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Hypoglycemic, suffering from frontal Glioblastoma. Treatment? - Online Doctor Chats

Date : 01-Mar-2013
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2270 Questions
Doctor:this is Dr. XXXXXXX
User:hi doc
User:wrt to my mother
Doctor:yes please
User:long query
User:1.Female 57 years old currently suffering from left frontal Glioblastoma since May'2010. 2.Suffers from Hyper hyperthyroidism,hypertension and diabetes.Was treated for acute Proteinurea since 2 years ago and currently stable on this front. 3.Tachycardiac in nature. Hear Rate mostly above 90. 4.First craniotomy performed during May'2010 and diagnosed as Anplastic Astrocytoma post biopsy. 5.Underwent radiation and Chemotherapy (Temozolomide 9 doses) and was pretty stable. 6.By July'2011 the tumor grew back protruding externally on the left frontal lobe with huge edema disabling her ability to swallow, ability to move around ,bowel incontinence intermittent seizures, loss of memory and behavioral disorder. 7.With increase in sleeping cycle and deteriorating condition the second Craniotomy performed during August '2011. Posy surgery biopsy revealed the tumor type to be Stage IV GBM. 8. After 10 days post surgery and having being weaned off from the ventilator post multiple attempts she was suffering from ARDS with continued seizures. 9. Tracheostomy performed due to ARDS and being Obese and fed through Nasogastric tube. 10.Within 3 weeks from the date of surgery ARDS continued, high fever and diagnosed with Sepsis, UTI infection and infection at the tumor surgery site with puss oozing out and continued Seizures. 11.Treated with 3rd/4th generation antibiotics and blood transfusions she recovered and started breathing normally through the tracheostomy tube. 12. Released from hospital on 5th October'2011 with a metal trach tube fitted with GCS 10 in a completely bed ridden condition under steroid and anti convulsion medication. 13. Currently under palliative care at home fed by tube, tracheostomy suctioning from time to time and normal O2 saturation in between 86-92 %. 14. Attempt to tracheostomy wean off during Novemeber'2011 failed owing to coffee brown emesis throw up during 2 day trial period. 15. CT Scan performed during November'2011 revealed huge edema and multiple tumors in the same surgery site and a spread in the forehead and protruding externally. Seems to exert huge pressure over the left eye. 16.Currently under steroid administration (20mg - 30 mg range) and insulin administration. 17. HUGE FLUCTUATION IN BLOOD PRESSURE and BLOOD SUGAR LEVELS. Suddenly turned abnormally HYPOGLYCEMIC in the last 2 days
Doctor:no problem
Doctor:give me a minute to read it
User:sure take ur time
Doctor:As the physicians might have told you, it is an advanced stage of the cancer
Doctor:Only palliative care is possible
Doctor:The pitutary gland actually secretes a number of hormones
Doctor:since that has been affected, hypoglycemia, fluctuations in BP can be expected
User:what can be done in this scenario
Doctor:We can just symptomatically manage her
Doctor:Which means just give treatment for her symptoms
User:what treatment do u suggest ?
Doctor:There are some treatment options which need to be individualized on a case to case basis
Doctor:these include surgery, radiation, chemotherapy
User:have u read cpmpletely ? this was her second surgery
Doctor:yes , I know
User:che has completed 9 doses of chemo
Doctor:Thats what I am saying
Doctor:It needs to be customized on a case to case basis. You need to see a oncologist and a neurosurgeon, Each case is different
Doctor:Thats why they would need a complete evaluation like history, examination and blood tests
User:For hypoglysemic situation ?
Doctor:to decide which treatment would work for her
Doctor:For hypoglycemia, treatment is glucose. Intravenously for her
Doctor:We usually give it with insulin to keep levels stable, as she is diabetic. This is what symptomatic treatment means
Doctor:are you there?
Doctor:I am sorry for your mother
Doctor:I do understand the situation you are in
Doctor:Unfortunately, we still don't have treatment options for preventing the spread of cancer
Doctor:are there any more concerns that I can answer?
User:no thanks
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