Mankind has planted flags on the moon, but a moon stroke for brain cancer has yet to be achieved.
Known diagnosis, we gradually stopped removing more tumor. The more tumors you remove, the longer the average survival, no matter how lean. But the quest for surgical perfection sometimes comes at a cost. In the brain, where essential human functions are clustered in mere millimeters of tissue, removing more tumors and eventually damaging healthy tissue risks losing strength, speech, vision, memory, etc. In glioblastoma, tumor cells that have moved a few centimeters away from the tumor mass, beyond the reach of any forceps, almost guarantee cancer recurrence. Surgical perfection is imperfect. She wanted to keep her strength.
We sutured the dura, then plated its bone. With care, we closed the layers of her skin. Shortly after, she was extubated and we brought her to our neurological intensive care unit for her recovery.
“I’m seven on my sister, and a lot of young people are dying these days, so I’m trying to be pragmatic,” she told me the day before. To negotiate.
Forty years ago, the median survival time for glioblastoma was four and a half months. Since then, researchers have characterized the genetics of glioblastoma and studied various vaccines, chemotherapies, immunotherapies, cell therapies, new imaging modalities, targeted radiotherapy and innovative forms of drug delivery to treat the disease. Many steps.
The median survival time today is around 15 months. Only a small percentage of patients survive more than five years.
Defeatism is a common sentiment among neurosurgeons, but you maintain your resolve, for your patients and for yourself. The next morning our patient was in a good mood, recovering well, with good strength. We delicately shared the diagnosis with her.
“It’s just my luck,” she said with a smile. She seemed to expect it.
Some cancers in siblings can be explained by genetics. But this is not the case with glioblastoma. As for his sister, and many others, it was really bad luck.