I would say use your judgement in terms of treatment intensity. There is little to be gained from backing off, but at the same time you can expect a deterioration for around 2-4 days post chemo especially if associated with nausea, headaches and fatigue. Same for RTx but usually less nausea (if not whole brain irradiation). If he had sx 2/52 ago most of the post op oedema should have settled and you should have a fairly realistic picture of impairments. Was there any gliadel wafers inserted? any dex used, seizures etc. (The amount of dexamethasone is a good indicator of brain swelling)

It is often very difficult for pts to deal with aggressive brain tumours especially if they have been very fit, physio offers them a way of tackling the tumour effects on their own- giving some semblence of control back.

I understand your predicament but it is likely that the family are aware exactly of what the diagnosis entails - you have to trust your patient and his wife and let them handle it in their own way- maybe suggest referral to mcmillan team/ local hospice for support? If you are concerned try and get him alone- maybe suggest she makes you all a cup of tea while you make some goals, or have him come to an OP appointment with you. I've always found both parties are afraid to upset the other - as one patient told me 'there's plenty of time for that later'

Try an make short term goals and suggest looking into what may happen IF (no guarantees) there is a functional deterioration. What is the minimum he need to be able to do to stay successfully at home? The earlier the support goes in/ is made aware of the situation the better. You are looking at quality not quantity of life here and always keep that in mind.