What is Glioblastoma? Understanding this Aggressive Brain Cancer

Receiving a diagnosis of glioblastoma can be a tremendous shock. Having access to reliable information about glioblastoma can help. Glioblastoma Foundation is a trusted source of valuable information for patients diagnosed with glioblastoma and families wanting to learn more about the disease.

Glioblastoma, or GBM, is a fast-growing brain tumor that develops from glial cells in the brain.  Glioblastoma (GBM) is also referred to as a grade 4 astrocytoma. Grade 4 astrocytoma, or glioblastoma, is an invasive and rapidly growing tumor that commonly spreads throughout the brain.

Glioblastomas often arise sporadically in the brain. It's less common that a glioblastoma results from a lower grade glioma (stage 1, 2, 3).

Glioblastoma is an aggressive and devastating cancer, that can result in death in as little as 15 months after diagnosis. The long term prognosis for glioblastoma remains poor. The current standard of care consisting of surgery, chemotherapy, and radiation, is not very effective. Newer therapies are desperately needed. The Glioblastoma Foundation is funding innovative research into improving surgical outcomes, new drugs, early diagnosis of glioblastoma, and many other new treatments.

Glioblastomas present unique treatment challenges for patients and physicians including:

• The brain is difficult to reach due to the blood brain barrier
• Glioblastomas are inherently resistant to current therapies
• Toxicity of current glioblastoma therapies
• Glioblastomas spread throughout the brain into healthy tissue

Prevalence

According to the National Cancer Institute, about 15,000 people are diagnosed with glioblastoma each year.

Glioblastomas account for half of all the tumors that arise in the brain.

The median age for patients diagnosed with glioblastoma is 65. The disease most commonly occurs in older individuals. Recently, however, it is beginning to be seen more commonly in younger adults under the age of 40.

Men are 50% more likely to be diagnosed with glioblastoma than women. 

Symptoms

Glioblastoma symptoms can vary depending on the location of the tumor in the brain. Sometimes there may be no symptoms at all.

Symptoms that are present can include:

• persistent headaches or even neck pain in some cases
• Visual changes such as blurry vision or double vision
• Changes in mood or personality
• New onset seizures
• Speech difficulties
• Difficulty with higher level cognitive processes such as social cues, decision making, balancing check books, etc.

Often times these symptoms can be confused with those of a stroke, so its important to get a full workup from your doctor if you are concerned about yourself or a loved one.

Diagnosis

Imaging techniques such as an MRI or CT scan can be used to pinpoint the location of a tumor. A full workup should be performed with referrals to neurologist, neuro oncologist, and neurosurgeon.

Intraoperative imaging techniques can be useful during tissue biopsies. Once tissue is biopsied it is examined by a neuropathologist before a diagnosis can be made. The tumor should also then be sent for genetic marker analysis as mutations may be present that can help with prognosis and provide targets for therapy.

Each glioblastoma is different from the next, so a personalized approach to treatment is necessary. What works for one patient, may not work for another. 

Treatment

Glioblastoma treatment consists of surgery to safely remove as much of the tumor as possible followed by radiation and chemotherapy. The neurosurgeon will try to remove as much of the tumor as possible without injuring surrounding normal brain tissue and compromising normal neurological function. Surgery alone is not enough for glioblastoma as these tumors are very invasive in nature. These tumor cells invade surrounding brain tissue, making it nearly impossible to ever remove the tumor entirely.

Surgery, however, is an important part of current glioblastoma therapy, because it allows for removal of the solid tumor and any cells that may make the tumor resistant to radiation and chemotherapy, debulking of the tumor, and reduction of intracranial pressure.

Surgery is presently an essential component to prolonging the lives of glioblastoma patients. 

The surgery for glioblastoma is a craniotomy. The skull is opened to reach the tumor with assistance from intra-operative mapping techniques. The patient can be awake for the surgery. The areas of the brain are mapped with the patient's assistance. The doctor will then decide which portions of the tumor are safe to remove.

After surgery and once the patient has healed, radiation can begin. The goal of radiation is to kill the remaining tumor cells that have infiltrated the normal brain tissue. Radiation is administered 5 days/week for 6 weeks. A total of 10 to 30 treatments are given. The use of radiation therapy provides patients with better outcomes than surgery alone.

Chemotherapy is also administered alongside radiation. Temozolomide, or Temodar, is an oral chemotherapy that is the current standard of care for glioblastoma. The drug is generally administered everyday during radiation therapy, and then for 6-12 cycles after radiation. Each cycle lasts 28 days with Temozolomide given the first five days of each cycle followed by 23 days of rest. Temozolomide is only effective for about 20% of patients. Before considering chemotherapy, patients are encouraged to talk to their neuro-oncologists.

Present treatments for glioblastoma are unlikely to result in prolonged survival for most patients. Most patients do inquire about clinical trials. The Glioblastoma Foundation is a leader in providing clinical trial matching to patients and families faced with a glioblastoma diagnosis. Please contact our staff if you or a loved one would like us to provide a list of clinical trials for which you may qualify. Our scientific staff of researchers, doctors, and pharmacists is available by phone or email.

If you have questions about glioblastoma clinical trials that you would like our scientific staff to help with, please contact us at:

Glioblastoma Foundation
2451 Croasdaile Farm Parkway Suite 109
Durham, NC 27705
Ph: 919-402-1775
Ph: 919-309-1489
Email: info@glioblastomafoundation.org