Gliomas are cancerous tumors that form in glial cells, supporting tissue in the brain and spinal cord. They are usually slow-growing and don’t spread to other parts of the body.
Doctors classify gliomas into grades, based on how aggressive the tumor cells are and how quickly they grow. People with low-grade gliomas have the best chance of survival.
1. What is a Glioma?
A glioma is a type of brain tumor. It starts when cells in the brain or spinal cord develop changes in their DNA. These changes cause the cells to grow and divide more quickly than normal. The excess cells can press against nerves and other parts of the brain and spinal cord. The pressure can cause symptoms like headaches, memory problems and seizures. It can also reduce the brain’s ability to work properly and can lead to long-lasting disability or, if untreated, death. Doctors aren’t sure what causes glioma. They know that the change in DNA begins with a single cell and can spread to other cells. The cells can be either benign (not cancer) or malignant.
There are five different types of glioma. They are classified by their microscopic appearance and by how much they resemble other brain tissue. They are also classified by how fast or slow they grow and by the type of cellular DNA they have. The lower the grade, the less likely it is to be malignant. The highest grade gliomas are called astrocytomas and include astrocytoma, oligodendroglioma and ependymoma.
The grading system also looks at the amount of “differentiation” that the tumor shows. Differentiation refers to how much the tumor cells resemble other brain tissue. Differentiated gliomas are low grade and non-malignant, while undifferentiated gliomas are high grade and malignant.
Most gliomas are made of slowly growing cells. They are usually benign, but they can sometimes become malignant over time. They can also transform into a higher-grade tumor if they are exposed to radiation or chemotherapy.
Gliomas can start in any part of the brain or spinal cord. They are more common in children and young adults. They can also happen in the lower part of the brain called the brain stem, which controls functions we don’t think about like breathing. Gliomas in the brain stem are called diffuse intrinsic pontine gliomas.
Doctors treat gliomas with surgery, radiation and chemotherapy. They also use medications to help control symptoms and prevent seizures. They may also prescribe steroids before, during and after treatment to protect against complications such as edema (swelling of the brain) and cerebral ischemia (lack of oxygen in the brain). In late stage gliomas, when they are not curable, doctors focus on improving quality of life by relieving symptoms.
2. What are the Symptoms of Glioma?
Glioma symptoms depend on the type of tumor, its location, and whether it is growing or recurring. They can range from mild to severe, and may cause a variety of symptoms. Some people have no symptoms at all, while others have a headache, weakness on one side of the body, or problems thinking or remembering. Symptoms usually develop as the tumor grows and puts pressure on brain cells. The symptoms that are most common include seizures, loss of consciousness, confusion, a change in vision, or changes in the way the body moves.
The most common sign of a glioma is seizures. About 60 percent of people with a glioma have seizures, which can vary in severity. They may be very mild and only involve a brief dizziness or a feeling of unsteadiness, or they can be more intense and lead to uncontrolled shaking. Other symptoms that may occur are a headache, numbness or weakness on one side of the body, problems thinking or remembering, and changes in the way the eyes move.
A doctor can diagnose a glioma by doing an MRI or CT scan of the brain and looking for the tumor. The tumor can be surgically removed or destroyed with radiation or chemotherapy.
If the glioma is low grade, doctors can usually cure it. However, it is very important to follow up regularly with your healthcare provider, have regular MRI scans, and take part in any tests that might be done, such as a positron emission tomography (PET) scan, to look for signs that the tumor has returned or spread.
Doctors aren’t sure what causes a glioma, although it is possible that certain things increase the risk of getting one, such as radiation to the head in the past or having someone close to you with a glioma. It’s also possible that a genetic predisposition plays a role, as do some chemicals. There is no way to prevent a glioma, but it is important to limit your exposure to radiation and chemicals. It’s also a good idea to talk with your healthcare provider about genetic testing for a family history of brain tumors.
3. What is the Diagnosis of Glioma?
Gliomas are types of brain tumors that grow out of cells called glial cells. These cells normally support nerve cells and help the central nervous system work. When a glioma grows, it can press on the brain or spinal cord and cause symptoms. There are several types of glioma, and they can be either slow or fast growing. They are also classified by their appearance under a microscope and by how they grow. Most gliomas are not cured.
A glioma can be found by having imaging tests such as an MRI or CT scan. Depending on the type of glioma, your healthcare provider may order a biopsy to take samples of brain tissue for a laboratory test. The biopsy can help your doctor tell whether the glioma is cancerous or not.
When a glioma is diagnosed, your healthcare provider will discuss treatment options with you. For most people, surgery and radiation therapy are the best treatments for a glioma. Other treatments include chemotherapy and biologic therapy. Your healthcare provider will explain these treatment options to you and answer your questions.
Because gliomas usually infiltrate the brain, it is important to remove as much of the tumor as possible during surgery. Your healthcare provider can use techniques such as brain mapping during surgery to know which areas of the brain control vital functions. This helps the surgeon avoid removing or damaging healthy brain tissue during surgery.
A low-grade glioma can grow slowly and is not as likely to spread to other parts of the brain or spine. For this reason, a low-grade glioma has the best prognosis of all glioma types.
High-grade gliomas are often very fast-growing. They can spread to other parts of the brain or spinal cord very quickly and are likely to be life-threatening. A higher-grade glioma is more likely to be malignant and less likely to respond to treatments such as surgery or radiation. It is also more likely to have mutations in the genes TP53 and ATRX, which are involved in the processing of DNA. These tumors are also more likely to have a family history of brain tumors.
4. What is the Treatment of Glioma?
Glioma is a brain tumor that starts from cells that support neurons (nerve cells) in the brain and spinal cord. These cells are called glial cells and include astrocytes, oligodendrocytes and ependymal cells. A glioma can be slow-growing or fast-growing, but a definitive diagnosis requires a biopsy. Doctors then use the cell types and molecular changes in the tumor to categorize a glioma from low-grade (grade I and II) to high-grade (grade III and IV).
There are four main treatment options for a glioma: observation, surgery, radiation and chemotherapy. Your health care provider will recommend the best option based on the type, grade and location of your tumor.
If the glioma is in a part of the brain that is difficult to reach or near delicate areas, your health care provider may choose to observe it instead of surgery. They will monitor it regularly for changes and then treat the symptoms as they develop.
A glioma that is in a very sensitive area of the brain, such as the cerebellum, may need to be treated with both surgery and radiation. This can improve your chances of having a complete cure.
Surgery is usually the first choice for gliomas because they are generally curable with complete removal. Radiation and chemotherapy are often used with surgery to destroy any remaining cancer cells and prevent them from growing back.
Doctors use a variety of medications to help reduce the side effects of these treatments. They can also try a newer type of treatment called targeted therapy, which targets certain proteins that help tumors grow and may make them shrink. This is given with a device that puts electrical fields directly on the scalp, called Optune.
Gliomas aren’t always curable, especially if they have spread beyond the original tumor. However, you and your health care team can work together to manage your symptoms, which may allow you to live longer.
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