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Glioblastoma Symptoms
What Is Glioblastoma?
Glioblastoma is a very aggressive brain tumor. It grows fast and invades the nearby brain tissue. But it doesn’t spread to other distant organs. In most cases, it emerges from lower-grade astrocytoma. Astrocytomas are tumors that originate from astrocytes. The disease affects the cerebral hemispheres in adults [1].
Types of Glioblastoma
There are two types of glioblastoma. The first one is Primary or “de novo.” Apart from being the most common one, it is also the most aggressive one. It makes up most of the cases and also grows very fast. It affects older people more than younger people. It also consists of a shorter life expectancy.
Secondary glioblastoma is not as common as primary glioblastoma. It starts from a less aggressive and lower-grade astrocytoma. But it often turns into a very aggressive grade 4 tumor. This type of brain tumor only affects about 10% of people [2]. Those who get it are 45 years old or younger.
How is Glioblastoma Diagnosed?
Doctors conduct a physical exam to diagnose glioblastoma. They also run other imaging tests, such as [3]:
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
Sometimes, experts also use advanced neuroimaging resources to confirm the diagnosis. These resources help them check:
- Blood volume
- Tumor’s metabolic function
- Fiber tracts
These imaging studies also help them with neurosurgical planning. They further use these to check:
- Tumor recurrence
- Response to therapy
A small biopsy also helps doctors confirm the diagnosis.
MRI has been the primary diagnostic tool for glioblastoma. The tumor diameter should be approx. 4 cm for diagnosis. Here’s what a study found out about the tumor size [4]:
- Of 645 patients, 38% had a tumor diameter of less than 5 cm
- 56% had a tumor diameter within 5 to 10 cm
- 6% had a tumor diameter of more than 10 cm
When experts view these cancerous cells under a microscope, the cells appear highly abnormal. They don’t have many features of healthy cells. They also reproduce at a rapid rate.
These tumors also produce their own blood vessels to support this growth. The lesions may contain cystic material and calcium deposits. At the time of diagnosis, these cells may already have invaded nearby tissues.
Glioblastoma Staging
Glioblastoma does not have stages. Instead, it has “grades." [5]. These grades help experts determine how likely the tumor is to reproduce. There are four grades of this tumor. The highest grade represents the most aggressive form of this cancer. In general, glioblastomas are grade 4 brain cancers.
This is because they are an aggressive form of astrocytoma. These tumors don’t have stages because they have symptoms consistent with stage 4 brain cancer.
Is Glioblastoma Hereditary?
Most glioblastomas do not have genetic causes. But the risk of developing them increases in those with certain genetic cancer syndromes such as:
- Li Fraumeni syndrome
- Turcot syndrome
- Neurofibromatosis type 1
Some scientists found that certain genes influence a person’s risk of developing [6]:
- Glioblastoma
- Non-glioblastoma
For example, certain DNA changes influence the activity of the HEATR3 gene. It increases the risk of glioblastoma. But the same procedure does not lead to the development of non-glioblastoma.
Glioblastoma Symptoms
Glioblastoma symptoms are not always very apparent. They are similar to the symptoms of many other diseases. This is why detecting them this way may not be easy.
What Are the Symptoms of Glioblastoma?
Some symptoms of glioblastoma include [7]:
Changes in mood, mental function, or personality: The disease can make you moody and inefficient. They may make you confused and drowsy. Sudden anxiety or depression can also be a giveaway of this tumor’s presence. Most importantly, they cause behavior changes.
Speech changes: People may have difficulty finding words to speak. They may speak incoherently. They may also have difficulty understanding or expressing language.
Headaches: Headaches are the first symptoms of this brain tumor. They are slightly different from normal headaches. You may notice that they are becoming frequent. You may also notice that they are not responding to OTC medicines. Most importantly, they may accompany vomiting or nausea. These headaches get worse when you lie down or bend over. So, bowel movements may trigger them.
Sensory Changes: You may experience changes in your ability to see, smell or hear. Your vision may get blurry. Your sense of touch may also feel different. People with glioblastoma may lose their ability to feel:
- Light touches
- Sharp edges
- Pressure
- Cold or hot
Seizures: Seizures can be subtle. They may not appear as sudden uncontrollable movements right away. They may appear as follows:
- Tingling
- Numbness
- Strange smells
- Unfamiliar sensations
- Difficulty speaking
- Unresponsive episodes
- Staring
Changes in breathing rates and pulse: This symptom occurs when a brain tumor compresses the brain stem. This stem controls basic bodily functions, including the heart rate and breathing.
