Glioblastoma: Causes, Symptoms, Treatment and Cost

Glioblastoma is a kind of brain cancer that develops in the glial cells. Glial cells are the support cells that surround and help protect neurons (nerve cells). Glioblastoma is an aggressive form of cancer, growing and spreading quickly. It may develop at any age, although it is more common in older adults.

There are several different types of glioblastoma including:

• Primary GBM: This type of GBM occurs in people with no prior history of cancer or other health issues. It is most common in individuals aged 45 to 70, and it accounts for around 15% of all brain tumours.
• Secondary GBM: This type of GBM occurs when another type of cancer spreads to the brain from another area, such as lung cancer or breast cancer. It accounts for 85% of all glioblastoma cases.
• Gliosarcoma: This is a rare subtype of glioblastoma that has both sarcomatous (tissue-like) and glial (nerve-like) components present within the tumour tissue. It typically affects younger patients, between 20 and 40 years old, and makes up less than 2% of all GBM cases.
• Giant Cell Glioblastoma: Giant cell glioblastoma is an uncommon subtype characterised by large cells intermingled with smaller cells in the tumour tissue sample under a microscope . It usually affects older patients over 60 years old, making up about 5-7% of all GBM cases

• Glioblastoma is a type of aggressive brain cancer, which is caused by changes in certain genes that control cell growth and division.
• There are risk factors associated with developing glioblastoma, including exposure to certain chemicals, radiation, and viruses.
• Some research suggests that genetics may also play a role in development of the disease.

• Headaches: Glioblastoma may result in chronic, severe headaches.
• Nausea and vomiting: These are typical glioblastoma symptoms, accompanied with dizziness and confusion.
• Seizures: Seizures may occur due to the pressure of the tumour on the brain tissue.
• Memory loss or difficulty concentrating: Glioblastoma can cause problems with short-term memory, concentration, and understanding complex information.
• Speech difficulties: Glioblastoma can affect speech due to its location in the brain and its interference with normal brain function.
• Personality changes: Some people may experience personality changes as a result of glioblastoma due to its impact on brain function and hormones associated with mood regulation.
• Blurred vision or double vision: Glioblastoma can cause vision problems such as blurred or double vision due to its effect on the optic nerve or other areas of the brain responsible for vision processing

• Avoid exposure to environmental toxins: Exposure to certain environmental toxins, such as formaldehyde, benzene, and pesticides, can increase your risk of glioblastoma.
• Reduce alcohol consumption: Glioblastoma risk is increased by excessive alcohol use.
• Exercise regularly: Regular exercise has been linked to a lower risk of glioblastoma and other types of cancer.
• Quit smoking: Cigarette smoking increases the chance of glioblastoma and other cancers.
• Eat a healthy diet: Risks for glioblastoma and other cancers may be lowered by eating a diet rich in fruits, vegetables, healthy grains, and lean meats.

• Medical history and physical exam: To look for signs of a brain tumour, a doctor will ask about symptoms and do a physical exam.
• Imaging tests: To aid in the detection of tumours, imaging techniques like magnetic resonance imaging (MRI) and computed tomography (CT) scans are used to provide high-resolution images of the brain.
• Biopsy: A sample of the tumor's tissue is removed for microscopic examination. This is currently the only reliable method for diagnosing glioblastoma.

Another test could be a blood test or an analysis of cerebrospinal fluid to look for certain proteins that are often found in people with glioblastomas.

• Seizures: Glioblastoma can cause seizures due to the presence of abnormal cells in the brain.
• Cognitive decline: Glioblastoma can cause cognitive decline due to the pressure placed on the brain by tumour growth and damage to healthy tissue.
• Vision loss: Glioblastoma can cause vision loss due to its location near the optic nerve and its ability to spread quickly throughout surrounding tissue.
• Mood changes: Glioblastoma can lead to mood changes due to disruption in neurotransmitters caused by tumour growth or treatment side effects.
• Balance issues: Glioblastoma can lead to balance issues as a result of its effect on nearby motor centres in the brain or from swelling caused by tumour growth.

