Glioblastoma is an aggressive brain tumor that is common in adults. It was discovered by doctors among people living in the United States, that 11000 cases of glioblastoma occur in the United States between the year 2009-2013. It is more common in men. It is also called glioblastoma multiforme.
In the United States of America, there are 700,000 people living with brain tumor compared to 37,000,000 people living with a migraine, despite this impressive statistics. This two diseases can be easily confused due to similar symptoms such as a headache.
It is an astrocytic kind of cancer. It is a type of astrocytoma ( A kind of cancer formed from start shaped cells in the cerebrum called astrocytes). It constitutes 15% of a brain tumor.
It is also known as grade 4 astrocytoma; it can be found in the frontal and temporal lobe of the brain, cerebrum, brainstem and some parts of the spinal cord.
Epidemiology of Glioblastoma
It is the most common cancer that initiates from the brain and the second most common brain tumor. The most common type of brain tumor is a meningioma. It often occurs in people above the age of 64.
They contain different types of cells such as cystic minerals, calcium deposit, blood vessels, and mixed cells of different grades. They have their blood supply which enhances their replication ability.
Types of Glioblastoma
- Primary or denovo glioblastoma: This is the most common form of glioblastoma, they are known for their rapid replication and spread, their presence is easily noticed. This is the tumors that originate primarily from within the brain; its origin is always from within the brain, not from outside the brain. It often appears at grade 4 glioblastoma.
- Secondary glioblastoma: This types of glioblastoma known for their slow replication and they represent only 10 % of the types of glioblastoma. It is the kind of glioblastoma common in younger people (45 years or younger). They are less aggressive when likened to the primary form. This type of tumors often develops from a lower grade astrocytoma.
Causes and Risk Factors of Glioblastoma
The etiology of glioblastoma cannot de-identified to a particular source. However, there are different risk factors that are linked to the formation of glioblastoma. These includes:
- Gender: It is more common in male than female. Men are at a greater risk of developing glioblastoma than women. It has been linked to people with other diseases such as neurofibromatosis.
- Age: It is common in younger adults, especially in people over 50 years old, however, secondary glioblastoma can be present in people less than 45 years.
- Race: it is more common in individuals that are Caucasians, or form the Asian race.
- Genetic factor: Some genes have to be linked to the development of glioblastoma
- Cell phone radiation: The radiation from a cell phone has been associated with causing, However, this is a controversial risk factor; it is advisable to place cell phones near the ear in moderation, we can use a headset once in a while.
- Previous head injury: A previous injury to the head, maybe in an accident could predispose an individual to have glioblastoma later in life
- Environmental factors: Smoking, exposure to pesticides, or formaldehyde are part of the risk factors that could predispose a person to have glioblastomas.
- Virus: Glioblastoma has been linked with various viruses such as cytomegalovirus.
- Radiation exposure: Individuals that are previous; ly exposed to cancer treatment through various chemotherapy and radiation are predisposed to having glioblastoma.
Is Glioblastoma Hereditary?
There is no known etiology. Causative factor, or genetic cause to glioblastoma. It is not hereditary. It is only linked with some hereditary associated diseases such as neurofibromatosis, and von Hippel Hindu. This associated disease only increases the risk or chances of having glioblastoma, not cause them.
Brain Tumor Causes Damages to The Body Through The Following Ways:
- Increasing the pressure the brain
- The increase in pressure pushes the brain towards the skull
- Destruction or compression of surrounding tissue, organs, or blood vessels
Signs and Symptoms of Glioblastoma
The symptoms of glioblastoma often present for a duration of fewer than 3 months in more than 50 % of patients. Ome of the primary symptom is increased intracranial pressure which leads to a persistent headache, nausea, vomiting, impaired cognitive functions.
Other signs and symptoms include:
- Seizures
- Headache
- Nausea and vomiting
- Decreased attention span
- Memory loss
- Mood swings
- Personality changes
- Cognitive problems
- Blurred vision
- Dysphonia and aphasia
- Confusion
- Difficulty in balance
- Urinary incontinence
- Focal symptoms such as hemiparesis, aphasia, sensory and visual loss
- Muscle weakness
- Hyperesthesia or pin and needing feelings on the body
- Emotional instability such as mood swing, depression, irritability, and change in personality
Why Do Brain Tumor Patients Have A Headache Since The Brain Has No Pain Receptors
The brain itself does not contain pain receptors, the headache and pain felt during a brain tumor, is due to the compression of surrounding structures such as meninges and spinal cord which contains pain receptors.
Is There A Difference Between Normal Headaches and Brain Tumor Headaches?
The difference in these types of a headache in ordinary people and individual varies among different individuals. Some people don’t feel different; they feel like, it is just like a regular headache.
Below are some of the most common differences experienced by individuals:
- Location: In brain tumor patient, they often have a tension headache at the back of the head and neck, due to the compression of lateral ventricles, this patient often misinterprets this tension headache for something a chiropractor could fix.
- Pressure effect: The pain and progressiveness of a headache in a brain tumor patient increase with barometric pressure, the pain increases during flight, high altitude, bending forward or coughing.
- Accompanying gastro-intestinal symptoms: a migraine headache is often accompanied by nausea, and increased sensitivity to light, while a brain tumor headache is not accompanied by nausea. This is one of the major difference between a migraine headache and brain tumor
- Radiation of a headache: a headache in a brain tumor could be localized to the top of the head or could radiate to the back of the head, eyes, or neck. It all varies from one individual to another.
- Timing and the degree of a first-time headache: Some patient reported that their brain tumor headache is worsened in the morning, and their first headache is the worst headache, they ever had in their life.
