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Approximately three to four weeks after surgery, when the scalp and tissues have had a chance to heal, the next stage of treatment generally involves a combination of radiation therapy and

chemotherapy, given at the same time. After this “concurrent therapy phase,” there’s a wait of four to six weeks. Then patients initiate what doctors call “adjuvant chemotherapy,” or

chemotherapy alone. They receive temozolomide, the same chemotherapy drug they received during radiation, but at a higher dose and in a different fashion: They take it for five consecutive

days every four weeks, for six to 12 cycles, or about six to 12 months. MRI scans are done periodically during and after treatment. WHAT DOES RESEARCH SHOW ABOUT SURVIVAL RATES? “Survival

numbers are averages, and we certainly have people who are on either end of these averages,” Harrison notes. “It’s important for people to be aware of that and to maintain the hope and the

knowledge that we don’t hold a crystal ball and that there are people who defy the statistics.” That said, glioblastoma is very aggressive. In adults as a whole, overall survival is

estimated to be around 15 to 18 months. In the elderly, overall survival can be less than a year, often between seven and nine months. WHAT ARE BRAIN CANCER SYMPTOMS OR WHEN SHOULD SOMEONE

WORRY THEY COULD HAVE THE DISEASE? Symptoms can take on different forms, depending on where in the brain the cancer is and how large it is. Some patients present with seizures, others may

experience weakness or numbness in some part of their body, or difficulty walking, or significant changes to their memory or their ability to process information or interact with people.

Again, Harrison emphasizes, it’s important for people to know that there are many potential causes for each of those symptoms, which is why if you have any of them, you should see a doctor

for a thorough evaluation. DOES PALLIATIVE CARE PLAY A ROLE IN TREATMENT? “Many of us who see brain cancer patients recognize its importance and we know that it has a really important role

in the care of our patients,” Harrison says. Palliative care can be given by a patient’s oncologist or a palliative care physician, and may involve talking about things like advanced

directives or how a patient and her family is coping; it could also mean dealing with symptoms such as fatigue or cognitive changes. Palliative care can be incorporated early on and will

take on an increasingly important role with time. WHAT COULD THE FUTURE HOLD FOR BRAIN CANCER TREATMENT? Cutting-edge treatments are being actively pursued, Harrison says. Right now, she

says, immunotherapies that try to harness the immune system or modify it to enable it to better recognize and attack a cancer are not routinely prescribed for glioblastoma. But that could

change. Many clinical trials are currently enrolling patients with the goal of evaluating which brain cancer patients may benefit from which type of immunotherapy in the future.