Cristina’s Story: Glioblastoma and smile

4 November 2020 1 By Roberto Pugliese

The story begins on a beautiful day in August 2003. Cristina, who has always been well, has an epileptic attack. They take her to the hospital, she looks like heatstroke and they send her home but during the night she has a second seizure and a second run to the hospital where they perform a CT scan from which it seems there is an injury that could explain the seizures.

Transfer to a specialized neurological institute was decided where a MRI is performed which results in a lesion located in a point that is difficult to reach surgically which could compromise the commands to the movements of the upper and lower left limbs. It is decided to intervene but the waiting list is long and the intervention that requires execution in “awake anesthesia” is postponed to December 2003. In the meantime, the epileptic attacks continue despite the drugs.

The surgery is performed successfully. The arm has not suffered any damage and the leg will recover with physiotherapy. For rehabilitation, Cristina was hospitalized for a month at the Maugeri Institute in Pavia. The result of the histological examination arrives after 15 days. It is a “Right Rolandic Fibrillary Astrocytoma” which is a low grade tumor. It is good news.

Unfortunately the crises recur but nothing seems to have changed in the radiological picture. Cristina learns to live with these epileptic seizures until 2008 when mild but continuous headaches begin to appear that do not go away with drugs. The arm rapidly deteriorates until it becomes unusable. A new resonance is made. A second intervention is needed. However, the situation seems very serious and the neurosurgeon from the local hospital refuses to operate, giving Cristina one month to live.

Cristina doesn’t give up and looks for a second opinion. Find another neurosurgeon who decides to have an emergency operation. The operation is fine. The neurosurgeon says he managed to remove the entire lesion. The outcome of the histological examination arrives early. This time it is a glioblastoma multiforme.

The postoperative course is perfect. After exactly one week, Cristina returns home. Radio therapy begins after about two months. The first treatment with 45 Gy in 15 fractions is well tolerated.
The second, with 20 Gy in 5 fractions, occurs simultaneously with chemotherapy. Finally, at the control in August 2008, there was a clear response to the treatment. Cristina is unable to complete the 12 prescribed chemo cycles due to a drop in white blood cells.
Cristina feels well but a control MRI results in a recurrency. Cristina was operated on for the third time in January 2009: “Resection of a RECIDIVE right parietal glioblastoma”.

The outcome of the histological examination is awaited, which this time is favorable. It was not a relapse but radiotherapy necrosis. We are in 2018. Cristina is still doing well. She is aware that he cannot lower his guard with a multiform glioblastoma but he is also aware that she is a “long term survivor”. Cristina decides to share her experience and give courage to those who do not find it and founded the facebook group Glioblastoma and smile.