Glioblastoma Multiforme

Glioblastoma multiforme (GBM) is unfortunately one of the most common forms of brain cancer. It is also the most aggressive, invasive and fast growing tumor of the brain or spinal cord. In fact, it is one of the most malignant and aggressive tumors that can occur anywhere in the body.

GBM is a tumor of glial cell origin. The glial cells are the supporting cells which are abundant throughout the central nervous system. They include astrocytes, oligodendrocytes and ependymal cells.

The symptoms of glioblastoma can vary depending on the location and size of the tumor. In general, they are the same types of symptoms as can occur with any type of brain cancer. However, symptoms tend to evolve quickly in patients with GBM because of its rapid growth and invasion of the surrounding brain tissue.

The diagnosis of these tumors usually starts with an MRI of the brain which demonstrates an enhancing tumor in the brain tissue. However, because other conditions can appear similar on brain scans, a definitive diagnosis cannot be made until some tumor tissue is sampled, either by a biopsy or more complete surgical removal of the tumor, and analyzed by a pathologist.

The cause of glioblastoma multiforme is not known. However, they tend to be slightly more common in older age and in males. Some other risk factors have been suggested but none are strong, clear causes of this fearful tumor.

Treatment of GBM depends on many specific features of each individual case but often involves multi-modality treatment. This means that any one patient is often recommended to undergo more than one type of treatment. Surgery to remove as much of the tumor as safely possible, as well as to confirm the diagnosis, is often a first step. This is often followed by some combination of radiation treatment and chemotherapy. The most commonly used chemotherapy drug for these malignant gliomas is temozolomide (Temodar).

Prognosis for patients with glioblastoma is grave in most cases. Without treatment, this disease will claim the life of most patients in less than a year. With maximal treatment, including surgery, radiotherapy and chemotherapy, patients can survive somewhat longer. The exact prognosis depends on many other patient-specific factors such as age at diagnosis, neurological symptoms and functioning at the time of diagnosis and some factors of the tumor itself. However, currently, the improvement in prognosis with maximal treatment is modest at best and this type of cancer cannot be cured. Several clinical trials and basic science research projects are underway to test novel treatments that hopefully will improve the outcome for patients with GBM in the future.