Glioblastoma

At this point, doctors don't know what causes this type of brain cancer.

Certain factors can increase the risk of glioblastoma. Many times, people with no risk factors develop the tumor.

Risk factors include:

• Past radiation treatment, especially to the head or neck.
• Rare genetic conditions, such as neurofibromatosis, tuberous sclerosis, and von Hippel-Lindau disease.
• Age, with most glioblastomas found in people 45 to 75.

Right now, there are no proven ways to reduce your risk of glioblastoma.

The symptoms of a glioblastoma might be mild at first, but slowly get worse.

Symptoms include:

• Headaches.
• Vomiting.
• Loss of appetite.
• Memory loss.
• Seizures.
• Balance or movement issues.
• Mood or personality changes.
• Speech problems.
• Problems processing information.

Doctors will first ask about your symptoms.

They will then do some simple tests that don't require advanced equipment. These include tests of balance, memory, and eye coordination.

If the doctor suspects a brain tumor, they may order one or more of the following tests:

MRI or other imaging tests

Doctors most commonly use MRI to diagnose glioblastomas. A doctor may order other imaging tests like a CT scan, but an MRI offers the clearest image.

For the test, you'll get a shot of a safe dye (or you can also take the dye by mouth). This improves the contrast between normal and abnormal tissue.

Biopsy to diagnose glioblastoma

Doctors can take a sample of the tumor using a needle. An MRI guides this process.

By looking at the sample under a microscope, doctors can diagnose the cancer as glioblastoma or another type of brain tumor.

They can also look for certain molecular markers that will help guide the treatment and affect prognosis.

While a biopsy can confirm a diagnosis, most people will benefit from surgery to remove the tumor.

Your brain surgeon will remove as much of the tumor as they can while avoiding damage to healthy cells.

They can use various techniques to guide this operation, such as:

• Real-time MRI scans of the brain.
• A drug that binds to the cancer cells and changes their color.

Surgeons can't fully remove glioblastomas because they have tiny branches that grow into healthy brain tissue. The human eye can't see these branches and they don't show up in MRIs.

Doctors target remaining cancer cells with radiation and chemotherapy.

With this treatment, the radiologist programs a machine to target high-energy beams at the site of the cancer.

You will lie down and be awake since the treatment is painless.

Doctors often treat glioblastomas with both radiation and chemo.

Chemo drugs shrink glioblastomas. You take them by mouth or through an IV in your arm.

Your surgeon may also place a very slow-release chemo drug in the brain during surgery.

The dose and delivery route depend on many factors, including:

• The genetic markers of the glioblastoma.
• Your age.
• Past treatments.

While chemo kills fast dividing cells (including some normal cells), targeted therapies go after cancer cells only. These drugs destroy or stop the activity of certain proteins found in the cancer cells.

There are a small number of targeted cancer treatments on the market.

A DNA test tells us if the tumor has genes that make any of the proteins these drugs target. 

TTF makes a low-intensity electrical field that disrupts highly-charged proteins in glioblastoma cells.

You wear transducers on the scalp, affixed with bandages and plugged into a battery. The treatment doesn't affect healthy cells and you can wear the transducers throughout the day.

Unfortunately, glioblastomas are often fatal within a few years. But 5 to 10% of people survive 5 years or more after diagnosis.

Over the last decade, research has found new treatments that have pushed the survival rate higher.

Doctors at UPMC and around the world are testing novel treatments that could greatly improve outcomes.