What does this mean?
Lately, you’ve been having headaches with blurred vision and occasionally vomiting. You figure that you’ve been stressed and aren’t taking care of yourself the way that you should. However, when you wake up in the back of an ambulance and the paramedic tells you that you had a seizure, you realize that something is wrong. Why are you having these symptoms? What can be done to treat them? Is there a way to prevent them from coming back?
Glioblastoma is an aggressive, and the most common, type of brain tumor among adults. It’s also known as glioblastoma multiforme (GBM). While what precipitates it to occur isn’t known, doctors do know that it arises from star-shaped cells, called astrocytes, that support the health of nerve cells within your brain. It can occur in your brain or spinal cord, but typically starts in the cerebrum, which is the largest part of your brain. Unfortunately, it can easily spread and rapidly grow, which makes it very hard to treat. Usually it results in death within 15 months of diagnosis. The survival rate for one year is around 40%, two years is close to 17% and five years is just over 5.5%.
Symptoms can vary due to the location of the tumor, but usually include persistent headaches, double/blurred vision, vomiting, loss of appetite, changes in mood/personality, changes in ability to think/learn, new onset of seizures and gradual onset of difficulty speaking. The majority of people who have these tumors are usually between the ages of 45 and 70, but it can occur at any age. So far, doctors have been unable to determine any one specific thing that increases a person’s chances of developing a glioblastoma.
In order to diagnosis glioblastomas, your doctor will perform a neurological exam and order imaging, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI). If a tumor is found, your doctor will want to do a biopsy of the tissue. This is key for several reasons. It allows the doctor to identify what cells the tumor came from (this gives it its name), whether or not there are signs of rapid growth and if there are any mutations that help with targeted therapy. Using this information, your doctor will provide you with a grade of your tumor (on a I-IV scale) and a prognosis.
The goal of treating glioblastomas is to slow and control the growth of the tumor and to help the person live as comfortable and well as possible. Treatment for glioblastoma usually involves surgery followed by radiation and chemotherapy. Surgery is done to remove the majority of the tumor without damaging surrounding brain tissue. Since the tumor grows into normal brain tissue, it’s impossible to remove all of the tumor cells. In order to access the area where the tumor is, your doctor will need to open your skull (craniotomy). Once the wound heals, you’ll need to start radiation therapy, which uses high-energy beams of X-rays or protons to kill cancer cells. The goal of this therapy is to selectively target the remaining tumor cells. To be effective, radiation is usually done once a day, five days a week and repeated 10 – 30 times depending on the type of tumor. Normal brain tissue is able to heal between sessions, but tumor cells are not. Chemotherapy uses medication to kill cancer cells. Sometimes, the medication is contained in thin, circular wafers that are placed in your brain during surgery. These slowly dissolve and release the medication. Another option is to take a pill, most likely temozolomide, that is usually given every day during radiation and then for 6 – 12 cycles after radiation. Each cycle lasts 28 days where the medication is administered for the first five days and the next 23 are rest days. A key component of treatment is palliative care. This isn’t just for those who decide that they don’t want further treatment with surgery, radiation or chemotherapy. Palliative care is designed to provide you with relief from pain and other symptoms of serious illness and side effects that the treatment can cause. It also addresses the many emotions you’ll be feeling as you go through the process. The goal of palliative care is to improve the quality of life whether or not you’re in treatment.
There are several factors that make glioblastoma hard to treat. These include the location of tumors in the brain, they are inherently resistant to conventional therapy, limited capacity of the brain to repair itself after treatment, the ease of migration of malignant cells into adjacent brain tissue, the variability of the tumor’s blood supply which inhibits effective drug delivery, tumor capillary leakage (resulting in an accumulation of fluid around the tumor), intracranial hypertension, limited response to therapy and neurotoxicity to the brain as a result of treatments. Due to the challenges it presents, the tumor often regrows. Even with all of the advances in medical treatments that have been made in the past 30 years, the median survival rate of people with glioblastoma who receive treatment increases on average by only 3 months. Obviously, every person and how cancer affects them is different. While doctors can’t predict how long someone will live, based off of statistics, they can give fairly accurate estimations.
Given that there isn’t much known about what contributes to the development of glioblastoma, there isn’t anything specific that you can do to prevent one. The best thing is to live a healthy lifestyle that includes plenty of exercise and eating a nutritionally balanced diet. Avoid things that can increase your risk of developing health problems of any kind. By taking care of your body, you’ll decrease your chances of having health issues. If you notice that you’re having any of the symptoms, be sure to seek help early because you might be able to catch the tumor while it’s still small.
Being diagnosed with glioblastoma can be a devastating blow. It’s up to each person as far as what they want in relation to treatment, but the goal should be to provide them with the best quality of life possible. If you have any questions or concerns about glioblastomas, please speak with your doctor. If you would like more information, please visit the American Brain Tumor Association’s Glioblastoma page at https://www.abta.org/tumor_types/glioblastoma-gbm/