What should you know about the final stage of glioblastoma?

Glioblastoma can grow within brain tissue and may recur after earlier treatment. As it advances, a person may experience worsening headaches, seizures, weakness, speech or vision changes, confusion, sleepiness, personality changes or increasing difficulty with eating and everyday tasks. The pattern varies with tumour location and individual health.

There is no single timetable that describes what will happen next. The oncology and neurology teams can explain the current scan, neurological changes and likely care priorities in plain language. Decisions should include the person's preferences whenever they can communicate them, along with the family's needs.

Ask whether further surgery, radiotherapy, chemotherapy or a clinical trial is suitable, what benefit is realistically expected, and what burdens it may bring. Brain tumour surgery may be considered for selected problems, while medicines and radiotherapy may target tumour activity or symptoms.

Palliative care can begin alongside cancer treatment. It can help with seizures, pain, nausea, mood, sleep, mobility, communication and caregiver support. Discuss a written plan for medicines, mobility assistance, nutrition, decision-making authority and the person's preferred place of care.

Call emergency services for a first seizure, a seizure lasting longer than the team's stated limit, repeated seizures without recovery, sudden one-sided weakness, severe breathing difficulty, a major fall or new unresponsiveness. Contact the care team promptly for persistent vomiting, rapidly increasing sleepiness, inability to take medicines or a sudden neurological change.

Ask what the latest scan shows, which symptoms are caused by the tumour or treatment, whether further therapy is worthwhile for this person, how seizures will be managed, what changes to expect, and whom to call day or night. Ask about advance care planning before a crisis occurs.