Side effects from medication or progression of glioblastoma?

Posted by naoj @naoj, 4 days ago

My husband, David, had surgery to remove a tumor in his frontal lobe on May 10th this year. The biopsy presented with Glioblastoma Grade 4. The surgery was successful in removing the tumor and he is now on the standard protocol of radiation and Temozolomide. He is beginning his 4th week of radiation. He has also been taking Keppra for seizures since his stay in the hospital for surgery. His symptoms now include bladder incontinence, blurry vision, poor balance (fell in grocery store), shaky hands (can't write and trouble holding fork to eat), poor sleep, some periods of confused thinking , and edema in face and feet (finally off steroids, so this may be improving). I know as the illness progresses these symptoms and more will occur. But wondering if the present symptoms are from the seizure medication, changes in the brain or treatment. Any thoughts or experience with these symptoms?

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Hi,

I don't necessarily have the answer to your question but I am in a similar situation, in that my husband was newly diagnosed with Glioblastoma Grade 4 on May 9 according to a needle biopsy. His tumor is sitting in between the sensory and motor cortex and his original symptoms (we went to the ER on April 21 because we thought he had a stroke) included speech difficulty, right-sided facial paralysis, and right-sided facial twitching. No other symptoms - balance was fine and no seizures. Between May 9 and June 11, his speech became increasingly challenging to understand and at times he could not speak at all. He had a craniotomy on June 11. It was successful and the neurosurgeon was able to remove about 80% of the tumor. Since then he has felt much better and his speech has improved. We know the tumor will grow back so we are headed to MD Anderson in Houston next week to find out what the next stage of treatment will be (we live in Austin, TX and a neurosurgeon in town not affiliated with MDA did the craniotomy). My husband was given Keppra after the May 9 biopsy but had side effects he could not tolerate that included inability to think well (he felt foggy), fatigue, depression. When he stopped Keppra he felt better. After the craniotomy on June 11 they prescribed a different seizure medication (I don't recall the name of it). He couldn't tolerate that one either and stopped it. So, I definitely think the medication could be causing some of the problems your husband is experiencing and it's worth asking about. Medications can be helpful but can also cause so many side effects that they can feel worse than the original ailment. Maybe your husband's doctor has another alternative to Keppra that will work better for your husband. Because my husband was prescribed the seizure medication proactively and had not had any actual seizures he felt like he wanted to try to go without it. He feels much better when he's not on it. From what I have read, Glioblastomas can grow back quickly, depending on the person, so I think tumor regrowth after surgery could also cause symptoms, in addition to the medication. I am no doctor, of course. I just wanted to share my experience. Because I am just beginning this journey with my husband, I am also curious to hear others' experiences. I am trying to remain positive despite the fact that "Google" does not provide much hope for this condition. My husband is willing to try any clinical trials that MDA offers so I hope they have something to offer. Best wishes to you and your husband.

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Thank you Nina for your helpful thoughts. Today the doctor took my husband off the seizure medication, Keppra, since he has not had seizures since the surgery. But he is back on a low dose of steroids to prevent any inflammation that may be causing the symptoms. The doctor thinks this change will alleviate most of the symptoms for now. Wishing you and your husband peace and wellbeing.

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Glad to hear the doctor was willing to take your husband off the medication and I hope being off the Keppra helps your husband.

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I have a GBM 4 diagnosed after surgery on 5/9 this year. I was already on keppra long term for past history of multiple meningiomas. I started chemo and TMZ on 6/7. So I am 3 weeks in today. Fortunately my only side effects have been fatigue later in the day. I can’t help but wonder if your husbands don’t have more going on? I am no doctor but again, there is such a variety of symptoms they are experiencing. I am happy to be able to say my symptoms thus far are mild but of course, there are still 3 weeks of treatments left.

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pnf24, thanks for the reply and so glad you are having only mild symptoms. We are taking things a day at a time and will see if the recent medication change results in reduction of symptoms. Wishing you the best. Joan (naoj).

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My wife had her left front lope removed but did not take Keppra. She had not side effects from the radiation treatments or chemo pills. She took an anti-nausea pill 1 hr. before the chemo pills and did not ever get sick.
I wasn't until about 1 year after her surgery that her balance started to be a problem and now, 15 months later, is using a walker.
GBM 4 is a bastard, you know what the end will be put don't know when it will happen. Many ups and downs along the way.
Bob

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Thanks Bob for your reply. We will try to enjoy and have gratitude for the ups along the way. Last night was difficult (much confusion along with incontinence) but the sun is coming up this morning.

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