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Glioblastoma Pain Facts & Treatments

Glioblastoma Pain
Glioblastoma Pain

Primary brain tumors can either be benign or malignant. Primary designates that the tumor would have got originated in the brain itself instead of spreading from elsewhere. Benign brain tumors do not harbour cancer cells, whereas malignant brain tumors carry cancer cells.

In The Article

What Is Glioblastoma?

There are certain types of brain tumors are commonly more dangerous and are generally a threat to life. The malignant tissue will have cells that look most abnormal and are likely to grow very fast. Categorized as a Grade IV Tumor by the doctors, this is recognised as glioblastoma multiforme, shortly called as GBM.

Glioblastoma or GBM is the most severe cancer that starts within the brain. Glioblastoma is a very aggressive type of brain tumor and fast growing. As these tumors make its own blood supply, it helps them grow and it is likely to spread.

Hence it becomes easy for them to seize normal brain tissue. The GBMs are composed mainly of star-shaped glial cells also known as astrocytes. GBMs arise instinctively in 95% of the patients. Around 15% of people affected with brain tumours are found to have glioblastomas.

Glioblastoma is a deadly disease found to be affecting around 2 to 3 people per every 100,000 people in the US and European countries. After meningioma, Glioblastoma is the second most common central nervous system cancer. Meningioma is a tumor that forms on membranes covering the brain and spinal cord inside the skull.

Not Genetic

  • Glioblastomas are mostly not inherited
  • They usually occur in people even with no family history of having tumors
  • But sometimes, it might sporadically occur in some people with certain genetic syndromes like neurofibromatosis Type 1 OR Turcot syndrome
  • Such abnormal genetic changes might occur spontaneously for reasons not known exactly or, more rarely, might be inherited as well

Name Origination

  • Glioblastoma multiforme was the term introduced in the year 1926
  • This term was coined by the people named Percival Bailey and Harvey Cushing
  • As the tumor originates from primitive precursors of glial cells called glioblasts, and because of the highly variable appearance due to the presence of necrosis, hemorrhage and cysts called multiform, the term Glioblastoma was formed

Glioblastoma Causes

Glioblastomas generally grow in the frontal and temporal lobes of the brain. This type of tumor grows rapidly inside the brain. It can be found in the brain stem, cerebellum, and other parts of the brain.

It can also be found in the spinal cord. But it hardly spreads to other parts of the body. As the cells reproduce quickly and are supported by a large number of blood vessels, these tumors are usually highly cancerous.

The cellular origin or the exact cause of glioblastoma is still not known. Researchers are making some progress in determining the causes of glioblastoma multiforme. Similar to other cancers, it starts when cells begin to grow swiftly and form tumors

  • Formation of Brain Tumors
    • The genes in the body control the way the cells grow and divide
    • Sometimes changes in the genes can make this process to go wrong
    • It might result in the cells growing uncontrollably and thus forming a tumor
    • These changes are mainly due to the fault made when the cell copies its DNA before dividing
    • Researchers are still going on to discover which genes are involved in the formation of which tumor
  • Risk Factors
    • Some of the risk factors that attribute to glioblastoma:
      • Though a brain tumor can occur at any age, Gliomas are generally common in adults aged between 60 to 80 years’ old
      • People who are exposed to ionizing radiation (like radiation therapy) have got an increased risk of brain tumor
      • Sometimes even a family history of glioma has the risk of developing it though it is very rare

Glioblastoma Symptoms

The symptoms depend on the tumor type, the tumor size, its location and the speed at which it grows. Sometimes symptoms may not be visible if the tumor is not very large in size.

Symptoms are seen when glioblastoma presses parts of the brain. Hence most of the symptoms result from increased pressure within the brain. Some of the symptoms experienced by the people are found to be similar to that of a stroke.

Common signs and Symptoms

  • Headaches
    • As brain has no pain receptors, headache is not caused by brain tumors themselves
    • But headaches are actually due to the pressure caused by the tumor or the tumor related fluid on pain-sensitive blood vessels and nerves within the brain
  • Memory loss
  • Some sort of mental confusion
  • Nausea and Vomiting
  • Vision problems like double vision or blurred vision
  • Lack of sleep or drowsiness
  • Body weakness, Fatigue or extreme tiredness
  • Speech related issues leading to difficulty in speaking
  • Visual impairment
  • Abnormality in walking
  • Swelling
  • Personality changes including changes in mood or concentration
  • It is advisable to immediately consult a doctor if the signs and symptoms are persistent

Glioblastoma Treatments

Glioblastoma is a fast growing central nervous system tumor. There are different treatments available for glioblastoma including radiation, chemotherapy and surgery. But the treatment for glioblastoma still remains difficult as there are no treatments available that can provide a complete cure.

