Glioblastoma

What is a Glioma?

Glioblastoma belongs to a group of tumors known as gliomas (glial tumors). A glioma is a tumor that can develop in the brain or spinal cord. These tumors originate from neuroglial cells, which provide support to neurons (nerve cells). Initially, neuroglial cells were believed to function as the connective tissue of the nervous system.

Gliomas are classified based on the cell type from which they originate and molecular markers that help predict disease progression and determine the best treatment approach.

What is Glioblastoma?

Glioblastoma is a type of glioma that can develop in the brain or spinal cord. It is highly malignant and aggressive, growing infiltratively among healthy brain cells without a clear boundary from surrounding tissues.

Glioblastomas arise from astrocytes, a type of neuroglial cell that supports neurons.

This highly malignant tumor can develop at any age, though the average age at diagnosis is 64 years.

Types of Glioblastoma

Glioblastoma can develop as:

• Primary glioblastoma – A tumor that initially forms with aggressive characteristics (most commonly diagnosed in older patients).
• Secondary glioblastoma – A tumor that develops more slowly, progressing from lower-grade gliomas (astrocytomas) over 8–10 years.

Where Can Glioblastoma Develop?

Glioblastoma can occur in any part of the brain or spinal cord, but it is most commonly diagnosed in the cerebral hemispheres.

Symptoms of Glioblastoma

Symptoms are not specific and can resemble many neurological conditions. Due to tumor mass effect and swelling in surrounding brain tissue, symptoms may appear suddenly.

Common Symptoms:

• Severe headaches
• Nausea and vomiting (often due to high intracranial pressure)
• Neurological deficits based on tumor location, including:

Weakness or numbness in limbs

• Facial drooping
• Balance and coordination issues
• Personality changes
• Memory and cognitive impairment
• Seizures (epilepsy) – A frequent symptom of brain tumors

How Are Brain Tumors Diagnosed?

Initial diagnosis is made using:

• Computed Tomography (CT/DT) scans
• Magnetic Resonance Imaging (MRI)

MRI is highly effective in determining tumor type, but other non-cancerous brain disorders can mimic tumor-like changes on imaging.

Definitive Diagnosis:

A biopsy or surgical tissue sample is required for:

• Histological examination
• Molecular analysis (glioblastomas undergo specific genetic testing)

What Should You Do If Diagnosed with Glioblastoma?

If you or a loved one has confirmed or suspected glioblastoma, a neurosurgical consultation is necessary.

We offer in-person and remote consultations via video calls. Appointments can be scheduled online, via phone, or email. Contact us to arrange a remote consultation.

Treatment Options for Glioblastoma

Glioblastoma is difficult to treat due to:

• Variability in tumor cell response to therapy
• Its ability to infiltrate healthy brain tissue

Thus, treatment generally involves multiple steps.

1. Surgical Treatment (if feasible)

The first step is surgery, aimed at:

• Confirming the diagnosis (tissue sample taken for histological and molecular testing)
• Maximally removing the tumor without harming the patient

In some cases, glioblastoma surgery is not possible due to location in critical brain areas (e.g., regions controlling speech or movement).

If tumor removal is riskier than leaving it, a biopsy may be performed instead.

• Biopsy provides critical molecular details (IDH1, IDH2 mutations, MGMT methylation) to guide further treatment plans.

2. Radiation Therapy & Chemotherapy

These methods are used after surgery or for tumors that cannot be surgically removed.

Despite significant advances in medicine, glioblastoma patient survival rates have only slightly improved over the past 20 years.

Ongoing Research & Experimental Therapies

Extensive clinical research is being conducted worldwide to develop new glioblastoma treatments. Patients may have access to experimental therapies through clinical trials.

Prognosis for Glioblastoma

With standard treatment, adult glioblastoma patients without IDH mutation have a median survival of 11–15 months.

Factors Influencing Prognosis:

• Better outcomes occur in patients under 50 years old at diagnosis.
• Higher survival rates are observed in those who undergo complete tumor removal.

Molecular Markers & Prognosis:

Modern cancer treatment relies on molecular biomarkers, helping:

• Optimize treatment effectiveness
• Prevent unnecessary or ineffective chemotherapy

Patients with IDH-mutant glioblastomas have significantly better survival rates:

• Median survival: 27–31 months (IDH-mutant glioblastoma)
• Median survival: 11–13 months (non-IDH-mutant glioblastoma)

Another crucial molecular factor is MGMT gene promoter methylation.

• MGMT helps maintain genetic stability in cells.
• Methylated MGMT tumors are more responsive to alkylating chemotherapy drugs, including Temozolomide (TMZ, Temodal) and Lomustine (CCNU).

Where Can You Seek Treatment?

Our surgical facility, where procedures and interventions take place, is the modern, well-equipped Aiwa Clinic.

If you are considering surgery with us, you can read patient testimonials from both Latvian and international patients.