Glioblastoma is a form of aggressive brain cancer and recently claimed the life of Senator John McCain.
What should patients and their families know about glioblastoma?
First, it is a malignant brain cancer that is treated with a combination of surgery, chemotherapy, and radiation therapy.
Second, it is not curable. The tumor is infiltrative, meaning there is no way to remove all of it. Even if the post-operative MRI doesn’t show tumor, it will come back. Senator McCain’s tumor was in a favorable location—the frontal lobe. His surgeon could have respected a wide margin around the tumor. He had the best treatment in the world.
Third, the life expectancy with treatment is variable but is around several months to a few years for the majority of patients. Four to five year survival would be at the very high end. Given the natural history of the tumor, the adage “do not harm” is doubly important. In practical terms, I would never want to cause a neurological injury to remove a glioblastoma. It’s a tumor I cannot cure. We treat glioblastoma to improve the patient’s quality and to an extend quantity of life.
The picture shows the brain of a patient with glioblastoma. The tumor is outlined by the black suture. We knew the tumor’s location based off a navigation technology based on the patient’s MRI called Stealth. The electrode is used to know where the motor region is to decrease the risk of injury and paralysis.