Radiation for 70 yr old (glioblastomas grade 4)?

Posted by antoines @antoines, Jan 20 12:03pm

Good afternoon,
A friend of mine learned that her dad was diagnosed with glioblastomas (grade 4.) He is 70 years old. He did the surgery and the surgeon asked the family whether to proceed with the chemo and radiation.
At this moment, he can barely walk.
The radiation will be around 8 weeks and we were wondering what would be the benefit of it. Reading articles, it seems that for his age, the gain would be marginal and if it is to gain 3 months more but 2 of them (at the start) are lost in daily radiation at the hospital, is it worth it?
Also, we were wondering as one of the potential benefit would be an health improvement (after some potential difficult moment during the chemo) but we could not find whether or not it would be the case?
Finally, is there any benefit in doing only chemo (which consist in daily pills but can be done at home hence less demanding)?
Did anyone had this dilemma and what was their choice/guidance? Any (recent) article/research paper?
For me it seems the most important question instead of increasing the life expectancy, is the state he will be in during/after the treatment.

Thanks for reading and any help would be more than welcome in this difficult moment

Interested in more discussions like this? Go to the Brain Tumor Support Group.

Why is the surgeon asking this question? There should be a neuro oncologist involved plus a radiation oncologist, both giving advice and statistics. I believe there are studies for 70 year olds that are useful.

Eight weeks of radiation is a LOT. My understanding is that 30 treatments (6 weeks) is the standard of care if you are below the age cut off (My 86 year old husband has grade 4 Glioblastoma, had surgical biopsy only because inoperable due to location of tumor. He had 10 radiation treatments plus the temodar chemotherapy is ongoing. It’s tough, but his tumor has responded well. As for quality of life, it’s hard to say. We went to church and lunch today, which was great. But his cognition has been impacted, which might have been underway anyway. )

We were told some patients get the radiation and 1 course of chemotherapy and call it a day.

Was the Optune device recommended? It’s a tumor treating field device, approved by Medicare for Glioblastoma only. My husband couldn’t deal with it because it agitated him, it didn’t hurt. Just a lot of work to wear the device. Electrode arrays, cords, a battery pack. But for younger folks this device makes sense.

Sorry I can’t cite studies. I’d push the doctors for more information and/or ask for study citations.

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My husband died two years ago from GBM. He was 76. His tumors were not removed by the doctor. We were told it was pointless because they just grow back and usually very quickly. After he healed up some from the brain surgery we did the chemo and radiation. He was scheduled for six weeks of radiation. After about seven treatments he was really going down hill since the radiation literally kills the brain. He got zero benefit from the radiation. We also knew before he started chemo that it might not do much because his tumors didn’t have the “good” receptors. We thought the radiation though would contain the tumors. The side effect of course is that you are killing the brain itself which isn’t good.

My husband passed away three months after he was diagnosed. I am sure he had it for a while before the diagnosis. He had been having many issues but we didn’t know why. He was bedridden the last six weeks of his life. From the time he was diagnosed until he died his quality of life was almost nil. We were in hospitals or rehab most of that time. He finally came home for hospice the last 11 days. I hate to say all of this because I know no one wants to hear it. But if we had it to do over again I would have just taken him home and cared for him the best I could and sat with him each day and just talk about the good 25 years we had together. It has been 2 years and I still miss him dearly. I am so sorry for anyone who goes through this.

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My 71 year old wife was diagnosed with GBM grade 4 June 2023. She did surgery, 30 radiations and 42 days chemo. She is not getting ready for cycle 3 chemo. Today we went to the library and she checked out several books, which she reads, not as voraciously as before. We went on a walk of 3/4 mile. We can still carry on a conversation. She had covid last week and made it through it ok, even with an impaired immune system. We have been to ER twice and hospitalization for 3 days in the last several months. There have been a number of daily challenges such as weight loss, and regulating daily bowels. However, MRI's have shown no tumor regrowth the past two cycles .
You asked is it worth it for a 70 year old to undertake this process. In the case of my wife and I, we have to say absolutely yes. You mention your friend has limited mobility. Do doctors say there is a chance of this correcting? Even if that is not the case, can the patient enjoy being with others, and converse? Does he have a willingness to go through the process, because it takes a strong will. I don't think there is a blanket answer to your question as each situation is uniquely different.
Dan

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My spouse was diagnosed with gr 4, gbm multiform in Apr 2023. It was all totally resected in July 2023. It was in the left parietal area and luckily was in an area that was not close to the motor strip.
The radiologist and neurologist should answer your questions on the treatments.
We asked the radiologist at first consultation how he’d tolerate the rad. Etc and what long or short term side effects might occur…etc..
He had 22 treatments of IMRT proton radiation concurrent with temozolomide for 42 days,
He took a 2 wk break from Temodar, and started maint. Cycles of Temodar, 5 days on, 23 days off. This will go til October 2024 unless Oncologist changes it.
My spouse has had 2 MRIs , Nov. and Jan that still show no regrowth. His next mri is mid March. Deep down we are still worried but praying for the best.
His hair has grown back a lot from the rad..
He is still really tired most days but has been managing to go on a sort walk or outing every other day.
He is fortunate that for a 71 yr old man, all the rest of his heal is in normal range, very healthy. His labs have been in the normal ranges, he is on anti seizure med.. he’s been tolerating his chemo pills fairly well but needed to use the anti nausea pill prior to his chemo pill.

