Glioblastoma Multiforme

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(GBM; Brain Tumor; Malignant Astrocytoma)

Definition

Glioblastoma multiforme (GBM) is the most common glioma—a type of brain cancer. This cancer starts in the glial cells, which are cells that help nerve cells work.
This condition can develop suddenly. It can also develop from a lower grade, less cancerous brain tumor. Most cases are located in the cerebral hemisphere of the brain. The cancer can also begin in the spinal cord or brain stem.
Brain Tumor
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Causes

GBM originates from astrocytes, which are a type of glial cell. The factors that cause normal-functioning astrocytes to become cancerous is not well understood.

Risk Factors

Factors that increase your chances of developing GBM include:
  • Age: over 50 years old
  • Ethnicity: Caucasians, Hispanics, Asians
  • Having a low-grade brain tumor, which occasionally develops into a higher-grade tumor
  • Having one of the following genetic disorders:
  • Having had radiotherapy
  • Working in the synthetic rubber or petroleum refining industries
  • Exposure to vinyl chloride or pesticides
  • Having had computed tomography (CT) scans during childhood

Symptoms

Symptoms include:
  • New onset headaches—more than 30% of patients
  • New onset seizures—20% to 30% patients
  • Progressive cognitive dysfunction—depends on the location of the tumor; problems with vision, language, motor function, or sensation may occur
  • Progressive neurological deficits, including weakness
  • Personality changes
  • Behavioral changes, development of inappropriate behaviors
  • Memory loss

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Images and scans may be taken of your brain. This can be done with:
Your brain activity may be measured. This can be done with:
Your bodily fluids and tissues may be tested. This can be done with:

Treatment

Surgery is often done to confirm diagnosis and relieve headache, but doctors cannot completely remove the cancer. Other types of treatment may include:
  • Radiation treatment is used to further decrease the size of the tumor.
  • Chemotherapy is used to increase survival time and quality of life.
  • Steroids to suppress swelling, antiseizure medication to suppress seizures, and pain medications are also used.
Even with aggressive treatment, few patients survive more than five years after diagnosis. However, there is evidence that medical and surgical intervention can increase life expectancy and improve quality of life.
A multi-disciplinary approach is important for you and your family. This approach may involve:
  • Support group
  • Psychotherapy and psychiatry
  • Pain management
  • Hospice care

Prevention

As the causes of GBM are unknown, there are no preventive measures.

RESOURCES

American Brain Tumor Association http://www.abta.org

National Brain Tumor Society http://www.braintumor.org

CANADIAN RESOURCES

Brain Tumor Foundation of Canada http://www.braintumour.ca

Canadian Cancer Society http://www.cancer.ca

References

Adult brain tumors treatment (PDQ). National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/adultbrain/healthprofessional . Updated May 14, 2013. Accessed June 11, 2013.

Brain tumors. The Merck Manual of Medical Information: Second Home Edition Online website. Available at: http://www.merck.com/mmhe/sec06/ch088/ch088b.html . Updated February 2008. Accessed June 11, 2013.

Glioblastoma multiforme. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 3, 2013. Accessed June 11, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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