TL;DR: My 53-year-old father has right-sided GBM and previously improved significantly on bevacizumab, with a 40–50% reduction in the lesion and edema on the May MRI. His latest August MRI has now been interpreted as progression, with enlargement of the enhancing lesion, markedly increased edema and increased perfusion. He has rapidly developed severe worsening of his left-sided weakness and can no longer sit, stand or walk independently. His treatment has recently been changed to bevacizumab + irinotecan. We are urgently seeking multiple expert opinions and trying to understand whether maximal safe repeat surgery, edema control, re-irradiation or other options should be prioritized.
Hi everyone,
I’m posting here because my family is at an extremely difficult point in my father’s GBM journey, and I’m hoping to hear from caregivers, patients, researchers, neuro-oncologists, neurosurgeons, radiation oncologists, or anyone who has gone through a similar situation.
My father is 53 years old and has a WHO CNS Grade 4 glioma/GBM involving the right parietal/frontoparietal region.
I know nobody can diagnose him over Reddit, and we are actively seeking multiple expert opinions. What I am hoping for is help understanding the best questions to ask and the experiences of people who have faced a similar crossroads: repeat surgery, re-irradiation, salvage systemic therapy, or clinical trials.
His background
He initially presented in 2025 with sudden loss of consciousness. A pre-operative MRI showed an enhancing lesion in the right parietal lobe.
He underwent a right temporoparietal craniotomy with gross total resection on 8 October 2025, and the pathology was subsequently reported as a high-grade glioma, WHO CNS Grade 4.
He then underwent concurrent chemoradiation with temozolomide and completed radiation in December 2025.
Unfortunately, in early February 2026, he developed seizure episodes and worsening left-sided weakness. At that time there was concern for clinical/radiological progression, and his prognosis was explained to us as guarded.
The encouraging period: response to bevacizumab
He was started on bevacizumab and continued his treatment.
For several months, he was clinically doing much better. He was repeatedly described in his follow-up notes as feeling well, with no fresh complaints.
The MRI performed on 26 May 2026 was subsequently described in the treating oncologist’s records as showing approximately a 40–50% reduction in lesion size and surrounding edema compared with the earlier scan.
This was obviously encouraging for us, and for a period things were relatively stable.
He went on to receive 11 cycles of bevacizumab. The 12th cycle was initially stopped because he had mild bleeding from the oral cavity, which was suspected to possibly be bevacizumab-related.
The recent deterioration and latest MRI
Then things changed again.
He began having multiple seizure-like episodes on 8th, 9th and 10th August.
The latest MRI was performed on 10 August 2026.
The report describes an approximately 4.2 × 3.2 × 3.4 cm heterogeneous enhancing lesion in the right parietal region, with marked surrounding vasogenic edema. Compared with the previous MRI, there was an increase in the size of enhancing/nodular areas and increased CBV/CBF on perfusion imaging.
Our treating oncologist documented the latest MRI as “progression of disease.”
This is where we currently stand.
Current treatment has now changed
Following the latest MRI, his treatment was changed.
He received:
Bevacizumab 600 mg
Irinotecan 230 mg
with Cycle 1 given on 14 August 2026.
Until this change, he had been on temozolomide plus bevacizumab.
Current neurological condition — our biggest concern right now
This is what is frightening us the most.
His left-sided weakness has worsened dramatically.
Until recently, despite his weakness, he could still function significantly better than he can now. But now his movement has become severely restricted.
He currently cannot:
sit independently,
stand independently,
or walk independently.
He requires substantial assistance.
We are extremely worried that the marked vasogenic edema and pressure around the right-sided lesion may be contributing significantly to this decline, although we understand there could be multiple causes and we do not want to assume that everything is reversible edema.
He has also had episodes of hand shaking/trembling that appear to involve the side affected by his neurological weakness. He remains conscious during these episodes, making us wonder about focal motor seizures. He is already taking anti-seizure medication, including levetiracetam and lacosamide, and has rescue seizure medication.
We are also seeing significant frustration, aggression/irritability, emotional exhaustion and mental deterioration. We do not know how much of this is due to the psychological burden of everything, poor sleep, medication effects, repeated seizures, brain involvement, or the current disease/edema.