It’s important to note that these symptoms don’t necessarily indicate a brain tumor. But you shouldn’t ignore them either. Discuss them with your doctor right away.
What Are Some Signs of Glioblastoma?
Some signs of glioblastoma include [8]:
- Loss of appetite
- Mood swings
- Headaches
- Vomiting
- Nausea
- Problems with memory
- Problems speaking
- Trouble walking
- Loss of balance
- Behavioral changes
- Personality changes, etc.
Symptoms of Glioblastoma In Women vs. Symptoms of Glioblastoma In Men*
Men are at a greater risk of developing glioblastoma. But women respond better to standard therapy than men [9]. There are no clear reasons for these sex differences. But researchers link them to sex hormones such as:
- Estrogen
- Testosterone
These hormones contribute to many biological differences between women and men. But men are at high risk at all ages. Explaining this disparity is not possible through studying sex hormones alone.
Women report a higher frequency of fatigue. But men report lower fatigue. These reports are exclusive of glioblastoma treatment response. Females have larger tumor sizes than males [10].
All in all, there needs to be more research on sex differences in cancer. This will help improve precision and determine better treatments. At the same time, there’s a lot to learn about this disease through molecular changes, etc.
Risk Factors for Glioblastoma
The following factors can increase the risk of glioma [11]:
Age: Gliomas can happen at any age. But they’re more common in adults between the ages of 46 and 65.
Radiation exposure: People with high radiation exposure have an increased risk of glioma. This exposure can also come in the form of radiation therapy for treating cancer.
Family history: Having a family history does not necessarily put you at risk. But glioma can run in families. There must be more research to understand if parents can pass it on to children.
Glioblastoma Prevention
At the moment, glioblastoma prevention isn’t possible.
Glioblastoma Prognosis and Treatment
A prognosis involves a doctor telling you what to expect after a diagnosis. With glioblastoma, your doctor can’t be certain about anything. But they can give you an estimate. They do this after evaluating your current situation and tumor type.
They might still not be able to predict your treatment response. This is why the prognosis is an ongoing process. Your doctor revises it at different stages in your journey.
Glioblastoma Survival Rate
The average glioblastoma survival time is one year to 18 months. Only 5% of patients survive more than five years. Only 25% of patients survive more than a year [12].
Glioblastoma Treatment Options
The primary treatment approach is surgery. Following this, your doctor may expose you to chemo or radiation therapy. The goal is to remove the tumor or as much of it as possible. Your surgeon will try their best to do it without harming the normal brain tissue. Glioblastomas have infiltrating tumor cells in their surroundings. This is why completely removing them is not possible. Through surgery, your surgeon reduces the amount of solid tumor tissue in the brain. This approach can prolong the lives of some patients.
Surgeons mostly perform a craniotomy to reach the tumor site. The procedure involves opening the skull. They may also use computer-assisted image guidance to find out the location of your motor and language cortex. Through technology, they determine which parts of the tumor are safe to resect.
Following surgery, they may expose the patient to radiation. But this only happens after the wound’s healing. Radiation therapy kills the remaining tumor cells. It’s important to note that in some cases, treatments can cause damage to healthy tissue too.
Before the next treatment, most normal cells repair the damage. Your doctor may repeat this process for as long as they need to, depending on your condition. They may give it once a day for five days after determining your response.
Radiation therapy can improve outcomes for many. They also ensure longer survival rates for some. Then comes radiosurgery. This approach involves the use of focused radiation. It minimizes the radiation dose to the rest of the brain. But doctors only use it in some cases. It isn’t the initial treatment for glioblastoma.
The current standard of treatment is chemotherapy with the drug “temozolomide.” The doctors administer it every day during radiation therapy.
Conclusion
Takeaway
Glioblastoma is a life-threatening disease. Preventing it is not possible, but improving life quality after the diagnosis still is. It's important to take prompt action as soon as you notice symptoms. Consult your healthcare provider in time to avoid future complications.