Patient education: Glioblastoma (The Basics)

What is glioblastoma? — 

Glioblastoma ("GBM"), also called "glioblastoma multiforme," is a fast-growing type of brain cancer. Brain cancer happens when normal cells in the brain change into abnormal cells and grow out of control.

Brain cancers are sometimes named after the type of cell they start from. GBM starts in the "glial" cells of the brain. These surround the brain's nerve cells.

As GBM grows, it can spread into healthy parts of the brain. It can also cause brain swelling. Both of these things can cause symptoms.

Most of the time, doctors don't know why a person gets GBM. Getting radiation treatment can raise a person's risk for GBM.

What are the symptoms of GBM? — 

The most common symptoms include:

●Headaches

●Seizures

●Memory or thinking problems

●Muscle weakness

●Vision changes, such as double vision or vision loss

●Language problems, such as trouble finding the right word for something

●Personality changes

Other conditions can also cause these symptoms. But tell your doctor or nurse if you have any of these symptoms.

Will I need tests? — 

Yes. The doctor will do an exam and order imaging tests, such as an MRI or a CT scan. These create pictures of the brain. The pictures can show GBM or other abnormal growths. They can also show other kinds of changes that might be causing symptoms.

If the doctor thinks a brain tumor might be GBM, they usually do surgery to take out as much of the tumor as possible. Then, another doctor looks at a small sample of the tumor tissue under a microscope. The sample can show if the tumor is GBM, a different type of brain tumor, or a sign of another brain condition.

Some people do not have surgery to remove the tumor. Instead, the doctor might use a needle to take a small sample from the tumor. This can be done if:

●The tumor is in a part of the brain where surgery is too risky.

●The tumor is too large for surgery to help.

●The person is too sick for surgery.

How is GBM treated? — 

Treatment usually includes more than 1 of the following:

●Surgery – Doctors take out as much of the tumor as possible without hurting healthy areas of your brain. This can help with symptoms and help you live longer.

●Radiation therapy – Radiation kills cancer cells. Most people have radiation therapy after surgery.

●Chemotherapy – These are medicines that kill cancer cells or stop them from growing. Most people have chemotherapy at the same time as radiation and then for 6 months after stopping radiation.

●Electric fields – You wear a battery-powered device called Optune on your shaved scalp. The device gives off low-strength electric fields around the tumor. You cannot feel the electric fields. You wear it for at least 18 hours a day.

GBM can cause seizures and brain swelling. Doctors can give medicines or do surgery to treat these symptoms.

What happens after treatment? — 

You will have regular checkups to see if the GBM comes back. This includes having imaging tests (usually MRIs) of the brain.

Watch for the common symptoms of GBM, and any other symptoms you had before your doctor found the tumor. Having symptoms could mean the GBM has come back. Tell your doctor or nurse about any symptoms.

What if the GBM comes back? — 

In most people, GBM comes back after treatment. If an imaging test shows changes in the brain after treatment, the changes could be caused by the GBM coming back, or they could be changes that happen in response to treatment. It can be hard to tell the difference. The doctor might do repeat imaging tests to see if the changes are cancer.

If GBM comes back or spreads, you might have more surgery, chemotherapy, radiation, or other treatments. But sometimes, there are no treatments to help control the tumor. In this case, you might still get medicines to help treat brain swelling or seizures. You might also need a nurse to visit you at home to help with your treatment.

Your doctor or nurse will talk with you about your options and the best treatments for you.

Should I be in a clinical trial? — 

A clinical trial is a research study that tests new medicines and treatments to see how well they work.

Being in a clinical trial might help your symptoms or help you live longer. It can give doctors more information about GBM and how to treat it. This helps them create new and better medicines and treatments.

There are clinical trials for GBM all over the world. If you want more information, ask your doctor.

What else should I do? — 

Follow your doctor's instructions about check-ups and tests. Talk to your doctor about any problems during treatment.

If GBM comes back, tell your doctors and nurses how you feel about the different treatments. Any time your doctor talks with you about a new treatment, ask:

●What are the benefits of this treatment? Will it help me live longer? Will it reduce my symptoms or stop them?

●What are the downsides of this treatment?

●Do I have other choices besides this treatment?

●What happens if I do not have this treatment?

Finding out you have GBM, or your cancer has returned, can be scary and upsetting. Having support from family and friends can help. It can help to join a support group, either in person or online. This is a way to connect with other people going through similar things.

More on this topic

Patient education: Brain cancer (The Basics)
Patient education: Seizures (The Basics)
Patient education: What are clinical trials? (The Basics)

Patient education: High-grade glioma in adults (Beyond the Basics)
Patient education: Seizures in adults (Beyond the Basics)