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Glioblastoma Cancer

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WHAT IS GLIOBLASTOMA CANCER?

Glioblastoma, also known as glioblastoma multiforme (GBM), is the most common and aggressive type of primary brain tumour in adults. According to the World Health Organization's GLOBOCAN database, brain tumours, including glioblastoma, account for about 2% of all
cancers in the country.

They are ranked as the 14th and 15th most common cancers among males and females, respectively.

The exact causes of glioblastoma remain largely unknown, but several risk factors have been identified that may increase the likelihood of developing this aggressive brain tumour.

  • Prior Radiation Exposure: History of radiation therapy to the head.
  • Family History: Although most glioblastoma patients do not have a family history of the
    disease, a small percentage may have genetic predispositions that increase their risk.
  • Genetic mutations: Genetic disorders that cause tumours, such as Turcot syndrome, Li-
    Fraumeni syndrome, and neurofibromatosis.
  • Environmental Factors: Exposure to certain chemicals and carcinogens. For instances,
    pesticides, petroleum, synthetic rubber, and vinyl chloride.

Glioblastoma is an aggressive brain tumour that can present a variety of symptoms depending on its location and growth rate. Here are some of the most common signs and symptoms associated with glioblastoma:

  • Headaches is often the first noticeable symptom which can differ from typical headaches and tend to become more frequent and severe over time, often worsening in the morning and may not respond to over-the-counter pain medications.
  • Cognitive changes including memory loss, confusion, and difficulty concentrating which
    can significantly affect daily living.
  • Seizures because of the tumor's impact on brain function that can vary in type and
    severity.
  • Visual or sensory changes such as numbness or tingling in certain body parts.
  • Nausea and vomiting which may be worse in the morning due to the tumour’s increased
    intracranial pressure.
  • Motor Weakness which includes difficulty with coordination and balance, also can be
    indicative of the tumour’s location in the brain.
  • Personality and mood changes as the tumour affects different areas of the brain.

Diagnosis

Diagnosing glioblastoma involves a combination of imaging studies and tissue analysis. Here are the key steps typically taken in the diagnostic process:

Medical History and Physical Examination

The process begins with a thorough medical history and a neurological examination. Doctors assess symptoms such as headaches, seizures, and cognitive changes to determine the likelihood of a brain tumour.

Magnetic Resonance Imaging (MRI)

MRI scans provide detailed images of the brain and can help identify the size, location, and extent of the tumour.

Computed Tomography (CT) Scan

A CT scan may also be used, particularly in emergency situations, to quickly assess the brain for abnormalities.

Biopsy

A definitive diagnosis of glioblastoma is made through a biopsy, it helps determine the tumour type and grade, which is crucial for planning treatment.

Molecular Testing

In some cases, additional molecular testing may be performed on the tumour tissue to identify specific genetic mutations or markers that can influence treatment options and prognosis.

Treatment

The treatment plan typically involves a combination of therapies aimed at maximizing tumour removal and prolonging survival. Here are the main treatment modalities:

Surgery

The first step in treating glioblastoma usually involves surgical intervention to remove as much of the tumour as possible while preserving brain function.

Palliative care

Palliative care offers comfort, support, and symptom reduction.

Chemotherapy

It works by slowing tumour growth and is typically administered alongside radiotherapy. Chemotherapy options may be considered based on individual patient factors and tumour characteristics.

Chemotherapy

It works by slowing tumour growth and is typically administered alongside radiotherapy. Chemotherapy options may be considered based on individual patient factors and tumour characteristics.

Tumour Treating Fields (TTFields)

This innovative treatment involves the use of electric fields to disrupt cancer cell division. TTFields are delivered through a device worn on the scalp and have been shown to improve survival rates when used in conjunction with other treatments.

Immunotherapy

This treatment targets the GBM cells by utilising your body's immune system.

Radiotherapy
Following surgery, radiotherapy is commonly employed to destroy remaining tumour cells. This treatment helps to reduce the risk of recurrence and is often combined with chemotherapy.

> Intensity-modulated radiation therapy (IMRT)

IMRT minimises the radiation exposure to the surrounding healthy brain tissue while yet enabling the delivery of radiation to the tumour.

> Stereotactic radiosurgery

Targeting the tumour precisely with highly concentrated energy beams minimises damage to healthy tissue. This method is occasionally used by providers when GBM increases following initial IMRT.

Prognosis

The prognosis for glioblastoma patients in Malaysia mirrors global trends, with many patients facing a poor outlook. Without treatment, survival can be less than six months, but with aggressive treatment, some patients may live longer, particularly if they respond well to therapy.

Advancements in treatment have led to improved survival rates for some patients, with more individuals living two years or longer. Early intervention and a multidisciplinary approach are essential for optimizing treatment effectiveness and enhancing survival rates.

In summary, glioblastoma is a challenging and aggressive form of brain cancer that requires
prompt and comprehensive treatment.

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