- Size and degree of a headache: The degree of a headache is nor directly proportional to the size of a tumor, some big tumor could cause a small headache or no headache, while some small tumor could cause a big headache. Don’t use the degree or feeling of your headache to determine or judge the size of a tumor.
- Motor weakness: a headache in brain tumor is often accompanied with motor weakness or muscle weakness.If motor weakness occurs in a regular headache or a migraine, it is not going to be a new symptom; it would be an existing motor weakness.
Characteristics of A Brain Tumor Headache
- A frequent headache particularly in a particular time of the day or morning.
- An unexplained headache, without a traceable etiology. A headache cannot be linked to any known etiology such as sinus infection, or herniated neck disc.
- Presence of other accompanying symptoms such as sensory and visual loss, impaired cognitive function or loss of balance.
- Abnormal location of a headache
- Previous family history of brain tumor, However, only 5% of patients present with a family history of a brain tumor, so this is not a definitive criterion.
- A persistent headache is lasting for an extended period such as days or weeks; some slow grading tumor could express itself in for a headache for several years before brain tumor is diagnosed.
Is a Glioblastoma The Worst Kind of Brain Tumor to Have?
Glioblastoma is not the worst kind of brain tumor anyone can have, despite the fact that it is rare cancer.The worst kind of brain tumor anyone can have is to give up and stop fighting.
When Do I Need to Get Checked for Glioblastoma?
There is no particular time frame for when to check for glioblastoma. There is a famous saying that, it is better than safe than sorry. The earlier is, the better. When you notice any of the above characteristics of a headache, especially with the accompanying symptoms, it is better to see the nearest doctor available as soon as possible.
Diagnosis of Glioblastoma
- MRI: This is used in diagnosing glioblastoma. Glioblastoma is revealed on an MRI as an enhanced ring lesion in the brain, the gold standard for glioblastoma is MRI spectroscopy.
- CT SCAN
- Pet scan(Positron emission tomography
- Cerebral angiography
- Electroencephalography
- Lumbar puncture: This is often contraindicated due to its various complications, but is necessary to rule out other conditions such as lymphomas
- Cerebrospinal fluid studies
Treatment of Glioblastoma
Treating Glioblastoma could be very tricky due to a; lot of reasons such as:
- The cancerous cell not responding to conventional treatment
- There is high risk of injuring the brain when regular treatment is used
- The brain cannot auto-repair itself
- Most conventional drugs cannot cross the blood-brain barrier, making it difficult to treat.
Despite all these difficulties in treatment. Glioblastoma can be treated by 2 ways:
1. Symptomatic Therapy
This is a method of therapy which focuses on alleviating the symptoms of the disease and enhancing the cognitive function of the patient. This treatment includes:
- Corticosteroid therapy, g., dexamethasone 4-8mg, every 4-6 hours
- Anticonvulsant therapy
2. Palliative Therapy
This treatment is focused on increasing the quality of life of a patient and enhancing their survival time. These treatments include:
- Surgery: It is the first step in the palliative treatment of a patient with a glioblastoma, it focuses on the removal of the tumor The surgical procedure is guided by a fluorescent dye called 5-aminolevulinic acid.
- Radiotherapy: this involves the use of radiation method to treat the cancerous cells, there are different discoveries in radiation therapy such as boron neutron capture thera[y. Various radiosensitizers, such as trans-sodium crocecinate can be used in radiation therapy. This type of therapy is used for killing the tumor cells left after surgery, and to cause a decline in the growth of these tumor cells
- Chemotherapy: This type of treatment is also beneficial, especially when it is combined with temozolomide. Temozolomide is the most common chemotherapeutic drug for the treatment of glioblastoma. Carmustine is a newly discovered chemotherapeutic drug for recurrent glioblastoma.
- Other therapies: There are other newly discovered therapies such as Alternating electric field therapy. This type of therapy involves the use of a device called one, which works by killing tumor cells through electrodes passed through the scalp.
What Is The Survival Rate For Someone With A Glioblastoma Brain Tumor?
A lot of factors determines the survival rate of people that are diagnosed with glioblastoma. However, there are statistics used by the doctor based on previous people that have been diagnosed with glioblastoma in the past. The chart proves that the younger you are, the better your chances. Below are the statistics for surviving glioblastoma:
- One year: 39.3%
- Two years: 16.9%
- Three years: 9.9%
- Four years: 7.0%
- Five years: 5.5%
- Ten years: 2.9%
Prognosis of Glioblastoma
With the latest discoveries and standard of treatment, the average survival time for adults diagnosed with anaplastic astrocytoma’survival rate is about 2 to 3 years. In adults diagnosed with more aggressive glioblastoma, or treated with a mixture of temozolomide and radiation therapy, the average or median survival is about 14.6 months. However, a 2009 study reported that almost 10% of patients with glioblastoma might live for about five years or longer.
The average time frame for patients with glioblastoma WITHOUT TREATMENT IS 3 MONTHS. While with treatment is 12-15 months.
Having accurate knowledge about glioblastoma can help save a lot of life, know that you know a lot about the disease, if you experience any an unusual headache, with accompanying symptoms, contact the nearest doctor or neurologist around you, there is a saying that, it is better late than sorry. Take care of that headache now that you can.
References
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Magrath, J. and Kim, Y. (2017). Salinomycin’s potential to eliminate glioblastoma stem cells and treat glioblastoma multiforme (Review). International Journal of Oncology.
Mayo Clinic. (2017). Glioma – Treatment. [online] Available at: http://www.mayoclinic.org/diseases-conditions/glioma/diagnosis-treatment/treatment/txc-20129508 [Accessed 29 Sep. 2017].
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