Glioblastoma

Glioblastoma is a type of abnormal tissue mass (tumor) that can develop in the brain and spinal cord (central nervous system). This type of tumor is also called glioblastoma multiforme or grade 4 astrocytoma. Glioblastoma tumors are made up of an overgrowth of glial cells of the brain called astrocytes. This type of cancer can grow very quickly and is the most common type of cancerous (malignant) brain tumor in adults.

What are the causes?

A tumor is formed when astrocytes grow and divide more than normal and form into a mass of tissue. What makes the cells grow and divide excessively is not known.

What increases the risk?

• Radiation exposure.
• Having a genetic disorder such as neurofibromatosis or a family history of cancer syndrome, such as Li–Fraumeni syndrome or Turcot syndrome.
• Age. People between the ages of 45 and 70 are more likely to develop this tumor.

What are the signs or symptoms?

• Headache, which may be worse in the morning and improve after vomiting.
• Nausea and vomiting.
• Vision, hearing, or speech changes and problems.
• Seizures.
• Inability to walk, loss of balance, or weakness and numbness on one side of the body or in an arm or leg.
• Changes in mood, personality, memory, or thinking.
• Changes in weight or energy.

Symptoms are most commonly caused by increased pressure in the brain.

How is this diagnosed?

This condition is diagnosed based on a medical history and a physical exam, including a neurological exam. Brain imaging tests will also be done, such as a CT scan or MRI. A sample of the tumor will be taken and studied in a lab (biopsy) to confirm the diagnosis. Glioblastomas are high-grade tumors, which means they are fast growing.

How is this treated?

• Surgery to remove as much of the tumor as possible.
• High-energy rays (radiation therapy) to help shrink or kill the tumor. There are different types of radiation therapy, including intensity-modulated radiation therapy, proton beam therapy, and stereotactic radiation therapy (radiosurgery).
• Chemotherapy. This is the use of medicines to shrink or kill the tumor. The medicines can be given by injection or as a pill. Sometimes, chemotherapy can be delivered by placing a wafer that contains the medicine directly in the area where the tumor was removed during surgery.
• Targeted therapy. This uses substances that damage or kill cancer cells without affecting normal cells.
• Immunotherapy. This involves the use of medicines to boost the body's defense system (immune system) to kill the tumor cells.
• New treatments through clinical trials.

Steroid medicines may be given to decrease brain swelling and improve symptoms. Other medicines may also be given to treat or prevent seizures.

Your health care provider may also refer you to physical, occupational, or speech therapy, or a combination of these therapies, as part of your treatment.

Glioblastomas can come back after treatment. If you have a glioblastoma that comes back, you may need additional treatment.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Consider joining a support group.
• Work with your health care provider to manage any side effects that you experience during treatment.
• Do exercises and activities as told by your health care provider or therapist.
• Keep all follow-up visits. This is important. Your health care provider will closely monitor you for any signs that the cancer is returning. You may need more frequent visits with your health care provider as well as periodic imaging tests, such as MRIs, to monitor the tumor or a previous tumor location.

Where to find more information

• American Brain Tumor Association: www.abta.org
• American Cancer Society: www.cancer.org
• National Cancer Institute: www.cancer.gov

Contact a health care provider if:

• You have worsening symptoms or symptoms that have returned.
• You have diarrhea or abdominal pain.
• You cannot eat or drink what you need.
• You have a fever.

Get help right away if:

• You have a seizure, particularly if this is new.
• You have new symptoms, such as vision problems or trouble walking.
• You have bleeding that does not stop.
• You have trouble breathing.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Glioblastoma, also called glioblastoma multiforme or grade 4 astrocytoma, is a type of abnormal tissue mass (tumor) that can develop in the brain and spinal cord (central nervous system). This type of cancer can grow quickly.
• This condition is diagnosed based on a medical history and a physical exam. Brain imaging tests will also be done, such as a CT scan or MRI.
• A sample of the tumor will be taken and studied in a lab (biopsy) to confirm the diagnosis.
• Treatment may include surgery to remove the tumor as well as radiation therapy, chemotherapy, targeted therapy, or immunotherapy.