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Patient education: Glioblastoma (The Basics)

Patient education: Glioblastoma (The Basics)

What is glioblastoma? — Glioblastoma (also called "glioblastoma multiforme" or "GBM") is a fast-growing type of brain cancer. Brain cancer happens when normal cells in the brain change into abnormal cells and grow out of control.

Brain cancers can be named after the type of cell they start from. Glioblastoma starts in the "glial" cells of the brain. Glial cells surround the brain's nerve cells.

As glioblastoma grows, it can spread into healthy parts of the brain. It can also cause brain swelling. Both of these things can cause symptoms.

Most of the time, doctors don't know why a person gets a glioblastoma. Getting radiation treatment earlier in life can raise a person's risk for glioblastoma.

What are the symptoms of glioblastoma? — The most common symptoms include:

Headaches

Seizures

Memory or thinking problems

Muscle weakness

Vision changes, such as double vision or vision loss

Language problems, such as trouble finding the right word for something

Personality changes

Other conditions can also cause these symptoms. But you should tell your doctor or nurse if any of these things happen.

Will I need tests? — Yes. The doctor will do an exam and order imaging tests, such as an MRI or a CT scan. Imaging tests create pictures of your brain. The pictures can show glioblastoma or other abnormal growths. They can also show other kinds of changes that might be causing symptoms.

To tell if a person has a glioblastoma, doctors need to look at a sample of the tumor under the microscope. If the doctor thinks a brain tumor might be glioblastoma, they usually do surgery to take out as much of the tumor as possible. Then, another doctor looks at a small sample of tumor tissue under a microscope. The sample can show if the tumor is a glioblastoma, a different type of brain tumor, or a sign of another brain condition.

Some people with glioblastoma do not have surgery to remove the tumor. If the doctor does not do surgery, they might use a needle to take a small sample from the tumor. This can be done if:

The tumor is in a part of the brain where surgery is too risky

The tumor is too large for surgery to help

The person is too sick for surgery

How is glioblastoma treated? — Treatment usually includes more than 1 of the following:

Surgery – During surgery, doctors take out as much of the tumor as they can. This can help with symptoms and help people live longer. But surgery can hurt healthy areas of the brain. During surgery, doctors take out what they can without hurting healthy areas.

Radiation therapy – Radiation kills some of the cancer cells. Most people with glioblastoma have radiation therapy after surgery.

Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Most people with glioblastoma have chemotherapy at the same time as radiation and then for 6 months after stopping radiation.

Electric fields – A battery-powered device (called "Optune") is another treatment option. The device goes directly on a shaved scalp, and gives off low-strength electric fields around the tumor. You will not be able to feel the electric fields. If you use this device, you will need to wear it for at least 18 hours a day.

Glioblastoma can cause seizures and brain swelling. Doctors can give medicines or do surgery to treat these symptoms.

What happens after treatment? — After treatment, you will have regular checkups to see if the glioblastoma comes back. This includes having imaging tests (usually MRIs) of the brain.

You should watch for the common symptoms of glioblastoma, and any other symptoms you had before your doctor found the tumor. Having symptoms could mean the glioblastoma has come back. Tell your doctor or nurse about any symptoms you have.

What if the glioblastoma comes back? — In most people, glioblastoma comes back after treatment. If an imaging test shows changes in the brain after treatment, the changes could be caused by the glioblastoma coming back, or they could be changes that happen in response to treatment. It can be hard to tell the difference between these changes. The doctor might do repeat imaging tests to see if the changes are cancer.

If glioblastoma comes back or spreads, you might have more surgery, chemotherapy, radiation, or other treatments. But sometimes there are no treatments that will help control the tumor. In this case, you might still get medicines to help treat swelling in the brain or seizures. You might also need a nurse to visit you at home to help with your symptoms.

Your doctor or nurse will talk with you about your options and the best treatments for you.

Should I be in a clinical trial? — If you have a glioblastoma, you might want to be in a "clinical trial." A clinical trial is a research study that tests new medicines and treatments to see how well they work.

Being in a clinical trial might or might not change your symptoms or help you live longer. But it can give doctors more information about glioblastoma and how to treat it. Information from the study can help them create new and better medicines and treatments.

There are clinical trials for glioblastoma all over the world. To find out more about being in a clinical trial, talk with your doctor.

What else should I do? — You should follow your doctor's instructions about checkups and tests. Talk to your doctor about any problems during treatment.

If glioblastoma comes back, tell your doctors and nurses how you feel about the different treatments. Any time your doctor talks with you about a new treatment, ask:

What are the benefits of this treatment? Will it help me live longer? Will it reduce my symptoms or stop them?

What bad things could happen if I have this treatment?

Do I have other choices besides this treatment?

What happens if I do not have this treatment?

Finding out that you have glioblastoma, or that your cancer has returned, can be scary and upsetting. Having support from family and friends can help. Some people also find it helpful to participate in support groups. This is a way to connect with other people going through similar things, either in person or online.

More on this topic

Patient education: Brain cancer (The Basics)
Patient education: What are clinical trials? (The Basics)

Patient education: High-grade glioma in adults (Beyond the Basics)
Patient education: Headache causes and diagnosis in adults (Beyond the Basics)
Patient education: Seizures in adults (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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