Dear Diary: My Best Friend Will Be Dying Soon
Dear Diary,
Last month I told you about how my best friend was undergoing brain surgery because doctors found a tumor on the language center of his brain. The surgery went well and he's been nervously anticipating the results of the biopsy since.
They came in earlier this week; yesterday I received an email from him with the results. As the title of this post already suggests, they weren't good.
Being in shock and unfamiliar with medical terminology, he couldn't remember the name of the cancer, but the mean life expectancy of people with "his" form of cancer is 2 to 3 years according to the treating physician. He would have to undergo 30 rounds of radiation, followed by chemo.
I asked ChatGPT to guess what type of cancer my friend has. Based on what I told it (duh, how else?), ChatGPT indicated it's probably glioblastoma [multiforme], GBM for short. It also mentioned that the "2 to 3 years" is an optimistic estimate that doctors initially give to cushion the blow a bit. A more likely value is 16 to 18 months; Wikipedia even puts "the typical duration" at 10 to 13 months.
I try to find some "good" in anything I'm confronted with. In the case of cancer, that's hard. The only thing I can come up with right now is to learn about it. If learning about cancer is good, then spreading the knowledge is better. So, dear reader...:
Glioblastoma is particularly horrible because
- Infiltrative growth
- GBM doesn’t form a neat ball you can cut out.
- Cancer cells infiltrate into healthy brain tissue, spreading like tentacles.
- Even after surgeons remove "all visible tumor," microscopic cells remain, so recurrence is almost inevitable.
- Blood–brain barrier (BBB)
- Many chemo drugs can’t cross the BBB effectively.
- Temozolomide is one of the few that does, but even then, only partly effective.
- Limits treatment options compared to other cancers.
- Genetic chaos
- GBMs accumulate multiple mutations (p53, EGFR, PTEN, etc.).
- Tumor cells within the same mass can be wildly different genetically, which makes them resistant to single treatments.
- The tumor evolves under therapy pressure (like bacteria under antibiotics).
- Rapid proliferation & blood supply
- Grows fast, often doubling in weeks.
- Produces abnormal blood vessels to feed itself, but they’re leaky and unstable. This contributes to swelling (edema) and neurological symptoms.
- Location, location, location
- It’s in the brain, so you can’t just cut wide margins like with a liver or lung tumor.
- Aggressive resection risks loss of speech, movement, vision, personality, etc.
- So surgery is always a compromise: remove as much as possible without destroying essential function.
- Recurrence
- Almost universal, typically within 6 to 9 months after initial treatment.
- And the recurrent tumor tends to be even more resistant.
Bottom line: GBM is deadly not just because it grows fast, but because it’s woven into the brain, hard to treat with drugs, genetically unstable, and essentially impossible to eradicate surgically.
My best friend will probably die at age 53, which isn't exactly "the prime of life", but it's close. It's anyway way too young. Cancer is horrible, and it needs to be beaten. As you've made it this far, dear reader, I would like to ask you to consider making a donation to a cancer research organization in your country. Thank you in advance!
If you live in the Netherlands, that would be:
Het Koningin Wilhelmina Fonds / KWF Kankerbestrijding
U kunt met weinig moeite via iDeal een eenmalige donatie doen via deze link.
Uw donatie is aftrekbaar van de belasting; het ANBI/RSIN nummer is: 002964491.
Hartelijk dank voor uw bijdrage!