The Year-Three Plan: Keep on Keeping On

Brain cancer is...

Carbon Canyon, back today after Superbowl Stroll 2017.

 ...ready for Year Three.

What an absolute privilege to plan for life after two full years of GBM!  The plan for Year Three: Keep on keeping on.   This sentiment from Dr. Cloughesy seemed simple until I updated my review of research on GBM treatment and survival in preparation for Year Three.

First, a sobering reminder about the vicious nature of GBM:

• The median survival for GBM patients, even with standard of care treatment, is 14.6 months.
• Five-year survivorship for GBM patients hovers somewhere between 5 and 10%. 

 And now the great news:
(Lots of hyperlinks ahead; they are solely for the purpose of further reading for the interested reader.)

• Darrell was physically healthy at time of diagnosis.  A significant GBM survivorship predictor is one's "performance status," or physical functionality at time of diagnosis.  It's often measured by a simple rating called the Karnofksy score.  Darrell's score was between 90 and 100 (the top rating). (Click here for a study demonstrating the importance of performance status as a predictor.)
• Darrell has survived two years with GBM; the longer he lives, the more likely he will survive an additional year.  Someone who is newly diagnosed with GBM has a less favorable prognosis than someone who has survived for two years. (Click here for resource.)  Many studies (click here for an example) dis aggregate the dismal five-year survival statistics and calculate the conditional probability of surviving another year for patients at different lengths of time post diagnosis.  Starting at two years, and markedly at three years, the chances of surviving GBM for another year are higher for each year post diagnosis.  This graph (click here for source) makes it clear:  Nowhere to go but up!

•  Darrell uses Optune. The percentage of survivors at all points in time are higher for Optune users than for non-Optune users. For instance, 43% of Optune users survive to two years, compared with 30% of non-users.  (Click here to see the graph.)
• Darrell is a highly compliant Optune user (90%+). Data suggest the importance of high compliance.  Patients who are 90%+ compliant have a five-year survivor rate of nearly 30%.  That's craazy!!   (Read the article here.)

There are statistically important factors working against Darrell (examples are age and a genetic biomarker--MGMT--status), but we can't do anything about those.  Taking all the great indicators together, our plan for Year Three is clear:  Keep on keeping on.  Keep on:

• Using Optune.
• Walking and staying healthy.
• Traveling.
• Laughing.
• Loving.
• Selfie kissing.

Happy anniversary, Darrell.
Team D., you've been there from the beginning.  Please join us for Year Three.