Glioblastoma multiforme (GBM), also called grade IV astrocytoma, is the most malignant of all brain tumors. Almost 50% of primary brain tumors are astrocytomas (arising from star-shaped glial cells that surround and protect nerve cells in the central nervous system) and over 60% of all astrocytomas are glioblastomas. When glial cells start reproducing rapidly and infiltrate large areas of nearby tissue, they are graded as GBMs. GBMs have dead cells in the center and continuously cause new blood vessels to form to feed their rapid growth, which results in increased pressure on the brain. However, like most types of cancer, the exact cause for glioblastoma is not known.
Doctors at BRAINS will first ask you questions about the symptoms, look into your medical history, conduct physical and neurological examinations to check your memory/cognitive abilities and how you walk, talk and move. Next they may employ brain scans, including MRI and CT/CAT scan to locate the tumour and its size.
GBMs form not even 2% of all cancers detected worldwide, but can be difficult to treat as they spread rapidly and characteristically have more than one cell type; when one type of cells die in response to a line of treatment, the other type continues to grow. This is why the treatment plan for glioblastoma may combine several approaches.
The treatment plan also depends on several factors like age, overall health, medical history, tolerance towards certain therapies, location, and size of the tumor and if the tumor is likely to spread or recur.
The first step in treating glioblastoma, if the patient is fit enough, is to relieve pressure on the brain and then safely remove as much tumor as possible through surgery called craniotomy. Since the tumour has tentacles, it is very difficult to remove all of it surgically, especially if it is growing in a part of the brain that governs important functions, like speech or motor abilities, microscopic tumour cells can remain at the site and re-grow. So a patient will need additional therapies, like chemotherapy, radiation or targeted therapy, which will slow the growth of cells to prolong and improve life.
For adults with glioblastoma, a combination of temozolomide (an oral chemotherapy drug) and radiation therapy increases survival, substantially. Children with glioblastoma, about 3% of all cases, respond better to treatment and also have a longer survival rate than adults.
Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body
Computed tomography scan: A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body.
Craniotomy: To put it simply, it is an open skull surgery and is the first line of treatment adopted if the GBM has significantly affected the patient’s daily functioning. Even partial removal of the tumour can offer relief from symptoms and significantly improves the quality of life.
MRI computer-assisted brain surgery: In computer-assisted brain surgery, neurosurgeons use imaging technologies, such as MR (magnetic resonance), CT (computerized tomography) and PET (positron emission tomography) scans, to create a 3-D model of the brain, which allows them to plan the safest way to treat a condition. During surgery, the computer system precisely guides them to the area(s) of your brain requiring treatment.
Stereotactic radiosurgery: Stereotactic radiosurgery (SRS) uses precisely focused radiation beams to treat tumors and other abnormal growths in the brain, spinal column and other body sites. This technology delivers high doses of radiation to the tumor with minimal exposure to surrounding healthy tissue. Specialists carefully monitor the doses to avoid the risk of radiation over exposure. No incision is made, minimizing the chance of infection or excessive bleeding. General anesthesia is not required for adults. In effect, it is surgery without a scalpel.
Radiation therapy: The term refers to external beam radiation therapy during which high-energy beams from a machine aim at a precise point on your body to kill the cancerous cells by destroying the genetic material that controls how cells grow and divide. Though more intense than chemotherapy, radiation is preferred as it destroys fewer normal, healthy cells than the former. It also delays growth of cancerous cells.
Chemotherapy: Refers to the use of drugs, taken orally, intravenously or injected into the blood stream, to kill cells on the verge of splitting. Normal cells don’t split in adults, other than in case of injury, normal cells are not affected and only the rapidly growing cancerous cells are targeted.