off.. She was on decadron, they had her stop taking that a few weeks after the radiation ended. The first chemo-only treatment made her extremely weak. The second one had her so weak she couldn't get out of bed by her self and fell a couple times and couldn't get up. By the way, she lives with my 76 yo dad. The started back up the decadron and her weakness greatly improved. She had an MRI at this point and it showed a pretty significant improvement, but cognitively she'd declined.

    She went to the hospitial in mid December for a routine checkup and the doctor was so concerned by her cognitive decline that she admitted her. They did tests for infection, but didn't see anything. She was discharged to a nursing home for PT, OT, and speech therapy. She was supposed to start back her chemo in early January, but they wanted her to get stronger first.

    She then fell and broke her hip the first day at the nursing home and went to the emergency room, this would have been around the end of 2017. Since then she went to the emergency room once again for a high heart rate, this would have been mid January of 2018. The ER thought she had pneumonia and even started giving her antibiotics, but her chest x-ray came back clear. I saw her in the hospital at that point and she seemed to be doing about the best I've seen cognitively since December, only missing a few words hear and there, but after 10 or 15 minutes she wasn't doing as well.

    She'd been at a plateau cognitively since mid December, but significantly below the levels she was at when radiation treatment ended. I saw her this weekend and she couldn't remember my name and it sounded like she was talking in her sleep, you could recognize a few words, but nothing she said made any sense. I pressed the hospital that's treating her glioblastoma to have her next appointment moved up a week. She's been admitted, they think she has a UTI now and are treating her for antibiotics. They said the MRI that she just got also appeared to indicate she might have had a small stroke a few weeks ago, but the tumor looked smaller.

    I'm curious as to what other folks experience is with glioblastoma, MRIs, and cognitive function. Her MRIs improve while cognitively she declines.

    Thanks,
    Eric

  2. #2
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    Hi ewgoforth, welcome. Yikes, a broken hip on top of everything else.

    The thing about symptoms that crop up after GBM treatment has started is that it can be very difficult to pinpoint the causes, even for a neuro-oncologist. In your mom's case it could be:

    1. The tumor itself. Even though it's smaller, it's still there.

    2. The radiation. Radiation is a "dirty" treatment, and many people will sooner or later have some kind of deficits because of it.

    3. The surgery. This can take months to recover from.

    4. Possible unnoticed seizure activity.

    5. The small stroke she apparently had.

    6. Plain exhaustion from all she's been through lately.

    Any of these could be the cause of the aphasia and cognitive issues that she's still having; and yes, this does happen frequently.

  3. #3
    I'm not sure whether this is still applicable to you; I don't come on here as often anymore and your post is now a month old. But I thought I'd share anyway, just in case.

    I posed this at the end of November, 2016. https://www.cancerforums.net/threads/49518-Symptoms-of-GBM-recurrence-or-something-else

    In a nutshell, my 74 year old father was diagnosed in June of 2016, had a near complete surgical resection immediately, went through chemo and radiation, was scanned immediately after finishing treatment in August and diagnosed with regrowth (NOT radiation damage). He continued to slowly decline, but insisted on having another scan in early November, which two of his three doctors (chemotherapist and radiation oncologist) interpreted as showing the tumor was not actually still growing. And yet my father continued to decline and passed in early December of that year. In other words, while the larger, enhancing section of the tumor did not seem to be growing measurably in my father between August and December, the invasive tendrils of the cancer apparently were.

    Whatever you're facing, I wish you the best.

  4. #4
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    Quote Originally Posted by GettingInfo View Post
    I'm not sure whether this is still applicable to you; I don't come on here as often anymore and your post is now a month old. But I thought I'd share anyway, just in case.

    I posed this at the end of November, 2016. https://www.cancerforums.net/threads/49518-Symptoms-of-GBM-recurrence-or-something-else

    In a nutshell, my 74 year old father was diagnosed in June of 2016, had a near complete surgical resection immediately, went through chemo and radiation, was scanned immediately after finishing treatment in August and diagnosed with regrowth (NOT radiation damage). He continued to slowly decline, but insisted on having another scan in early November, which two of his three doctors (chemotherapist and radiation oncologist) interpreted as showing the tumor was not actually still growing. And yet my father continued to decline and passed in early December of that year. In other words, while the larger, enhancing section of the tumor did not seem to be growing measurably in my father between August and December, the invasive tendrils of the cancer apparently were.

    Whatever you're facing, I wish you the best.
    Thanks, my mom kept declining and passed away last Wednesday. The oncologist had told us we had two or three years to live repeatedly. It wound up being nine months. She was doing well after the initial chemo and radiation, but I wonder if she'd have been better off had she not undergone the higher dose chemo after that. She had several falls due to weakness and wound up being bed ridden for her last couple months due to a broken hip. She also had a stroke.

 

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