Even though glioblastoma multiforme, or GBM, is the most common malignant brain tumor, it’s also very rare: Just two or three cases occur per 100,000 people in North America.
Yet at least two of those patients are in Columbia County: Ray Lilly, 46, co-owner of Hardwood Floors and More in Evans; and Deborah Marshall, 48, executive director of the Columbia County Board of Elections.
A reception and silent auction for Lilly, who had surgery for a GBM in January, is being held Wednesday at Savannah Rapids Pavilion. And coworkers of Marshall, who is being treated at the Medical College of Georgia Hospital, are holding a fundraiser cookout Friday behind the Evans library.
Dr. Cargill Alleyne, professor and chairman of the Department of Neurosurgery at Georgia Health Sciences University, explained the challenges of patients diagnosed with a GBM.
Its name – glioblastoma multiforme – refers to the tumor originating in the glial cells that make up the majority of the tissue of the brain, Alleyne said, and the “multiforme” designation means those cancerous cells take many different shapes and forms.
“It’s very rare in the very, very young,” Alleyne said. “It tends to occur in ages 50 and onward, although it can literally occur in anyone, including kids. It’s not that common, overall; it’s about two or three cases per 100,000 in North America, but it does happen to be the most common type of (brain) tumor that we encounter as neurosurgeons and neurologists.”
Unfortunately for patients, the GBM is difficult, and sometimes impossible, to treat.
“The prognosis is pretty bad,” Alleyne said. “By the time a patient has been diagnosed with a GBM, the median survival is only about a year, 12 to 14 months.”
The reason, Alleyne said, is that by the time a patient shows symptoms, or the GBM shows up on an MRI, “the tumor has literally spread outside the confines of any observable tumor... By the time you get an MRI scan and you see an area of tumor lighting up with contrast, the tumor cells have long spread beyond that border.”
That means surgery alone can’t cure a GBM, he said – though that hasn’t always stopped surgeons from trying.
“Back in the old days, when this was discovered, people would actually try to aggressively remove brain tissue, in fact to the point of removing almost half of one side of the brain,” Alleyne said. “They quickly realized that by the time it was discovered, there are sometimes tumors cells on the opposite side. So regardless of how aggressive you are with surgery, the tumor would still come back and end up killing the patient.”
Modern treatment options typically involve surgically removing as much of the tumor as possible, followed by whole-brain radiation treatment and chemotherapy, Alleyne said.
Marshall, who underwent surgery at MCG on April 9, is undergoing conventional treatment, family members said, while Lilly, whose surgery took place Jan. 19 at MCG, also is being treated in a study program at Duke University, Suzanne Lilly said.
“It’s not the greatest prognosis he has,” Lilly said. “So we’re doing a study through Duke... It’s probably one of the most aggressive treatments that’s ever been done on this. And we’re doing fabulous with it.”
The fundraisers for the Lillys will go 100 percent toward treatments that aren’t paid by insurance, she said. The Marshall fundraiser Friday, and donations to an account in the Marshall family name at Georgia Bank and Trust, helps pay expenses for family members while Marshall is hospitalized indefinitely, said Board of Elections Registration Coordinator Nancy Gay, an organizer of Friday’s cookout.
Meanwhile, for patients battling a GBM, the outlook for recovery often is bleak – but not unheard-of, Alleyne said.
“There are reports of long-time survivors,” he said. “In fact, one of my patients is now five years out from a GBM.”