Brain tumors have several types. But one type stands out from the rest. Primary brain tumor is vastly different from other tumors since it has the ability to multiply and spread from one organ to another. This type of tumor has the brain itself as its primary source.
Malignant or benign. A primary brain tumor can be classified in that manner. Benign tumors are the “good tumors” since performing brain surgery is the only necessary thing to do to prevent the cancer from causing further damage. On the other hand, malignant tumors are the “bad” ones. This is because unlike benign tumors, they spread a lot faster and are ten times more difficult to surgically remove.
Below are examples of benign tumors:
- Acoustic Neuromas
- Pituitary Gland Tumors
Here are notable malignant tumors:
- Anaplastic Astrocytomas
- Glioblastomas Multiforme (GBM)
The above-mentioned Glioblastoma Multiforme is an aggressive form of malignant brain tumor. It also happens to be the most widespread among all primary brain tumors. According to a recent survey, GBM is affecting more than half of brain tumor sufferers in the United States. GBM is categorized as Grade IV Astrocytoma. This means that it is a type of brain tumor that is capable of spreading so rapidly that a huge chunk of the brain has to be largely invaded before any manifestations will be obvious. So by the time treatment has started, it may already be too late for the patient.
Who are the most susceptible to Glioblastoma Multiforme?
GBM is a disease that typically affects adults 40 to 70 years of age. Children ranging from 3 to 12 years old also suffer from the disease though cases are few and far in between. The cerebrum, particularly at the frontal and temporal lobes, is where glioblastomas usually develop during the early stages. Its definitive characteristic from other malignant brain conditions is that in various areas of growth, dead tumor cells are abundant all over. GBM may take as long as 10 years or as short as 12 months to progress.
Below are the factors that cause Glioblastoma Multiforme:
1. Age - patients below 45 years old are statistically the most affected.
2. Sex - more men have been recorded to suffer from GBM than women.
3. Race - the disease is most common among African-Americans.
Furthermore, GBM has no direct relation from a person’s lifestyle or exposure to carcinogens and other diseases. In fact, the main reason for causing GBM still remains uncertain up to this very day.
Clinical Manifestations To Be Aware Of
The size of the tumor, the location of the growth, and the rate of the tumor’s growth all contribute to what symptoms the patient will experience. Though the symptoms may commonly develop during the latter stages of the disease (the tumor becomes significantly bigger), there could be times that the symptoms will be obvious much earlier.
Below are the signs and symptoms a Glioblastoma Multiforme patient will have to anticipate:
- headaches that are more serious during daytime
- one sided paralysis (hemiparesis)
- increased intracranial pressure
- frequent mood swings
- behavioral changes
- inability to concentrate and act appropriately (usually evident in frontal or temporal lobe located tumors)
- inability to speak coherently (aphasia)
- loss of sensation (when the parietal lobe is involved)
- generalized body weakness
- cognitive impairment
- loss of vision
It rarely happens, but it is possible that GBM will develop in an adult’s brainstem. This will lead to experiencing decreased level of consciousness, one-sided body weakness, and progressive and persistent headaches.
Standard GBM Diagnostic Examinations
There are several ways to help detect the presence of Glioblastoma Multiforme. The most notable ones are listed below:
1. Computed Tomography Scan (CT Scan) and Magnetic Resonance Imaging (MRI) - this helps catch the tumor’s abundance early on. It can however be easily mistaken from a benign tumor.
2. Biopsy - this is the most effective way to make a diagnosis on the presence of high-grade Glioblastomas.
3. Positron Emission Tomography Scan (PET) - help emphasize the extent of more complex GBM cases, especially when the tumor is bleeding heavily or has undergone exposure to radiation.
A team of specialists that consist of neurologists, neuro-oncologists, neurosurgeons and radiation oncologists should always be closely monitoring a Glioblastoma Multiforme sufferer’s condition. This helps the treatment proceed on an orderly manner.
Glioblastoma Multiforme Treatment Modalities
Treating GBM can be done in several different ways. But the three most common are surgery, chemotherapy, and radiation therapy. These interventions all revolve around the idea of relieving the symptoms rather than curing the disease. This approach is called Pallative. Using this type of approach is the right thing to do since surgically removing the cancerous tissue will not guarantee a future cancer-free life. At the same time, a lot of Glioblastoma cells eventually become resistant to the therapeutic effects brought about by chemotherapy and radiation.
Since a Glioblastoma Multiforme has the ability to get bigger in very little time, it is recommended to immediately begin treatment as soon as it is diagnosed. It can also begin post-operatively as soon as the surgical wounds have healed. Chemotherapy is usually the first treatment method done when a patient is about 30 days removed from surgery.
After chemotherapy, radiation therapy may be prescribed in order to kill all cancer cells missed by the previous treatment. But the negative thing about is it also affects otherwise healthy tissue. As a result, further surgery might be needed to remove all the radiation-affected tissue.
The main objective of any surgical procedure is to take out much of the tumor as it can. Several studies have shown that those who underwent gross total resection surgery have a 19% rate of surviving for two more years or 27 to 47 more weeks. This is as a result of the tumor reducing in size. In the case of GBM, surgery should always be followed by aggressive chemotherapy to prevent it from spreading further cancer to other nearby organs. There is a 25% rate of survival for those who underwent chemotherapy following surgery.
Other Treatment Options
Aside from the aforementioned three most typically used, there are other ways to treat Glioblastoma Multiforme. The doctor may prescribe or administer medications like carbamazepine (Tegreto) or phenytoin (Dilantin) if the patient experiences episodes of seizure. Dexamethasone (a type of corticosteroid) and ranitidine (an anti-ulcer drug) may also be given to the tumor from swelling.
Besides medication therapy, the use procedures like antianogenesis, biologic therapy, gene therapy, and immunotherapy have also been explored as alternative and allegedly better mechanisms.
Highly-experimental procedures are already being considered for GBM treatment. Among them are interstitial radiation via balloon implantation and Boron Neutron Capture therapy. The latter is regarded as the more medically advanced among the two since it reportedly has the capability to kill cancerous cells while sparing healthy tissue - something radiation therapy has failed to do time and again. This is according to a study in progress conducted by the European Organization for Research and Treatment of Cancer.
Avastin, Cytarabine, Epirubicin, Etoposide, Filgrastim, Fulvestrant, Idarubicin, Temodar, Matulane, Gliadel, BiCNU, Ondansetron