On December 26, 2022, Chris Cook went for a six-mile run with his German Shepherd, Sully, near his home in Holland, Michigan. Around mile four he tasted metal. By mile five he felt sick and his vision was going white. He woke up with police officers, bystanders and the dog around him.
A hospital CT scan that day looked clear, and he was sent home. Weeks later a neurologist’s non-contrast scan showed a mass. It was glioblastoma.
Cook began treatment at MD Anderson in February 2023. Surgeon Sherise Ferguson removed a 1.54-centimeter tumor in an operation that lasted more than nine hours and involved the right middle cerebral artery. Four weeks later he started 42 days of chemotherapy, then six weeks of radiation. He married on September 30, 2023.
What the disease is
Glioblastoma is a grade 4 brain tumor, the highest grade, and the most common and aggressive primary brain cancer in adults. It starts in astrocytes, star-shaped support cells, and the cells multiply fast. It accounts for 15% of all brain tumors. About 3 in 100,000 people develop it each year, and the average age at diagnosis is 64.
Symptoms include headaches, seizures, nausea and vomiting, memory loss and changes in mood or personality. They often come on over days or weeks.
Nobody knows the cause of most cases. The best-known risk factor is ionizing radiation. About 5% of cases arise from hereditary syndromes such as neurofibromatosis and Li-Fraumeni syndrome. Men, people 50 and older, and white people face higher risk, according to MD Anderson. It also stresses that most people who get radiation to the head never develop the cancer.
Treatment and outlook
Doctors remove as much of the tumor as is safe, then use radiation and chemotherapy. Temozolomide is the drug generally advised. Tumor treating fields are another option, and current NCCN guidelines prefer clinical trial participation where one is available.
There is no cure. Survival figures vary by source: Cleveland Clinic puts the average at about 15 months, MD Anderson at 15 to 18 months, and Wikipedia at 10 to 13. Five-year survival is under 10%.
The tumor sends out microscopic branches, which is why surgeons cannot get all of it. One tumor also holds many cell types, so a drug that works on some cells may miss others. Without the IDH gene mutation, glioblastomas tend to grow faster and respond worse to treatment.
Cleveland Clinic notes that survival rates are estimates based on past data, and they cannot predict how any one person will respond. Consult your doctor for medical advice.