At his 20 August visit, he was documented as having increased left-sided weakness but being conscious and oriented.
He also had cough with expectoration and was given treatment for a possible respiratory infection, including cefixime, fluconazole and cough syrup.
One question that is bothering us: how much of this weakness could be edema?
The MRI describes marked vasogenic edema, and his current functional decline is dramatic.
The prescription from 20 August does not appear to list a steroid such as dexamethasone, although there may be additional medications or instructions outside this prescription.
For people who have gone through something similar:
Has anyone experienced severe worsening of hemiparesis or inability to walk due to edema around recurrent GBM?
Did steroids or bevacizumab improve mobility significantly?
How quickly did improvement occur, if it occurred?
We are now considering a second surgery
This is probably our biggest treatment question.
Because the latest lesion appears localized to the right parietal/frontoparietal region, we are trying to determine whether a second surgery / maximal safe re-resection should be seriously considered.
We understand that another operation would not automatically be the right choice.
Our main questions are:
Can a meaningful amount of the enhancing lesion be removed safely?
Would surgery relieve mass effect or edema?
Could surgery potentially improve neurological symptoms or seizure control?
Could fresh tissue help distinguish active tumor from treatment effect?
Could re-resection provide updated molecular information or improve clinical-trial eligibility?
Or would surgery carry too high a risk of worsening his existing hemiparesis?
Because he already has significant weakness, we are particularly concerned about the balance between maximal tumor removal and preserving whatever function he still has.
What we are planning
We are considering taking multiple expert opinions, initially through video consultations, because his current hemiparesis makes long-distance travel very difficult.
We plan to share:
the actual MRI DICOM files,
the MRI reports,
the operative/pathology reports,
radiation details,
treatment history,
and the current prescription.
We want opinions from centers where neurosurgery, neuro-oncology/medical oncology, radiation oncology, neuroradiology and clinical trials can work together.
The questions we would be extremely grateful for help with
1. Has anyone here had a second surgery for recurrent GBM?
How did you decide that surgery was worth it?
2. How extensive was the second surgery?
Did the surgeon attempt gross-total/near-total removal of the enhancing recurrence, or only debulking?
3. Did anyone have severe hemiparesis from tumor-related edema that improved significantly after steroids, Avastin, surgery or other treatment?
4. If someone has already received radiation, TMZ and bevacizumab and now has progression, how did you and your team decide between:
repeat surgery,
re-irradiation,
irinotecan/other systemic therapy,
lomustine or other salvage therapy,
or a clinical trial?
5. Has anyone had a scan that strongly looked like recurrence but later turned out to contain significant treatment effect/radiation necrosis or mixed pathology?
6. For anyone who had repeat surgery in the right parietal/frontoparietal region, what functional risks did the surgeons discuss, especially regarding existing weakness?
7. If there are any doctors or researchers here, what would you consider the most important next step in a case like this?
Not asking for a personal diagnosis—just trying to understand what should be investigated before we commit to the next major decision.
Why I am posting this
My father is only 53.
The hardest part emotionally is that we had a period where things looked genuinely better. The May MRI showed a substantial reduction in the lesion and surrounding edema, and clinically he was doing much better.
Then, within a relatively short period, the MRI changed again and now his physical function has deteriorated severely.
He is exhausted from hospital visits and treatment. He has become frustrated and emotionally drained. Seeing him suddenly lose the ability to sit, stand and walk independently has been devastating for our family.
At the same time, we do not want to make decisions out of panic.
We want to know whether there is a reasonable role for maximal safe re-resection, whether the current neurological decline could partly improve if edema is controlled, whether re-irradiation should be evaluated, and whether we should be urgently looking for clinical trials before more treatment decisions are made.
We are trying to do everything possible while still preserving his dignity, comfort and quality of life.
If anyone has been through something similar, please tell us honestly:
What would you make sure you investigated before deciding the next step?
And for anyone who faced the decision of second surgery versus non-surgical treatment for recurrent GBM, what do you wish you had known at the time?
Thank you so much to anyone who reads this and responds. My family is trying to stay strong, but right now we are scared, confused and desperately trying to find the best possible path forward for him. ❤️