This information is intended to provide a general overview of Glioblastoma. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.
Glioblastoma is the most common and most aggressive form of primary brain cancer, accounting many new cases in India each year. All glioblastomas are classified as grade IV tumours, meaning they contain the most abnormal-looking cells and grow rapidly.
The cancer begins in star-shaped brain cells called astrocytes. Astrocytes are a type of glial cell, which supplies the brain with nutrients, gives it shape, and protects neurons. Glioblastoma most commonly starts near the forehead (frontal lobe) or the bottom of the brain (temporal lobe), although it can start anywhere.
There is currently no cure for glioblastoma. The median length of survival after a diagnosis is 15–18 months, with a five-year survival rate of around 10%. Although all glioblastomas recur, initial treatments may control the tumour for months or even years.
Treating glioblastoma presents several inherent challenges:
The tumour forms microscopic branches that spread into different parts of the brain, making complete surgical removal almost impossible.
A single tumour can contain many different cell types, meaning a drug that works for some cells may not successfully treat the entire tumour.
The brain's blood vessels are designed to block diseases and toxins in the blood (the blood-brain barrier), which unfortunately also prevents many drugs from reaching the tumours effectively.
Anything that increases the chance of developing a particular disease is a risk factor. Doctors have only identified a few for glioblastoma.
The most significant risk factor is prior radiation to the head, often received to treat other nearby cancers.
A few hereditary cancer syndromes are also connected, including Li Fraumeni syndrome, neurofibromatosis type 1, and Turcot syndrome.
The cancer tends to develop more often in men, people aged 50 or older, and Caucasians.
Like all brain tumours, the symptoms of glioblastoma depend on the area of the brain where the tumour begins and spreads, as well as how quickly it grows. Glioblastoma can cause symptoms by invading and destroying tissue, putting pressure on nearby tissue, or increasing pressure within the skull (known as intracranial pressure). It can also cause fluids to accumulate, block cerebrospinal fluid circulation, or cause bleeding.
It is important to discuss any symptoms with your doctor as they may signal other health problems.
Obtaining the most accurate diagnosis possible is essential for pinpointing the tumour and designing an advanced treatment plan with the least impact on the body.
At SSCHRC's Brain and Spine Centre, we have sophisticated equipment and renowned neuropathologists who focus solely on diagnosing brain and spine tumours. These experts ensure the most accurate diagnosis from the very beginning.
If symptoms signal a brain tumour, your doctor will examine you and ask questions about your health, lifestyle, and family medical history. Further testing may include:
Used to visualise tumours in and around the brain and to monitor treatment effectiveness. Glioblastoma imaging exams include:
While imaging tests suggest a tumour's location, a tissue sample is required to definitively diagnose a primary brain tumour. For glioblastoma, the tissue sample is usually retrieved during surgery. A pathologist then examines the cells to make the diagnosis.
Some primary brain tumours, including glioblastoma, are defined by key molecular features resulting from tumour mutations. These features can be used to diagnose, provide a more accurate prognosis, and enhance the treatment plan. Key molecular subtypes currently include:
At SSCHRC's Brain and Spine Centre, leading glioblastoma experts develop personalised treatment plans. They use a team approach, with neurosurgeons, neuro-oncologists, and radiation oncologists working together to coordinate care, deliver the best therapies with the fewest side effects, and ensure a focus on the patient's quality of life.
The standard treatment begins with surgery to safely remove as much of the tumour as possible. Because total removal is typically impossible, surgery is followed by a combination of chemotherapy and radiation therapy, and then chemotherapy alone. In cases where elderly or frail patients may not withstand the combined phase, they may receive a modified combination or just one of the two therapies.
Glioblastoma surgery is most successful when performed by a neurosurgeon with extensive experience in brain tumour procedures. SSCHRC neurosurgeons are world-renowned leaders in their field and utilise the most advanced surgical technologies, such as the Brainsuite® intraoperative MRI (which images the brain during surgery) and functional magnetic resonance imaging (fMRI) and navigated transcranial magnetic stimulation (nTMS) to map critical areas.
Surgical options include:
Radiation therapy uses focused, high-energy beams to kill tumours or tumour sections that cannot be removed with surgery. SSCHRC offers advanced radiation techniques designed to maximise impact on the tumour while minimising the effect on healthy brain tissue. Options include:
Chemotherapies are drugs that kill fast-growing cells, including cancer cells. Delivering these drugs to the brain is difficult due to the protective blood-brain barrier.
This treatment requires patients to wear an adhesive skull cap with wires attached to a battery pack for 18 hours a day. The device emits radio waves into the brain to slow or stop tumour cells from multiplying.
Given the difficulty in treating glioblastoma, doctors are constantly searching for new approaches. SSCHRC runs one of the most active glioblastoma clinical trial programmes in the world, exploring entirely new treatments, new combinations of existing therapies, and personalised approaches built around the specific features of a patient's cancer, including new targeted therapies and immunotherapies.
Because it is nearly impossible to remove or destroy all glioblastoma cells, all tumours recur, with timing ranging from weeks to years. Some patients with recurrent disease may be eligible for a second surgery or LITT. Radiation therapy can also be used as a palliative measure to slow tumour progression and relieve symptoms. Clinical trials are a vital consideration for recurrent glioblastoma, and SSCHRC offers a large programme of trials for patients whose disease has returned.