Signs and Symptoms of Approaching Death from Glioblastoma

Understanding Glioblastoma and Its Symptoms

Glioblastoma is an aggressive type of brain cancer that forms on the supportive tissue of the brain, known as glial cells. It is also called glioblastoma multiforme or GBM. This type of brain tumor grows and spreads quickly, making it difficult to treat. Knowing the signs and symptoms is important for getting diagnosed and treated as early as possible.

What Are the Causes and Risk Factors?

The exact causes of glioblastoma are unknown. However, there are factors that can increase the risk of developing this disease:

• Being between 45 and 75 years old
• Being male
• Having a family history of glioblastoma
• Having had radiation therapy to the head/neck area
• Having certain genetic conditions like neurofibromatosis, Li-Fraumeni syndrome, tuberous sclerosis

Glioblastoma can occur in any part of the brain but is more commonly found in the cerebrum which controls functions like thinking, understanding, and reasoning. The symptoms depend on where the tumor is located and how much of the brain tissue is affected.

Common Symptoms and Warning Signs

Some early symptoms of glioblastoma are vague and similar to other medical conditions. However, worsening symptoms should be evaluated by a doctor. Common signs and symptoms include:

• Headaches - Severe, persistent headaches that get worse over time, especially in the morning.
• Nausea and vomiting - Caused by increased pressure in the brain.
• Vision problems - Blurred vision, double vision, loss of peripheral vision.
• Seizures - Can be focal seizures affecting one area or generalized affecting the whole brain.
• Cognitive difficulties - Memory loss, confusion, difficulty concentrating or making decisions.
• Personality changes - Increased irritability, forgetfulness, acting out of character.
• Weakness - Usually on one side of the body (face, arm or leg) caused by damage to the motor cortex.
• Speech problems - Difficulty speaking or understanding speech.
• Balance and coordination issues - Vertigo, dizziness, abnormal gait, loss of balance.

In some cases, the first obvious symptom is a seizure. The type and severity of symptoms depend on the tumor size, rate of growth, and location. Symptoms get progressively worse over time as the glioblastoma enlarges and spreads.

Changes and Behavior as the Disease Progresses

In the early stages, symptoms may be subtle and sporadic. But as the glioblastoma grows and the condition advances, the symptoms become more severe and noticeable. Changes to expect as the disease progresses include:

• Worsening headaches that do not respond to medication
• Frequent seizures
• Cognitive deficits and confusion
• Increasing weakness and paralysis on one side of the body
• Vision loss
• Slurred speech and difficulty communicating
• Drastic personality changes, such as irritability and lack of inhibitions
• Loss of coordination, dizziness and difficulty walking
• Fatigue, drowsiness, excessive sleeping
• Urinary incontinence

As the tumor grows, it can block the flow of cerebrospinal fluid causing hydrocephalus. This leads to symptoms like nausea, vomiting, blurred vision, severe headaches and confusion. Patients may experience progressive cognitive decline and memory loss. Without treatment, glioblastoma can be fatal in 3-6 months after diagnosis.

Signs of Approaching End of Life

There is no cure for glioblastoma and it is generally aggressive and difficult to treat. In later stages, treatments focus on extending life while managing pain and symptoms. Recognizing end-of-life signs can help patients and families prepare.

• Worsening weakness - Increasing loss of movement on one side of the body or both sides.
• Difficulty swallowing - Can lead to aspiration pneumonia, a serious complication.
• Minimal verbal communication - Decreased ability to speak and interact with others.
• Sleeping more - Excessive sleeping throughout the day and night.
• Lack of appetite - Refusing food and drink, leading to dehydration and malnutrition.
• Irregular breathing - Slow, irregular breathing patterns.
• Increasing confusion - Disorientation to time and place, inability to focus or process thoughts.
• Loss of bowel/bladder control - Incontinence as the brain loses control over these functions.
• Seizures - Increased seizure activity even with medication.
• Personality changes - More irritable and combative or increasingly quiet and withdrawn.

Patients withdrawing from life engagement, losing interest in social interaction, and sleeping more are also signs that the illness is advancing. As patients near death, they fall unconscious for longer periods of time before permanent coma precedes death. Hospice care and pain management are vital during end-of-life stages.

Diagnosing Glioblastoma

Getting an accurate diagnosis begins with a thorough medical history, physical exam and neurological evaluation by an oncologist. The doctor will check functions like coordination, reflexes and response to sensations. Based on symptoms, doctors may order imaging tests like:

• MRI - Detailed images of the brain and tumor using magnetic fields.
• CT scan - Cross-sectional X-rays to view internal structures.
• Angiogram - Injection of dye to view blood vessels and tissues.
• PET scan - Imaging with radioactive tracers to detect cancer activity.
• Biopsy - Removing a tissue sample for examination under a microscope.

These tests can pinpoint the tumor location, determine if it has spread, and analyze its properties. Age, medical history, speed of symptom progression, and imaging results help confirm a glioblastoma diagnosis. Early diagnosis and treatment provide the best chances for survival and positive outcomes.

Treatment Options for Glioblastoma Patients

Treatment for glioblastoma involves a combination of approaches to slow tumor growth and manage symptoms. Common options include:

• Surgery - Removing as much of the tumor as safely possible. This helps reduce pressure, relieve symptoms, and obtain tissue samples.
• Radiation - Using high-energy beams to destroy remaining cancer cells and slow growth.
• Chemotherapy - Powerful drugs like temozolomide administered orally or intravenously to kill cancer cells.
• Targeted therapy - Drugs that specifically target tumor cells based on genetic profile.
• Corticosteroids - Used to reduce brain swelling, pressure, and edema.
• Anticonvulsants - Prescribed to prevent seizures associated with glioblastoma.

Treatment also focuses on managing symptoms and side effects. This includes medications for pain relief, anti-nausea drugs, physical therapy, and occupational therapy. Even with maximal treatment, average survival is 12-18 months. Some factors associated with better outcomes are young age, good functional status, certain genetic markers, and aggressive treatment.

Coping With a Glioblastoma Diagnosis

Being diagnosed with glioblastoma is a devastating and life-changing event. Adjusting to the diagnosis, treatments, and prognosis can be extremely difficult emotionally. Some tips for coping include:

• Learn about your disease but avoid dwellings on statistics.
• Express your feelings to loved ones and join a support group.
• Maintain a hopeful but realistic attitude.
• Keep up with normal routines and favorite activities as much as possible.
• Reduce stress through relaxation techniques, light exercise, therapy.
• Stay connected with family and friends for positive social support.
• Join clinical trials to access emerging treatments.
• Work closely with your care team on managing symptoms.
• Consider complementary therapies for comfort like massage, acupuncture.
• Focus on living life in the present moment to the fullest.

Glioblastoma presents many challenges. Having a strong support system, maintaining hope, and focusing on quality of life can help patients cope. Early palliative care and hospice should be utilized to improve comfort and peace during end-of-life stages.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.