Sadly, there have also been relatively few treatment options when these cancers come back.
Glioblastoma Recurrence
Unfortunately, even when glioblastoma is discovered and treated aggressively, it almost always recurs.
Statistics
Without treatment, overall survival may only be a few months.
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The five-year survival is 5%.
Some treatments do improve survival, and several can improve quality of life.
That said, repeat surgery can sometimes be very helpful for relieving symptoms triggered by the tumor.
The combination of Keytruda and surgery almost doubled survival relative to surgery alone.
The treatment uses low-intensity, intermediate-frequency, alternating electric fields to interfere with cell division in cancer cells.
The treatment, fortunately, has very little effect on normal, healthy brain cells.
Optune was initially approved because it has fewer side effects than other treatments that offered similar improvements in survival.
Since that time, Optune has been found to have a benefit on survival as well.
With Optune, small transducers are applied to the scalp and attached to a battery pack.
Its safety and activity were confirmed by this study, and a phase 3 study is planned.
While only recently studied in humans, immunotherapy options such as oncolytic viruses offer hope.
Chemotherapy
Chemotherapymay be used for recurrent glioblastoma.
The drug TMZ (temozolomide) is used in the initial treatment of glioblastoma, and occasionally at recurrence.
Cytoxan (cyclophosphamide) and CCNU/CuuNu/Gleostine (lomustine) are other options.
Angiogenesis inhibitors (such as Avastin) have been used along with chemotherapy with some benefit.
Endostatin (recombinant human endostatin) is a very strong angiogenesis inhibitor.
It can be used with cytotoxic drugs to treat recurrent disseminated glioblastoma.
DNA sequencing (DNA and RNA) can identify these anomalies.
A gene found in theEbola virushas even recently helped researchers uncover a weakness in glioblastoma cells.
In laboratory and animal studies, fasting appeared to increase the response of glioma cells to radiation and chemotherapy.
The purpose of these early studies is primarily to address safety and tolerability issues (feasability studies).
A different 2019 study looked at the use of the ketogenic diet in children with recurrent pontine glioblastoma.
It found that side effects were only mild and transient.
Some people do very well despite having a very poor prognosis, and vice versa.
Coping
Coping with a tumor that has the statistics of glioblastoma can be incredibly lonely.
Support is Essential
Some people have found immense support via support groups.
Not only are these groups a source of support, but they can be educational.
While the term clinical trial can be frightening, these studies have changed significantly in the recent past.
In some cases this has been dramatic.
The reason for this isprecision medicine.
What are your wishes?
The language surrounding cancer has done a disservice to many people living with the disease.
You win with how you live your life while you are here.
Courage does not mean receiving treatments that drastically reduce your quality of life with little potential benefit.
Sometimes it takes the greatest courage to forego some of these efforts.
Most importantly, your cancer is your journey, not that of someone else.
Looking at statistics alone can leave you with a sense that there are few choices.
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