Glioblastoma
Glioblastoma, also known as glioblastoma multiforme (GBM), is the most aggressive cancer that begins within the brain. Initially, signs and symptoms of glioblastoma are non-specific. They may include headaches, personality changes, nausea, and symptoms similar to those of a stroke. Worsening of symptoms often is rapid. This may progress to unconsciousness.
The cause of most cases is unclear. Uncommon risk factors include genetic disorders such as neurofibromatosis and Li–Fraumeni syndrome, and previous radiation therapy. Glioblastomas represent 15% of brain tumors. They can either start from normal brain cells or develop from an existing low-grade astrocytoma. The diagnosis typically is made by a combination of CT scan, MRI scan, and tissue biopsy.
There is no clear way to prevent the disease. Typically, treatment involves surgery, after which chemotherapy and radiation therapy are used. The medication temozolomide is used frequently as part of chemotherapy. High dose steroids may be used to help reduce swelling and decrease symptoms. It is unclear whether trying to remove all or simply most of the cancer is better.
Despite maximum treatment, the cancer usually recurs. The most common length of survival following diagnosis is 12 to 15 months, with fewer than 3% to 5% of people surviving longer than five years. Without treatment, survival is typically three months. It is the most common cancer that begins within the brain and the second most common brain tumor, after meningioma. About 3 per 100,000 people develop the disease a year. It most often begins around 64 years of age and occurs more commonly in males than females. Immunotherapy is being studied.
Common symptoms include seizure, headaches, nausea and vomiting, memory loss, changes to personality, mood or concentration, and localized neurological problems.
Mark Greene
While suturing a patient's wound, Mark loses control of his faculties and is temporarily unable to speak. After a CT scan and a biopsy, he is diagnosed with an aggressive form of brain cancer, glioblastoma multiforme, that is thought to be inoperable. Embarrassed, Greene briefly tries to hide his condition, but his cover is blown when he has a seizure while arguing with Carter. With little time, Mark seeks a second opinion from an eminent New York City neurosurgeon, Dr. Burke. Mark is told that the tumor is near a critical section of his brain but hasn't "invaded" it yet and they can perform an operation on New Year's Eve 2000. Mark's surgery is performed by Burke and things appear to be positive, although it takes him a while to return to his old self. A year or so later, however, Mark finds out his tumor has returned, and Dr. Burke both confirms this and says he cannot operate again because the tumor regrowth is now in part of his brain where an operation would render Mark completely vegetative. While chemo treatment will only allow Mark to live for another 5–6 months, Burke points out: "You should have been dead a year ago, Mark. You got married, saw your daughter be born - I'd say that was time well spent."