Monday, June 20, 2011

Glioblastoma Multiforme

GBM in the right hemisphere (the left side of this picture)
source of photo

Otherwise known as GBM, is a tumor I've been seeing quite a bit lately. The sad part about this tumor is that the prognosis is very poor. People diagnosed with this tumor usually have from 3 months to 2 years to live. What bothers me about this is that when we see patients and discharge them, we're basically sending them home to die. Many of them need acute rehab care but some of them refuse, stating that they'd rather spend their remaining time with their family. I don't blame them, really. But seeing this diagnosis really bothers me because these patients know they are going to die and their families know this as well. I just can't imagine.

GBM is treated the same as most other tumors--surgery (which is popular where I am), radiation, chemotherapy, steroids, etc. But let me back up and bit and give you a bit of info on this tumor. GBM is a very aggressive brain tumor of the glial cells. Glial cells are cells that support neurons by protecting neurons from foreign invaders, providing nourishment to neurons and destroying old neurons. Glial cells also hold neurons in place, assist with neuroplasticity and help repair neurons when they are injured. What I find interesting is that glial cells are not neurons themselves, they only serve as bodyguards.

As you can probably infer, glial cells are very important to the nervous system. GBM is more common in males, particularly white and Asian men over 50. Unfortunately, the tumor can grow without symptoms until it has become a dangerous mass. As an occupational therapist (student :-) in an acute hospital setting, we work on a variety of functional activities, such as orientation (making sure the patient knows who they are, where they are and the date), upper extremity active range of motion, functional mobility that is comparable to walking a distance within the home, putting on shirts, pants and socks, sitting balance, walking balance, vision and perception and fine motor coordination. We work on other things depending on the needs of the client but these are the most common.

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