What is Glioblastoma cancer?
Glioblastoma cancer is a type of tumor that affects the Central Nervous System and develops in the spinal cord or brain with invasive growth. Headache, loss of appetite and balance, seizures, and difficulty.
Glioblastoma Multiforme is a primary malignant tumor of the Central Nervous System responsible for the majority of deaths among patients with primary brain tumors.
It can occur in the brain or spinal cord and is highly invasive, with its most striking characteristic being the potential for infiltration into the surrounding brain parenchyma, typically remaining confined to the Central Nervous System (CNS).
It forms from cells called astrocytes, which support and nourish the nerve cells (neurons) in the brain. Although this tumor grows rapidly in the brain, it rarely spreads to other parts of the body.
In a WHO (World Health Organization) classification from I to IV, with IV being the most aggressive, glioblastoma is classified as grade IV. Currently, this classification has been updated to incorporate molecular findings present in the tumor with characteristic histological findings.
The risk factors for the development of glioblastoma are poorly understood. Like other types of cancer, it begins when cells grow uncontrollably and form tumors. Less than 1% of glioblastomas may be associated with hereditary cancer syndromes, including neurofibromatosis type 1 and 2, Turcot syndrome, and Li Fraumeni syndrome.
Usually, glioblastoma can arise from a transformation of a grade II or III astrocytoma. Ionizing radiation is the only known external risk factor for the development of glioblastoma.
Symptoms of glioblastoma
Some of the symptoms of glioblastoma are related to the location of the tumor. For example, if it grows in an area that controls arm movements, the limb may lose strength. If it grows in an area that controls speech, the ability to communicate verbally may be affected.
As the GBM tumor continues to grow, it begins to take up space. This increases pressure inside the brain, leading to symptoms such as:
- Headaches;
- Difficulty learning;
- Loss of appetite;
- Loss of balance or difficulty walking;
- Mood changes;
- Nausea and/or vomiting;
- Behavioral changes;
- Speech problems;
- Memory problems;
- Seizures;
- Difficulty concentrating;
- Changes in vision.
Diagnosis of glioblastoma
In the clinical consultation, after collecting the patient’s history and performing a physical examination, the doctor will request complementary exams, which may include:
- Computed Tomography (CT) – usually the first to be performed when the patient is brought to the emergency room with symptoms. With CT, it is possible to find areas suggestive of tumor presence, evaluate areas of recent bleeding, and calcifications;
- Magnetic Resonance Imaging (MRI) – ideal for evaluating typical glioblastoma findings through images, as it can help define the tumor’s location, areas of edema related to the tumor, and areas of ischemia.
Typical findings found by MRI often differentiate glioblastoma from other pathologies such as abscesses, primary central nervous system lymphomas, and metastases from non-primary brain tumors.
In addition, they assist in evaluating the degree of resection after surgical treatment and in evaluating the response to radiotherapy and chemotherapy, as well as in monitoring the disease.
- Biopsy / Surgery – The diagnosis of glioblastoma is made by removing tumor fragments for histological and molecular analysis.
This assessment can be done by biopsy, when only small samples of the tumor are removed for analysis, or by surgical resection of the tumor, when it is intended to remove a large part of the tumor or resect it almost completely.
After the tumor and/or its fragments are removed, this material is evaluated by a neuropathologist who focuses on histological, immunohistochemical findings, and sometimes molecular tests present in the tumor to confirm the diagnosis of glioblastoma.
Treatment for glioblastoma
The treatment of glioblastoma involves a multidisciplinary medical team including neurosurgeons, oncologists, radiation oncologists, and neurologists, as well as essential professionals for parallel procedures, such as physiotherapists, occupational therapists, speech therapists, nutritionists, and psychologists.
The choice of protocol will depend on the patient’s age, overall health, and the size and location of the tumor at the time of diagnosis.
Generally, the standard treatment for glioblastoma usually involves surgery followed by chemotherapy and radiation therapy, always associated with clinical supportive care.
Surgery is used to remove as much of the tumor as possible while preserving the patient’s functions. Resection of a part or all of the visible part of the tumor can help relieve pressure on the brain, reducing symptoms and improving quality of life, as well as providing data for the histological and molecular diagnosis of the disease.
Even with the best surgical techniques, some tumor cells may remain. Therefore, after the surgical procedure, it is recommended to complement the gbm cancer treatment with chemotherapy, radiation therapy, medications to reduce cerebral edema and seizures, and palliative clinical supportive care.
After completing the indicated treatment, the patient will continue to be monitored by the multidisciplinary medical team, undergoing imaging exams and periodic consultations.
Prevention
As glioblastomas are not caused by controllable factors, this disease cannot be prevented.
