An Overview of Glioblastoma Multiforme
Medically reviewed by Nicholas R. Metrus, MD
Glioblastoma, also known as glioblastoma multiforme (GBM) or a grade 4 astrocytoma, is one of the most common and aggressive brain cancers, causing about 50% of all gliomas. Although it is a fast-growing brain tumor, it usually does not spread to distant organs.
This article covers what to know about glioblastoma including how long a person can live with glioblastoma multiforme and whether it is curable. It also discusses the symptoms of glioblastoma multiforme as well as the diagnosis and treatment of this cancer.
Symptoms of Glioblastoma Multiforme
While GBM typically occurs around the age of 64 years, it may occur in younger people as well, causing a number of symptoms.
Not everyone will have the same GBM symptoms. Brain tumor symptoms depend on the location of the tumor and can include:
Persistent headaches
Doubled or blurred vision
Vomiting
Loss of appetite
Changes in mood and personality
Changes in ability to think and learn
New onset of seizures
Speech difficulty that starts slowly
How Long Can a Person Live With Glioblastoma?
The cancerous cells of GBM spread quickly. The tumor spreads insidiously through the brain without a clear border, making it difficult if not impossible to completely remove surgically.
The average time from first symptoms of glioblastoma to death is eight months. However, almost 7% of patients make it to five years or more.
About 40% of patients live for at least a year after diagnosis, and 17% survive for two years or more.
Causes of Glioblastoma Multiform
Glioblastoma multiforme, like all tumors, results from inappropriate cell division. In this case, glial cells that normally surround and protect the nerve cells of the brain multiply without restraint.
This results from alterations in how the genes in the cells are expressed—for example, cells may have amplified gene expression in areas such as epidermal growth factor receptor (EGFR) or a loss of a tumor suppressor gene such as PTEN. Other mutations include MDM2 and the RB gene.
How Is Glioblastoma Multiforme Diagnosed?
If a patient has symptoms that are suspicious, healthcare providers can use sophisticated imaging techniques to accurately locate and diagnose brain tumors. These diagnostic tools include computed tomography (CT) and magnetic resonance imaging (MRI).
On MRI, a GBM has an irregular appearance—often with a central area of dead tissue or hemorrhage—and a bright area around the tumor that enhances with gadolinium contrast. This abnormality may press on other brain structures and distort the normal structure of the brain.
While other things may have this appearance on MRI, a concerned physician will likely attempt to arrange for a neurosurgeon to take a piece of this unusual tissue out of the brain.
When evaluated under a microscope, the tissue will show a high number of dividing cells in a characteristic “pseudopalisading” pattern—meaning the cells seem lined up. This is likely related to cell death, as their formation is adjacent to areas of dead tissue seen in GBM under the microscope.
Is Glioblastoma Multiforme Curable?
GBM is aggressive and resists most treatments. Often the goal of treatment is more about reducing symptoms and prolonging life rather than completely curing the disease.
Treatment for glioblastoma multiforme usually includes three components:
Surgery: Surgeons remove as much tumor as they can without hurting healthy areas of the brain.
Chemotherapy: Medicines are given to try to target the tumor cells. Temozolomide or a combination of procarbazine, lomustine, and vincristine are some of the more common treatments.
Radiation therapy: Radiation delivered to the brain can kill some of the cancer cells. This usually involves administering the radiation in a beam to just one part of the brain, rather than irradiating the entire brain which is more common for some metastatic tumors.
After treatments, people who have had GBM are monitored to see if the tumor returns. Most of the time, unfortunately, the GBM comes back. At that time, further treatment may be advised on a case-by-case basis.
Because GBM is so aggressive and because available treatments can have serious side effects, the management of this cancer is very personal. It involves working closely with a neurological specialist as well as a neurosurgeon.
Summary
Glioblastoma multiforme is an aggressive brain cancer that grows quickly. It usually occurs in older adults. Depending on the location of the tumor, symptoms may include persistent headaches, vision problems, vomiting, personality changes, and more.
People diagnosed with glioblastoma multiform usually live for eight months. However, with treatment, some are able to live for five years or longer. Treatments involve surgery, chemotherapy, and radiation therapy.
Talk to a healthcare provider if you think you may have glioblastoma. There may be several explanations for your symptoms and healthcare providers will run tests to determine whether its glioblastoma or something else. You can get the right treatment for your symptoms once you know what's causing them.
Read the original article on Verywell Health.
