Glioma

Glioma is a tumor that arises from the supportive tissue of the brain that contains the glial cells. The glial cells help to keep the neurons in place. The glial cells help in maintaining the blood-brain barrier by supporting the nerve cells with energy and nutrients. The symptoms and the treatment of the malignant glioma depend on different factors such as age, type of tumor, and location of the tumor. Radiation to the brain is a risk factor for malignant gliomas. Genetic disorders in children increase the development of these tumors.

Types of glioma

80% of the tumors of glioma are malignant whereas remaining tumors are benign. Mainly there are three types of gliomas:

Astrocytomas:Almost 50% of all brain tumors are astrocytomas. These originate from the brain cells called as astrocytes. These can be spread throughout the normal brain tissue and they cannot be cured. These astrocytomas are further classified based on their growth rate into a low grade, intermediate grade, or high grade. The highest grade of astrocytomas is called as ‘glioblastoma multiforme (GBM)’. The glioblastomas are the most common and fastest growing malignant tumors in adults.

Oligodendrogliomas:These tumors spread in a similar manner to astrocytomas and have a slow progression. However, they spread to nearby tissues. These can sometimes be cured. Anaplastic oligodendroglioma is a high-grade tumor which spreads quickly and can’t be cured.

Ependymomas:Nearly 10% of brain tumors in children are ependymomas. Only two to three percentage of adults are related to this type. These tumors originate from ependymal cells and are not spread to other brain tissues. These can be cured by surgery. Sometimes, they are rarely spread outside the brain.

Symptoms

The symptoms of glioblastoma are similar and related to the other malignant tumors of the brain. Some of the symptoms are listed below:

  • Headache

  • Seizures

  • Numbness

  • Confusion

  • Personality changes

  • Physical weakness

  • Loss of muscle control

  • Language problems

  • Visual symptoms

  • Cognitive decline

The symptoms are experienced based on the part of the brain that is affected. The symptoms may worsen as the tumor grows destroying the brain cells, compressing the parts of the brain, and creating pressure in the skull. This leads to swelling in the brain.

Diagnosis

The diagnosis of glioma is done by imaging tests that include CT and MRI scans. A biopsy may be needed if the brain scan indicates a tumor.

Prognosis

The glioblastoma prognosis is reported in the form of years in median survival. The median survival for adults is two to three years. However, some reports say that median survival for adults is five years or longer. If the glioblastoma is aggressive, the median survival is 15 months to two years. There are many cases which showed remission (no evidence) of disease. If the tumor recurs, surgery is performed. If you are unable to undergo surgery, then radiation therapy is preferred.

The gliomas are characterized to subtypes by the numerical grading system. The grading is given based on the growth and appearance of the tumor under the microscope. Usually, the grade I tumors grow slowly and can be treated by surgery. The grade IV tumors are fast-growing and difficult to treat. The low-grade tumors grow slowly and transform into high-grade tumors with time.

The astrocytomas are graded as:

  • Grade I - Pilocytic astrocytomas (seen in children)

  • Grade II - Diffuse astrocytomas (low grade)

  • Grade III - Anaplastic astrocytoma (high grade)

  • Grade IV - Glioblastoma (high grade)

The oligodendrogliomas are graded as:

  • Grade II or low-grade oligodendroglioma

  • Grade III or anaplastic oligodendroglioma

The ependymal tumors are classified as:

  • Ependymoma

  • Anaplastic ependymoma (aggressive)

The treatment for glioblastoma depends on the age of the patient, physical condition, location of the tumor, type, and the grade of malignancy. The treatment is multifaceted, and it includes:

  • Removal of the tumor by surgery is the best option of the treatment with fewer side effects. But your doctor prefers surgery if you are healthy and functional. The surgery will be assisted by the imaging techniques such as CT scan and MRI to remove the tumor completely.

  • Radiation therapy is used to destroy the tumor cells. In the radiation therapy, high-energy X-rays are used.

  • Chemotherapy may be suggested by oral route or injections to stop the growth of the tumor cells.

  • Electric-field therapy is used to target cells the tumor cells by using electrical fields. The device is called optune, and the electrodes are placed directly on the scalp and targeted to the tumors. It is given along with chemotherapy after surgery and radiation.

  • Supportive therapy is used to improve the symptoms and neurologic functioning. It includes corticosteroids to reduce swelling in the brain that is caused by the tumor and anticonvulsants to control or prevent seizures.

The meningioma treatment includes surgery, radiation therapy, and chemotherapy. Surgery is the most common treatment and chemotherapy is occasionally given.

Certain lifestyle changes would help to ease pain and discomfort. These include:

  • Taking adequate rest

  • Lying down to keep the scrotum elevated

  • Applying cold packs to your scrotum

  • Wearing an athletic supporter

  • Avoiding lifting of heavy objects

  • Abstaining from sexual contact