Glioblastoma – from Diagnosis to Treatment and Clinical Trials
Tumors that occur in the brain without a known origin are called gliomas. The most malignant forms are glioblastomas.
Glioblastoma is an aggressive, infiltrative type of cancer that can strike in the brain or spinal cord. Glioblastoma forms from star-shaped glial cells of the central nervous system, called astrocytes.
“While glioblastoma tends to occur more often in seniors; it can however, occur at any age,” said William Fisher, CEO of Leaf Vertical, an innovative, clinical-stage biopharmaceutical cannabidiol cancer research company. “As the cancer progresses, it can produce worsening headaches, nausea, vomiting and seizures,” Fisher continued.
Additional symptoms of glioblastoma vary greatly depending on the location of the tumor, but they may include: blurred vision, loss of appetite, changes in mood or personality, changes in ability to think and learn, memory loss, muscle weakness, and speech difficulty.
Glioblastoma, also known as glioblastoma multiforme (GBM), can be very tough to treat and a cure is often not possible. Glioblastoma is one of the most common forms of brain cancer, affecting approximately 10,000 patients each year — about half of those patients will die within 15 months of diagnosis.
To diagnose glioblastoma, the doctor will perform a neurological exam, order imaging tests and biopsy a tissue sample for laboratory examination.
The doctor will ask about the patient’s signs and symptoms during a neurological exam. The patient’s vision, hearing, balance, strength, coordination and reflexes may be checked. An issue in any one or more of these areas will help the doctor hone in on the area(s) that may be affected by a brain tumor.
MRI’s, including functional MRI and magnetic resonance spectroscopy, CT scans or PET scans, short for positron emission tomography, are some of the imaging tests frequently utilized to diagnose brain tumors, including glioblastoma. These image tests help the patient’s doctor identify the location and size of the tumor.
Depending on the location, size and advancement of the brain tumor, a biopsy, or removal of a tissue sample for testing, may be done with a needle before or during surgery to remove the glioblastoma. Once removed, the tissue sample will be analyzed in a laboratory to determine the aggressiveness and define the types of cells present. These laboratory tests can indicate the types of mutations the cells have experienced, giving the doctor more complete data to better indicate the patients prognosis and possible treatment options.
While glioblastoma is currently not curable, some treatments have been shown to slow the progression of the brain cancer and reduce signs and symptoms in some patients.
Brain Cancer Surgery: Currently, glioblastoma cannot be cured by surgery because it grows into the normal brain tissue; however, the patient’s neurosurgeon may indicate that surgery is still necessary to remove as much of the tumor as possible to slow its progression. A craniotomy is typically the first stage of treatment for patients with glioblastomas. Surgery may allow for the removal of brain tumor tissue to relieve pressure in the brain. Once the brain surgeon removes as much of the brain cancer as possible, many patients will receive additional treatments after surgery to target the remaining cells.
Radiation Therapy for Glioblastoma: Using high-energy beams to target and kill brain cancer cells, radiation therapy is usually recommended after surgery and possibly in combination with chemotherapy. Should a neurosurgeon not be able to perform brain surgery on a glioblastoma, he or she may use radiation therapy and chemotherapy as the primary treatment. Radiation therapy does not require an incision. Patients typically have less discomfort, shorter recovery times and fewer complications than when having surgery.
There are several methods for delivering external beam radiation therapy to treat glioblastomas:
Intensity modulated radiation therapy (IMRT): IMRT is a state-of-the-art radiation delivery system that is used to treat hard to reach tumors. It can also spare healthy tissue from radiation therapy. Doctors find IMRT most useful in treating a tumor near the brain stem or other critical parts of the brain.
Stereotactic radiation therapy: Focusing radiation from various angles to the outline of the tumor, stereotactic radiation therapy is designed to reduce the damage to healthy tissue.
Chemotherapy for Brain Cancer: There are several types of chemotherapy delivery methods including pills, wafers and intravenous drugs. Chemotherapy drugs, which can be taken daily as a pill, can be used during and after radiation therapy. In some instances, chemotherapy medicine can be placed in the patient’s brain during surgery. This chemotherapy medicine comes in the form of thin, circular wafers that slowly dissolve and release the medicine to kill the cancer cells. Another type of chemotherapy can be administered through a vein in the patient’s arm or a port, if one has been initiated.
Tumor Treating Fields (TTF) Therapy: TTF or tumor treating fields therapy uses an electrical field to disrupt the tumor cells’ ability to multiply. This therapy entails adhesive pads being applied to the patients scalp and then connected to a portable device that generates an electrical field. TTF can be utilized in combination with chemotherapy and may be recommended after radiation therapy and after surgery.
Targeted Drug Therapy: Cancer research has enabled doctors to have access to targeted drugs that focus on specific abnormalities in the cancer cells. The drugs target and attack the abnormalities, so that the cancer cells die.
Clinical Trials: Studying new treatments, clinical trials give doctors and patients an opportunity to try the latest treatment options; however, the side effects of the new treatments may not be known. Patients can discuss the options and eligibility for a clinical trial with their doctor.