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Glioblastoma Multiforme

Treatment Provided by Our Board-Certified Neurology Team

The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health treats brain and spinal tumors, including glioblastoma multiforme, often called the most aggressive of brain cancers. Our neurology and neurosurgery specialists are board-certified in their fields and will give you the most comprehensive, individualized care available.

If you suspect you have a brain tumor or if you have already been diagnosed with brain cancer and are looking for the best treatment, our neurologists and neurosurgeons are ready to help you find the best treatment plan for you. Our multi-disciplinary team includes board-certified neurologists, neurosurgeons, neuro-oncologists, oncologists, radiation oncologists, and a support staff of rehabilitation specialists. Many of our patients have come to us from other doctors, seeking a second opinion or for more specialized treatment.

Have you been diagnosed with glioblastoma multiforme or another brain tumor? We encourage you to reach out to us today for a consultation.

What Is a Glioblastoma Tumor?

Glioblastomas represent about 15% of all brain tumors, and half of all primary brain tumors (those originating in the brain rather than spreading to the brain from another part of the body). They are cancerous, difficult to treat, and usually terminal. Also called GBM, or a grade IV astrocytoma, this highly aggressive, malignant brain tumor originates in the astrocyte cells of the brain and is a subtype of glioma brain tumors. Glioblastoma multiforme is a grade IV cancerous tumor, meaning the cancerous cells divide and reproduce rapidly into surrounding brain tissue.

GBMs can occur “de novo,” meaning they begin as a grade IV tumor with no evidence of a lower grade tumor being present previously. De novo tumors are the most common GBM and are usually more aggressive. Some glioblastomas progress from lower-grade astrocytoma tumors and evolve into a grade IV tumor over time.

GBMs are extremely aggressive, and they present unique treatment challenges because of the following characteristics:

  • Resistance to conventional therapies: Some cells may respond well to certain therapies, while others are not affected at all.

  • The brain has little capacity to repair itself.

  • Malignant cells migrate quickly into surrounding brain tissue.

Glioblastoma Prognosis

Glioblastomas are notoriously aggressive and difficult to treat, because they spread quickly and do not have clearly defined borders, which usually makes them inoperable. Median survival rate for patients who receive standard treatment is approximately 11 to 15 months, according to the American Brain Tumor Association. Some patients have better prognoses, if they are younger than 50 at the time of diagnosis, or if their tumor can be nearly completely removed in surgery.

Glioblastoma Symptoms

Symptoms vary based on location of the GBM, but may include the following:

  • Persistent headaches

  • Double or blurred vision

  • Nausea, vomiting, and loss of appetite

  • Mood swings

  • Personality changes

  • Problems thinking or learning

  • Seizures

  • Difficulty speaking

Glioblastoma Diagnosis

A neurologist is the best physician to diagnose and treat glioblastomas, as these doctors have specialized training in disorders of the brain, spinal cord, and nerves. Before making a definitive diagnosis of a glioblastoma, physicians must rule out related conditions such as stroke, brain abscesses, and cavernous malformations. Other conditions affecting the brain can also mimic the symptoms of glioblastomas, such as central nervous system lymphomas and lower grade brain tumors. Only a biopsy can definitively diagnose a GBM, as imaging tests are not enough to determine the location and origin of a brain tumor.

Tests and procedures used to diagnose GBM include:

  • Neurological exam: Your physician will test your vision, hearing, speech, balance, coordination, memory, and reflexes. A problem in one of these functions could give your doctor reason to suspect you have a brain tumor.

  • Imaging tests: Magnetic resonance imaging (MRI) scans are useful for neurologists to locate a brain tumor. The image of a GBM often has an irregular appearance, with a central area of dead tissue. The neurologist will be able to see how the abnormality of the brain presses on other brain structures and therefore distorts the normal brain structure.

  • Biopsy: A neurosurgeon obtains tumor tissue for a biopsy to be analyzed by a neuropathologist. Microscope analysis of the tumor tissue can assign a name and grade to the tumor and answer questions about the origin of the cancer cells, and if there are signs of rapid growth in the tumor cells.

Risk Factors for Glioblastoma

The exact cause for GBM is unknown, but there are risk factors for this type of brain cancer. Prior ionizing radiation therapy can damage normal cells and even lead to new cancer cells forming. There is also a higher correlation of GBM patients employed in fields such as synthetic rubber manufacturing, petroleum refining, and exposure to pesticides and vinyl chloride. Rarely, glioblastoma can be inherited. Rare diseases such as Turcot syndrome, Li-Fraumeni syndrome, and neurofibromatosis type 1 account for a small minority of GBM diagnoses.

Age is another factor in diagnosis, as the average age of diagnosis is 64, with a slightly higher rate of occurrence in men versus women. White people have the highest rate of GBM diagnoses compared to other races.

Glioblastoma Treatment

Once a glioblastoma has been diagnosed, the first step in treatment is to relieve pressure on the brain.

  • Surgery: If possible, your glioblastoma tumor will be removed. Complete removal is not possible for GBMs, however, because they grow into the normal brain tissue. Because of this, most patients receive a combination of treatments after surgery to target the remaining cells.

  • Chemotherapy: This drug therapy is designed to kill cancer cells. Some patients even have dissolvable, circular chemotherapy wafers placed in the brain during surgery, which then slowly release medicine into the system. Some patients take chemotherapy pills, while others have intravenous chemotherapy administered through a vein in the arm.

  • Radiation therapy: High-energy radiation beams kill cancer cells at precise points in the brain. Usually, this is recommended in combination with chemotherapy, or for people who can’t undergo surgery.

  • Tumor Treating Fields (TTFields) therapy: An electrical field disrupts the tumor’s ability to multiply in this therapy, which involves applying adhesive pads to the scalp connected to a device that generates electrical fields.

  • Targeted therapy: This drug therapy focuses on blocking abnormalities in cancer cells and is usually administered intravenously.

  • Clinical trials: These research studies look for new treatments for any given disease or disorder. By participating in a clinical trial, you can try the latest treatment options, but the side effects of these therapies may not yet be known. Ask your doctor(s) whether you are eligible to participate in a clinical trial.

  • Alternative medicine: Some patients turn to eastern medicine to cope with their diagnosis, which may include complementary therapies such as acupuncture, meditation, music therapy, relaxation exercises, and more. Note, these are always add-on treatments, and they are not proven to have any curative outcome. If you have GBM and wish to try alternative medicine, be sure to inform your neurologist.

Request an appointment online now or call 833-656-3876.