Glioblastoma

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Last stages of glioblastoma. Image from MD Anderson Cancer Center.

Almost six years ago my older brother Gerry died of glioblastoma, a cancerous tumor of the brain. Today I had lunch at Crystal Bridges Museum of American Art with an old friend, Bob, though not as old as I am (he’s a mere 64), who recently was diagnosed with the same malady. As he says on social media, “I’ve now started a non-drug, electrical field treatment called Optune which offers the possibility of extending my life for several more years.” This treatment consists of an electronic device inserted in a pack hanging at his side, from which wires go up through the shaved and gauzed head into the brain, where they  are used to “disrupt cancer cell division.”

Good luck with that, Bob. The Optune and the continuing chemotherapy.

Optune has been around since 2011, he told me, though few doctors even now apparently know about it.  It was certainly not something offered to my brother in 2016 when his tumor was discovered and a craniotomy performed. (Gerry died within four months of the diagnosis.)

Northwest Arkansas, says my friend, is not somewhere where you want to get a brain tumor. (Or anywhere else, I would think.) According to him, his NWA doctor has been ignorant and feckless, and it’s only through the intervention of a  neurosurgeon based in Little Rock that he came to know of the Optune treatment and the (limited) hope if offers him. (According to the Optune company, “Nearly half of people using Optune + chemotherapy were alive at 2 years compared with 31% of people on chemotherapy* alone,” while another source suggests that the malady is “Very rare (Fewer than 20,000 cases per year in US)” (data from Focus Medica cited on Bing search).

Not encouraging data, all in all, I would think, though Optune, as in opportunity, may temporarily help preserve unity of body and mind, or prevent separation, before the final decision is handed down by the fates.  So where would you put brain cancer, friends, in the list of the top 100 maladies by which you might choose to die? Up there at the top? Down near the bottom, just above drowning and fire and torture in an Iranian or Russian prison?

This unhappy malady, at any rate, leads us to wonder what it is and where it comes from as well as the course it takes. According to a quick look, I see that the exact cause is not now known, though it appears to be associated with a gene that also causes early childhood cancers.

And according to the Moffitt Cancer Center it may spring from

    • Inherited DNA defects
    • Cumulative effects of exposure to chemicals and other carcinogens
    • High-dose exposure to ionizing radiation

My friend Bob told me his great grandfather died of a cranial malady not known or appreciated at the time, which may well have been glioblastoma. Not sure about any genetic factors in my own family.

Do chemicals and carcinogens include marijuana? My brother indulged lustily and often. But I may be off the mark here.

And as for ionizing radiation (say what?), see the Biology Dictionary, which suggests that occupational factors are just one source.

All definitions and etiologies, however, are technical and don’t help shield us from the effects of cancer. Nor reconcile us to them. For that we might need philosophy or poetry. Some way of continuing to be in the world without being overwhelmed by horror and hopelessness.

Any ideas? Any of us might be struck, at any time, by such dread disease, after all, or another form or putting our existence into sudden question.