End-stage glioblastoma

Introduction

Glioblastoma is considered to be the most aggressive brain tumor and is associated with an infaust prognosis for patients. There is no cure for the disease and even under therapy, patients die very early. The WHO (World Health Organization) assigns grade IV to glioblastoma.

This is the highest grade that can be assigned to a brain tumor based on the severity of the disease. Depending on the type of glioblastoma, the survival time under therapy can range from a few months to 2 years. The final stage of this life-threatening disease is characterized by distressing symptoms where the aim of therapy is to alleviate the suffering.

Duration of the final stage

It is very difficult to give an exact duration for the final stage of the glioblastoma, since the final stage is not defined in time either. The temporal transitions are therefore fluid. Basically, the final stage is to be regarded as a stage in the course of the disease, when the disease is treated only palliatively and no longer curatively.

This means that the aim of therapy is not to cure the disease, but to alleviate the symptoms and ensure quality of life. In the case of glioblastoma, however, the therapy is never intended to cure, as the disease cannot be cured. The final stage represents the last months and weeks of life. Accordingly, the duration of the final stage varies between a few weeks and months.

What are the symptoms of end-stage glioblastoma?

Depending on the location of the tumor in the brain, a glioblastoma can cause very different symptoms. In the final stage of the disease, this is no different, but additional symptoms can be added to those already present. In addition, the intensity of existing symptoms can increase as the tumor continues to grow.

In the final stage, the tumor is usually very large and therefore leads to increased pressure in the brain (cerebral pressure). This leads to morning nausea and sobering vomiting in many patients. Severe headaches and loss of consciousness are the consequences.

The patients are sleepy up to comatose. The increased intracranial pressure can lead to constrictions of the brain, which can ultimately result in respiratory paralysis and death. Patients are very weakened in the final stage of the disease, so that they are usually largely bedridden and dependent on care.

Severe pain is treated with strong painkillers at this stage, so that the suffering of those affected is reduced. Not only glioblastomas, but also brain tumors in general, can lead to changes in the nature of those affected. Depending on where in the brain the tumor is located, the symptoms also differ.

Tumors that spread in the frontal lobe can lead to pronounced changes in the being. Aggressive outbreaks, verbal expressions and absentmindedness can be the result. The change of character is a very individual symptomatology and therefore proceeds somewhat differently in each affected person.

Many relatives of affected persons often speak of aggressive, spiteful behavior that was not known before. One part of such a change of character can be the tumor, another part the high psychological burden of such a diagnosis. The changed behavior can initially only manifest itself selectively and become permanently present as the disease progresses.

The increasing intracranial pressure also contributes to a change of character in the long term. What is most noticeable here is a listless, aspontaneous and listless attitude of the patients. Completely inadequate behavior is also described.

Frequently, the behavior seems to be no longer controllable by the affected person on purpose, so that the affected person appears quite adequate in some situations and very inappropriate in others. Frequently relatives continue to report that aggressive or spiteful behavior is particularly directed against them, whereas outsiders would not notice much of such changes. It is not possible to say how often this is the case.

Of course, such assurances never apply to all those affected, but are to be regarded as very individual. Glioblastomas cause severe headaches, which are rather diffuse in nature. This means that they can affect the entire head.

The pain occurs suddenly and gets worse over time. It is also typical that they do not respond to conventional painkillers.In the advanced stages of the disease, those affected usually complain of diffuse body pain, for example in the back or abdomen. A good pain therapy is therefore very important in the final stage of the disease in order to minimize the suffering of those affected.

Usually suddenly, within a few weeks, epileptic seizures can develop in the case of a glioblastoma. These manifest themselves by a brief loss of consciousness, which is accompanied by a seizure. Not only glioblastomas but also other brain tumors can lead to epileptic seizures, depending on their location.

These can be focal or generalized seizures. A focal seizure manifests itself as a localized seizure, for example a twitching of the arm, whereas a generalized seizure affects the entire body. The seizure can also start focally and generalize in the course of the seizure.