With the evolution of modern medical treatment strategies, there also comes the realization that many times we reach a point where traditional goals of medical care, such as overall survival or disease-free survival, are not realistic goals for many patients facing devastating illnesses. One such disease is malignant primary brain tumors, known as malignant glioma (MG). With median survival of only 20.9 months following best available standard of care treatment strategies, including surgery, chemotherapy, radiation, and tumor treating fields, MG is one of the deadliest malignancies of the modern era. Along the course of treating patients with MG, clinicians often realize that traditional treatment therapies can at best provide incremental benefit of symptom management without any survival benefit. However, even in these difficult situations, it is possible to make significant positive changes in patients’ health-related quality of life (HRQoL) using creative, non-traditional interventions. In this paper, we describe the initial findings from our project that takes a unique approach to studying the intersections of clinical care and art by using pet therapy and art-making as interventions for patients diagnosed with brain tumors. Our preliminary findings suggest that pet therapy and the ability to reflect as well as speak about their journey through a life-altering disease significantly increases patients’ overall feeling of wellbeing and reduces anxiety about future uncertainty.

Newly diagnosed GBM patients experience challenges to maintain their health related QoL throughout the disease course. Disease-and treatmentrelated factors impact health related QoL. We sought to evaluate the trajectory of health related QoL in newly diagnosed glioblastoma patients treated with bevacizumab at diagnosis, through the disease course, and beyond progression. In this prospective single-center study, newly diagnosed subjects with GBM were treated with concurrent radiation and temozolomide plus bevacizumab followed by adjuvant temozolomide and bevacizumab. At progression, bevacizumab use was continued but chemotherapy could be changed per the treating neuro-oncologist recommendation. Health related QoL was evaluated using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) at time of study enrollment (before chemoradiation), after chemoradiation, and then every 6 mos until study discontinuation or subject demise. Higher scores on the FACT-Br correspond to better QoL. 68 newly diagnosed GBM patients were enrolled with a mean age of 55.4 yrs (sd=10.7 yrs). KPS ranged 70-100 with the following distribution: 70 (n=4), 80 (n=28), 90 (n=34), and 100 (n=2). FACT-Br scores were relatively maintained from baseline evaluation (mean=96.71, sd=17.64) to 20 months from baseline (mean=100.68, sd=22.12). Subjects who continued study participation 6 mos after the completion of chemoradiation were divided into two groups: subjects with (n=16) and without (n=35) tumor progression 6 mos after chemoradiation completion. Regardless of disease progression, both groups maintained QoL (with progression baseline (mean=98.06, sd=17.18) and 14 months from baseline (mean=91.80, sd 7.16) and without progression baseline (mean=96.34 sd=17.09) and 14 months from baseline (mean=96.75, sd=24.95)). Our observations of health related QoL throughout the disease course and beyond progression suggest that health related QoL can be maintained in GBM patients treated with bevacizumab. Continued evaluation of health related QoL throughout the disease course is warranted in the evaluation of novel treatment regimens in GBM.