In spite of the maximum treatment provided, it is found that cancer always recurs. But without a proper treatment, survival will be more difficult. It could be even less than 3 months in such cases.

The main objective of glioblastoma treatment is to slow down the tumor growth and control the growth, thereby supporting the patients to live comfortably and increase their survival rate to whatever extent possible

  • Research on Treatment

    • Approximately 200+ clinical trials listed with the National Institutes of Health are investigating treatments for different patients affected with gliomas
    • A research indicates that 22 drugs have been identified with anti-glioblastoma activity, that includes combination of irinotecan and statins
  • Specialists for Treatment

    • Typically, neurologist – doctors specialized in giving treatments for brain-related disorders does the complete physical examination
    • There are other specialists as well including Oncologist who are specialized in cancer and Neurosurgeon who are specialized in nervous system disorders
    • The diagnosis for Glioblastoma is generally a combination of CT scan, MRI scan, and tissue biopsy
    • Depending on the symptoms, doctors might recommend for either MRI Scan, CT Scan OR other form of tests
    • Sometimes doctors might prescribe to take steroids to reduce swelling and alleviate pressure on affected areas of the brain
  • Surgery

    • For patients with glioblastomas, surgical resection is usually considered as the first stage of treatment
    • Surgery might help to remove the tumor tissue. This will remove the pressure in the brain caused due to tumor
  • Radiation

    • For some Glioblastomas, radiation is usually recommended after surgery
    • Radiation might also be recommended to treat glioblastomas when surgery is considered as not very safe for some reason
    • Radiation therapy generally involves treatment using x-rays by the radiology technician and other high-energy rays to kill the abnormal cells
  • Chemotherapy

    • For nearly all glioblastomas, Chemotherapy and radiation therapy are usually recommended for treatment
    • Chemotherapy helps to kill the cells that are growing very quickly
    • Drugs are used in Chemotherapy to kill cancer cells
    • There could be side effects due to chemotherapy
    • But it depends on the type and dose of drugs received
  • Temozolomide Treatment

    • It is found that, for patients older than 60 years, Temozolomide (It is an oral chemotherapy drug) treatment helps in longer survival than with regular radiotherapy treatment
    • For patients who are older than 70 years, sometimes less aggressive therapy is tried using radiation or with temozolomide alone
  • Rehabilitation

    • As brain tumors might develop in some parts of the brain that control speech, vision and thinking, rehabilitation is necessary as part of recovery process
      • Doctors might refer the patient to various services that can be of help
      • Some of them are: physical therapy, occupational therapy and speech therapy
      • Physical therapy helps the patient to regain the lost muscle strength
      • Occupational therapy helps the patient to get back to normal routine activities after a brain tumor
      • Speech therapy with specialists helps the patients to overcome the speech difficulties if any
  • Other Forms of Treatment

    • Only very little research has been done on other form of treatments for brain tumor
    • But so far, no alternative treatment has been found to provide complete cure for gliomas
    • Still such treatments might help the patients to cope their brain tumor and its treatment
    • Some of the complementary treatments that helps to cope:
      • Hypnosis
      • Music therapy
      • Meditation
      • Acupuncture Treatment
  • Factors affecting the Treatment

    • Though there are different treatments available to treat Glioblastomas, in reality, it is very difficult to treat glioblastoma due to various factors
    • Some of them:
      • Due to conventional therapy, the brain is vulnerable to damage
      • The tumor cells are highly resistant to conventional therapies
      • Cells within the tumor are not all of the same type
      • Many of the drugs cannot easily cross the brain and blood barrier to act on the tumor
      • The brain has only a very limited capacity to repair by itself

Glioblastoma Grade 4

Tumor Grades

Brain tumors are grouped by the doctors with different grades. This grading system was developed by the World Health Organization (WHO). The grade refers to the way the cells appear when seen through a microscope.

There are different grades like Grade I, Grade II, Grade III and Grade IV cancers.

  • Grade I is termed as Low Grade Tumor
  • Grade II is termed as Intermediate Grade Tumor
  • Grade III and Grade IV are termed as High Grade Tumors

Grade I tumors might be cured if they are completely removed through surgery

Grade II – Here the tumor cells grow but doesn’t spread so quickly compared to Grade III and IV tumor cells. It may spread into nearby tissue and might reoccur

But Grade IV tumors generally cannot be cured. In Grade IV, the infectious tissue will have cells that will look most abnormal. These cells generally tend to grow quickly.