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@kylebar

My husband died two years ago from GBM. He was 76. His tumors were not removed by the doctor. We were told it was pointless because they just grow back and usually very quickly. After he healed up some from the brain surgery we did the chemo and radiation. He was scheduled for six weeks of radiation. After about seven treatments he was really going down hill since the radiation literally kills the brain. He got zero benefit from the radiation. We also knew before he started chemo that it might not do much because his tumors didn’t have the “good” receptors. We thought the radiation though would contain the tumors. The side effect of course is that you are killing the brain itself which isn’t good.

My husband passed away three months after he was diagnosed. I am sure he had it for a while before the diagnosis. He had been having many issues but we didn’t know why. He was bedridden the last six weeks of his life. From the time he was diagnosed until he died his quality of life was almost nil. We were in hospitals or rehab most of that time. He finally came home for hospice the last 11 days. I hate to say all of this because I know no one wants to hear it. But if we had it to do over again I would have just taken him home and cared for him the best I could and sat with him each day and just talk about the good 25 years we had together. It has been 2 years and I still miss him dearly. I am so sorry for anyone who goes through this.

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I’m very sorry for your loss.
It must have been very hard to go through ..

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@freebird36

I’m very sorry for your loss.
It must have been very hard to go through ..

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Thank you. It has been a struggle everyday. What makes it worse is I have very few friends and despite asking them for help in the form of a phone call or quick email from them maybe once a week, I get nothing. I have read so many accounts online where a good support group is needed to help deal with the grief. I thought I had that but I was fooled. I talk to a therapist three times a week so I have someone to talk to. Even he is surprised at how little support I have gotten from family and friends. It is a very lonely experience.

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Oh my how our lives somewhat match….I sit here alone my husband inside sleeping and has been all day. I read your post & totally relate….the friends I thought were there weren’t; includes church people as well. Yes, they ask how is Joe? How are you doing? That’s the end of it.

What can I say, no family around even - why don’t ya move closer! Yikes, where are the visits? No phone calls even except for our 2 children but are working & live in distance States. Yes a very lonely experience!! I have ‘surrendered’ to just me & him! I am in a ‘protector’ role and wonder when will this ever end. Is it THEN when I will find ‘that friend’??? Sorry TOO LATE & now I don’t CARE

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@djw

My 71 year old wife was diagnosed with GBM grade 4 June 2023. She did surgery, 30 radiations and 42 days chemo. She is not getting ready for cycle 3 chemo. Today we went to the library and she checked out several books, which she reads, not as voraciously as before. We went on a walk of 3/4 mile. We can still carry on a conversation. She had covid last week and made it through it ok, even with an impaired immune system. We have been to ER twice and hospitalization for 3 days in the last several months. There have been a number of daily challenges such as weight loss, and regulating daily bowels. However, MRI's have shown no tumor regrowth the past two cycles .
You asked is it worth it for a 70 year old to undertake this process. In the case of my wife and I, we have to say absolutely yes. You mention your friend has limited mobility. Do doctors say there is a chance of this correcting? Even if that is not the case, can the patient enjoy being with others, and converse? Does he have a willingness to go through the process, because it takes a strong will. I don't think there is a blanket answer to your question as each situation is uniquely different.
Dan

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@djw Touching base to see how your wife is doing. My 74 year old mother was diagnosed with GBM grade 4 in October and has done much of what you've outlined regarding your wife. How have the past two months gone for you?

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@saintdijo

Oh my how our lives somewhat match….I sit here alone my husband inside sleeping and has been all day. I read your post & totally relate….the friends I thought were there weren’t; includes church people as well. Yes, they ask how is Joe? How are you doing? That’s the end of it.

What can I say, no family around even - why don’t ya move closer! Yikes, where are the visits? No phone calls even except for our 2 children but are working & live in distance States. Yes a very lonely experience!! I have ‘surrendered’ to just me & him! I am in a ‘protector’ role and wonder when will this ever end. Is it THEN when I will find ‘that friend’??? Sorry TOO LATE & now I don’t CARE

Jump to this post

I just saw your post. I am sorry you are dealing with the same issue. I guess it makes me feel “better” to know it isn’t just me. One friend told me I was being too needy when I kept asking to hear from him once a week in an email. Now he won’t even talk to me. I also was told that since I am “privileged” I should not be having as much grief. I am still trying to figure that one out. If privilege keeps you from grieving then why do so many famous and rich people have grief. I read that Regis Philbin’s wife still isolates herself from others and he has been gone about three years. I would say she is pretty privileged too. I tell people that until it has happened to you, you have no idea how bad it is and how lonely it is when your spouse dies.

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Alone yes…..can’t believe how much of a need ‘conversation’ is desired!! I find myself just to grab anybody even it means a store clerk! THEN I realize how little of conversation i have…my husband’s Cancer!

What else can I offer?? Maybe I dusted my front-room, perhaps, by the way I heard we might get rain - seems weather is a safe zone?? I catch myself & realize what is happening - its lonely

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