Do you suffer from persistent headaches, experience seizures, nausea, vomiting or feel disoriented at times? Then, it could well be time to see your doctor. For all you know, these symptoms might be the first triggers to brain tumors and could possibly be leading to Glioblastoma Multiforme disorder (GBM).
WHO classifies tumors of the central nervous system (CNS), especially glioblastoma into two variants, giant cell glioblastoma and gliosarcoma. The precaution becomes more pronounced as we herald June 8 as ‘World Brain Tumor’ day; reinforcing the need to bring forth new thoughts and research studies on alleviating primary malignant brain tumors.
What Is GBM?
GBM is a form of malignant brain tumour that is one of the most widespread amongst primary brain tumors. GBM is also referred to as Grade IV astrocytoma which is a rapidly growing malignant astrocytoma of the central nervous system.
The harrowing impact of primary brain tumor is that, it can develop in any area of the brain. As with other brain cancers, GBM can also spread through the brain tissue. It however might not always spread to other areas outside the central nervous system.
What Causes GBM?
Neither is GBM directly related to a person’s lifestyle makeup nor does it depend on a person’s exposure to any form of disease or carcinogens. What is most defeating is that there still remains some anomaly or lack of understanding on the actual causes of GBM.
In the early stages, glioblastomas usually develop at the frontal and temporal parts of the cerebrum. It is known that the progression of GBM could span over 10 years or sometimes over a year.
Medical experts explain that all GBM tumors have numerous blood vessels which deliver necessary oxygen and nutrients to GBM tumors that help them to grow. These blood vessels can get embedded with regular brain tissue and move away from the main tumor, making GBM tumors difficult to treat.
What is known however is that the disease can affect adults in the 40 to 70 years age range. Children in the age group of three and 12 years are also known to be affected but such cases are rare. According to the U.S. National Brain Tumor Society, “glioblastoma accounts for approximately 23 percent of all primary brain tumors diagnosed in the U.S.”
The nature of prognosis for patients with glioblastoma therefore depends on early detection of the tumor and early onset of treatment. Some primary malignant brain tumors are identified as glioblastomas, astrocytomas, and some as oligodendrogliomas and ependymomas.
As regards GBM, a patient’s age, sex and race could be the usual contributory factors to the condition. Males below 45 years are more susceptible to the disorder; while the disease is known to occur most amongst African-Americans.
Common Symptoms of GBM
Headache is one of the common symptoms for GBM. These headaches could be because of increased intracranial pressure or as a result of cerebral oedema, tumor growth, or intracranial haemorrhage. One of the prime symptoms of GBM is persistent daytime headaches.
There is a possibility that GBM develops in an adult’s brainstem and when this happens, it could lead to a decline in the level of consciousness. Other symptoms are related to one-sided body weakness (paralysis) along with progressive and persistent headaches.
Certain common symptoms of glioblastoma multiforme are general body weakness, cognitive impairment and loss of vision. Other changes seen are frequent mood swings, behavioural changes, inability to concentrate and act appropriately and also speech dysfunction. Sometimes there is loss of sensation and the disorder could also lead to cognitive impairment.
Patients also suffer from treatment related fatigue before, after and during the course of the treatment. Management of this allied syndrome needs to be planned clinically as well. The other side effect could be diarrhea in patients receiving chemotherapy and needs to be treated.
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Like any other type of cancer, GBM also follows a palliative mode of treatment than an actual cure. Therapy involves surgery, chemotherapy, and radiation therapy. These interventions however help relieve the symptoms rather than cure the malignancy. Like any other cancer therapy, it must be noted that surgical removal of cancerous tissue might not always lead to a cancer-free life.
Likewise, many glioblastoma cells also become resistant to chemotherapy or radiation. In some cases, surgery followed by a sound chemotherapy regime might lead to a 25 per cent survival rate. Radiation therapy, post-chemotherapy might kill those cancer cells which might have been missed out in the radiation segment. As
is the case, healthy tissues might also be affected requiring further surgery to get rid of the radiation-affected tissues.
Some of the more common prescription drugs to control the condition are carbamazepine or phenytoin to relieve patient’s episodes of seizure. In case of swellings, dexamethasone and ranitidine is also prescribed.
Other experimental procedures being considered for GBM treatment are interstitial radiation via balloon implantation and Boron Neutron Capture therapy. Boron therapy is understood to attack and kill the cancerous cells without affecting the healthy ones.
This therapy is considered more advanced and steps in where radiation therapy might fail. Other procedures such as anti- anogenesis, biologic therapy, gene therapy, and immunotherapy are also being explored to cure or relieve glioblastoma.
Vaccines, Will They Help?
Due to limitations of current treatments, clinical trials that offer new therapies may provide an alternate remedy for patients with poor prognosis. Researchers from Cedars-Sinai Medical Center, in Los Angeles, California, have reported on T cell response seen after therapeutic vaccination for glioblastoma multiforme which was directly related to clinical outcome.
Researchers have recently announced the first results of a multicenter Phase 2 clinical trial on a new brain cancer vaccine tailored to a patient’s own tumor. An objective of the recent trial was to see if the vaccine could evoke immune response to the disease in all patients, which it did. A result suggests that doctors may now be able to extend survival of patients with glioblastoma by combining the vaccine with other drugs that enhance this immune response.
Device, As New Technological Intervention
In another breakthrough, the FDA has been asked to approve a new device that can possibly treat glioblastoma. The device known as NovoTTF-100A System (NovoTTF) is designed to zap tumors using an electrical field that can be generated by a 6-pound battery pack.
It could well be prescribed in patients with recurrence of the GBM symptoms following the standard therapies. While new breakthroughs to alleviate sufferings caused by glioblastoma continue to be placed on the anvil, it would definitely help to be watchful of that headache that could be killing your brain silently!