Over a period of time, it is possible that low-grade tumor may turn out to be a high-grade tumor. But such changes are more common in adults only than children.

Grade IV Tumor

There are different types of primary brain tumors. According to the type of cells or the portion of the brain in which they start, primary brain tumors are named. As most of the primary brain tumors begin in glial cells, this type of tumor is called as Glioma.

There are different types of Gliomas.  Astrocytoma, Oligodendroglioma and Meningioma are the most common types of brain tumor for adults.

Astrocytoma includes astrocytoma, anaplastic astrocytoma and glioblastoma; Ependymomas includes anaplastic ependymoma, myxopapillary ependymoma and subependymoma; Oligodendroglioma includes oligodendroglioma, anaplastic oligodendroglioma and anaplastic oligoastrocytoma.

Glioblastoma is one of the group of tumors called as astrocytoma’s. For adults, an astrocytoma generally arises in the cerebrum, the largest part of the brain. Grade IV astrocytoma is called as Glioblastoma. It is also called as malignant astrocytic glioma.

Glioblastoma Survival Rate

Glioblastoma is one of the most typical form of brain cancer that attack thousands of patients every year eventually causing life-threatening complications. Malignant Astrocytomas and Glioblastomas are generally considered to be fatal within two years with treatment and usually within few weeks if not treated properly.

They are very aggressive and cannot be easily cured through surgery. At least half of the affected people lose their life within 15 months after diagnosis. Though the survival rate is minimal, it has also been found that 17% of patients especially adults have a survival rate of around 2 years. 4% of patients are found to have a survival rate of around 5 years.

In some cases, patients survive even for 10-20 years but that is extremely minimal.

Glioblastoma Prognosis

Patients surviving for a long-term with glioblastoma is very rare. Higher the grade of tumor, the more malignant is the tumor. Hence the prognosis is worse. Similarly, with an increase in age (more than 60 years or so), the prognostic risk is worse.

The patient’s survival rate depends on various factors. This includes both clinical and biological parameters. Some of the factors are tumor size, its location, age at the time of diagnosis, kind of treatment given and so on.

Though there are many improvements in neurosurgery, radiotherapy, and chemotherapy treatment techniques in the last several years, still the overall prognosis for Glioblastoma has not improved much.

Glioblastoma Dos and Donts

Patients affected by glioblastoma should take care of many precautions. Some of the Do’s and Don’t’s are given below.

Do’s

  • Regular exercise is important
  • To have the regular intake of fruits and vegetables
  • To have adequate nutrition. To eat less fat
  • The routine physical examination is needed and to take medications on time
  • To drink more water and avoid dehydration
  • To maintain hygiene
  • To monitor signs of infection
  • Above all, it is utmost necessary to have a positive attitude and a clear mind

Dont’s

  • Not to rely on pills for nutrition
  • Not to take sugary foods in the morning
  • To avoid smoking and drinking
  • Not to get exposed to intense sunlight or ultraviolet rays
  • Not to get exposed to certain harmful chemicals or ionizing radiation
  • Not to get exposed to pesticides, petroleum refining or rubber manufacturing

Home Treatments For Glioblastoma

Though Glioblastoma is a dangerous brain tumour, many patients have learnt to keep glioblastomas in check.  Many of them have even improved their survival possibilities significantly through the intelligent choice of treatments and giving more attention to various treatment options.

While radiation, chemotherapy and surgery are the usual treatments available, many patients have started adopting a drastic change in their diet and lifestyle.

Since surgery cannot remove all the cancerous cells and as these cells grow quickly into a new tumour, doctors usually recommend for chemotherapy and radiation treatment to prevent recurrence. Sometimes even radiation and chemotherapy fail to eradicate the disease permanently.

This is when people decide to go for natural treatment. Such methods are recommended in homoeopathic medication. Some of them are given.

  • Having a strict diet of food with green gram lentils, turmeric or ginger
  • Avoid eating anything that might increase the glucose level
  • To drink a glass of freshly squeezed vegetable juice with few pieces of turmeric every morning and so on
  • Patients are looking at cannabis oil as a possible treatment for different brain cancers
  • Some of the other methods adopted to handle brain tumor:
    • Hyperbaric Oxygen Therapy
    • Inhaling frankincense oil that helps to alleviate inflammation in the brain
    • Calorie Restriction

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