Only a few drugs have any activity at all against grade IV astrocytomas and unfortunately none are curative. They are given with the hope of controlling the cancer and improving any troublesome symptoms. This may result in an improvement in quality of life and possibly prolonging of life by a few months.

Temodal is the latest drug to become available and clinical trials have shown that it has an advantage over other chemotherapy but the benefits are modest. Only a minority 25 to 30% of patients do respond to treatment, with some shrinkage of the cancer and a possible increase in life-expectancy of a few months.

Temodal is given as a tablet, usually for five days at a time with courses repeated every four weeks. By examining the patient and repeating scans it should usually be possible after three courses to tell if the treatment is working or not. If your husband's doctors have clear evidence that there is a definite improvement after the four courses he has received then there is a case for offering two more courses to maximise the benefit.

However, it is always a difficult decision when deciding to continue treatment particularly if it is causing terrible side effects. You and your husband may find it helpful to talk this through with his doctor to help you both decide whether further treatment is likely to give him additional benefit, or if it is now better to concentrate on improving quality of life.