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Talk to DoctorA highly aggressive and fast-growing type of cancer that develops in the brain or spinal cord from supportive star-shaped cells called astrocytes.
Overview
What is glioblastoma? Glioblastoma multiforme (GBM) is the most common form of malignant (cancerous) brain tumor found in adults. For those wondering what glioblastoma is, it originates as an abnormal growth of cells within the brain or spinal cord, characterized by its rapid growth and the ability to infiltrate and damage healthy surrounding tissue. Glioblastoma develops from specialized cells known as astrocytes. These are star-shaped glial cells that provide vital structural support and nutrients to the nerve cells in your central nervous system. When the DNA in these astrocytes mutates, they multiply uncontrollably and form a fast-growing tumor.
Common symptoms associated with glioblastoma include progressively worsening headaches, nausea, vomiting, blurred or double vision, and seizures.
There is currently no cure for glioblastoma. Available treatments aim to slow down the cancer’s growth and alleviate the associated symptoms.
Symptoms
Since GBM cancer cells spread quickly, glioblastoma symptoms can also appear suddenly. Common signs and symptoms of GBM include:
- Headaches
- Memory issues
- Shifts in personality or mood.
- Double or blurred vision
- Convulsions
- Weakness in the muscles or balance issues
- Sensational changes, numbness, or tingling
- Nausea and vomiting
- Speech issues
Causes
When patients ask what causes glioblastoma, the answer can be frustrating. Experts have yet to determine the exact reasons why certain individuals develop cancerous brain tumors, including GBM. The primary glioblastoma causes are linked to spontaneous DNA mutations within the astrocytes, which tell the cells to grow too fast and evade normal cell death. Most cases do not run in families, and inherited causes are exceptionally rare.
Risk factors
Certain factors can elevate your risk of developing GBM:
- Gender: Men are at a slightly higher risk.
- Age: GBM is more prevalent among individuals aged 45 to 70, with an average diagnosis age of 64.
- Exposure to Chemicals: This includes contact with substances like pesticides, petroleum, synthetic rubber, and vinyl chloride.
- Genetic Predisposition: Individuals with genetic conditions that promote tumor formation, such as neurofibromatosis, Li–Fraumeni syndrome, and Turcot syndrome, are at increased risk.
- Previous Head Radiation Therapy: Having undergone radiation therapy directed at the head area in the past can also be a contributing factor.
Diagnosis
Tests and procedures used to diagnose glioblastoma include:
- Neurological examination: This type of examination assesses vision, hearing, balance, coordination, strength, and reflexes. Problems in one or more of these areas might provide insights into the region of the brain affected by the glioblastoma.
- Imaging tests: Imaging tests can assist in locating and determining the size of a glioblastoma. Magnetic Resonance Imaging (MRI) is frequently employed to diagnose glioblastoma. Other imaging tests that may be utilized include Computed Tomography (CT) scans and Positron Emission Tomography (PET) scans.
- Tissue sample extraction for testing: A biopsy is a procedure that involves extracting a sample of tissue for testing. It can be performed using a needle biopsy before surgery or as part of the surgical removal of the glioblastoma. The obtained tissue sample is sent to a laboratory for testing, which can reveal whether the cells are cancerous and specifically glioblastoma cells.
Treatment
While there is no cure, various glioblastoma treatments can help manage the disease and improve quality of life. Treatment options for glioblastoma include the following:
- Surgical Intervention: A neurosurgeon will perform surgery to remove as much of the glioblastoma tumor as possible. Due to its invasive nature, complete removal may not always be achievable. Often, additional treatments are needed to address any remaining cancer cells.
- Radiation Therapy: Radiation therapy uses high–energy beams like X–rays or protons to eliminate cancer cells. During this procedure, patients lie on a table, while a machine administers targeted radiation to specific areas of the brain. Radiation therapy is typically recommended post–surgery and may be combined with chemotherapy. For those ineligible for surgery, it can be the primary treatment.
- Chemotherapy: Chemotherapy employs potent medications to destroy cancer cells. After surgery and sometimes concurrently with radiation therapy, patients may take chemotherapy in pill form. In some cases, intravenous chemotherapy may be used to treat recurrent glioblastoma. Additionally, thin wafers containing chemotherapy drugs can be implanted during surgery, gradually releasing the medication to combat cancer cells.
- Tumor Treating Fields (TTF) Therapy: TTF therapy disrupts cancer cell multiplication through electrical fields. It involves attaching adhesive pads to the scalp, which are connected to a portable device generating an electrical field. TTF is often combined with chemotherapy and may be considered following radiation therapy.
- Targeted Therapy: Targeted therapy employs drugs that specifically target chemicals within cancer cells, leading to their demise.
- Clinical Trials: Clinical trials offer access to cutting–edge treatments. However, the potential risks and side effects may not be fully understood. Patients should consult their healthcare providers to explore participation in clinical trials.
- Supportive Care (Palliative Care): Supportive care, also known as palliative care, concentrates on alleviating pain and other symptoms associated with serious illnesses. It complements other treatments such as surgery, chemotherapy, or radiation therapy to enhance the overall quality of life during treatment.
When to See a Doctor
If you or a loved one experience any worrying signs, it is vital to seek medical attention immediately. You should consult a healthcare provider if you have severe or worsening headaches, new-onset seizures, unexplained memory problems, sudden shifts in personality, or progressively worsening weakness, numbness, or vision issues.
Complications
As the tumor grows and presses on nearby brain tissue, it can lead to several complications. These may include worsening seizures, brain swelling (edema), hydrocephalus (a buildup of fluid pressure around the brain), and noticeable changes in thinking, speech, or motor function. Even with rigorous treatment, the tumor often returns, requiring further management.
Prognosis
A glioblastoma prognosis is generally challenging because the tumor grows rapidly and is highly invasive. While treatments can improve quality of life and prolong survival, the disease remains fatal. On average, patients live 12 to 18 months after diagnosis. The five-year glioblastoma survival rate is approximately 5%, meaning only a small percentage of patients survive five years past their initial diagnosis. However, ongoing research and clinical trials continue to look for more effective ways to manage the disease.