• Turmeric: Turmeric is known to have anti-inflammatory and antioxidant properties, which can help reduce inflammation in the body and reduce oxidative damage caused by Glioblastoma cells.
• Ginger: Ginger is another excellent herb with potent anti-inflammatory qualities that may aid in lowering inflammation and pain caused by Glioblastoma tumours. It may also aid in improving cognitive function in those suffering from Glioblastoma.
• Ashwagandha: Ashwagandha is an Ayurvedic herb that has been used for centuries as a natural remedy for a variety of conditions, including cancer treatment and prevention. Studies suggest it may have anticancer effects on Glioblastoma cells, as well as improve quality of life by decreasing anxiety and depression associated with the disease.
• Triphala: Triphala is a combination of three herbs (amalaki, bibhitaki, haritaki) that are known to have anti-inflammatory, antioxidant, and immunomodulating properties which could be beneficial for treating Glioblastoma tumours. Studies suggest it may also help improve cognitive function in those suffering from the disease as well as reduce side effects of chemotherapy treatments used to treat Glioblastomas such as nausea, vomiting, fatigue, etc..
• Guggul: Guggul is an Ayurvedic herbal remedy made from the resin of the Commiphora mukul tree which has long been used in traditional Indian medicine to treat numerous diseases including cancerous tumours such as glioblastomas due to its anti-tumor activity on glial cells (brain tumour cells). Guggul has also been shown to enhance immunomodulatory activity which can help fight off infection or other disorders related to weakened immunity caused by glial cell cancers such as glioblastomas.

• Eating a diet rich in nutrient-dense foods is beneficial for those with glioblastoma.
• Include a lot of fruits, vegetables, whole grains, lean proteins, essential fats, and protein sources that come from plants.
• Consume plenty of antioxidants and foods high in omega-3 fatty acids to support brain health and reduce inflammation.

• Processed meats: It is best to avoid processed meats such as bacon, sausage, hot dogs and deli meats due to their high levels of preservatives and additives.
• Refined carbohydrates: High-sugar, refined carbohydrates such as white bread, white pasta, pastries and sugary cereals should be avoided as they can cause inflammation and disrupt blood sugar levels.
• Alcohol: Drinking alcohol can increase the risk of developing certain types of cancer including Glioblastoma so it is best to avoid or limit alcohol intake.
• Fried foods: French fries, fried chicken, and doughnuts are just a few examples of the kinds of high-fat, fried foods that have been linked to a higher risk of inflammation and cancer in the body.
• Red meat: Red meat such as beef, pork and lamb have been linked to an increased risk of developing Glioblastoma so it is best to limit or avoid these types of meats altogether.

• Radiation therapy: Radiation therapy involves destroying cancer cells with high-energy beams. It is often provided after surgical procedures.
• Chemotherapy: In chemotherapy, drugs are used to eradicate cancer cells. Chemotherapy drugs like temozolomide are often used to treat glioblastoma.
• Clinical trials:Some people with glioblastoma might be able to take part in clinical trials of new treatments.
• Gross total resection (GTR): During this procedure, the surgeon will attempt to remove a significant portion of the tumour.
• Subtotal resection (STR): This surgery aims to remove as much of the tumour as possible without causing significant neurological deficits.
• Stereotactic radiosurgery (SRS): This is a type of radiation therapy that uses a precisely focused beam of radiation to treat a small, well-defined area of the brain.
• Fractionated Stereotactic Radiotherapy (FSRT) : This approach of radiation therapy involves directing numerous beams of radiation to the area where the tumour is located.
• Optune: This is a device that delivers low-intensity electric fields to the brain, which can slow or stop the growth of cancer cells.
• Laser interstitial thermal therapy (LITT): This procedure uses a laser to heat and destroy cancer cells in the brain.

• Depending on the severity of the tumour, you may need to see an oncologist, neurosurgeon, or radiation oncologist.
• An oncologist will work with you to develop a treatment plan and provide medication if necessary.
• The tumour may be removed by surgery performed by a neurosurgeon.
• Finally, a radiation oncologist will use radiation therapy to kill cancer cells and shrink the tumour.

• Immunotherapy: Pembrolizumab, nivolumab, and atezolizumab are examples of medicines that assist the body's immune system in recognising and eliminating cancer cells.
• Tocilizumab: It is an interleukin-6 receptor antagonist that blocks the activity of a protein that helps cancer cells grow and stay alive.
• Targeted therapy: Drugs, like lapatinib, that target certain proteins or pathways in cancer cells to slow or stop their growth.
• Steroids: Medications such as dexamethasone that have the ability to lessen swelling and inflammation in the brain brought on by the tumour.
• Supportive therapy: Medications like anti-seizure drugs, pain relievers, and anti-nausea drugs to help with the symptoms of the disease.
• Temozolomide: Temozolomide is a chemotherapeutic medication that may be taken orally and is often used in the treatment of glioblastoma. It is effective because it disrupts the DNA of cancer cells, which in turn prevents those cells from growing and dividing.
• Other chemotherapeutic drugs: Procarbazine, lomustine, and vincristine are all chemotherapy drugs that work by slowing the growth of cancer cells. They are usually given along with other drugs.
• Anti-angiogenic drugs: Bevacizumab, aflibercept, cediranib, and irinotecan are all anti-angiogenic drugs, which means they attack the blood vessels that feed the tumour. By cutting off the tumour's blood supply, these drugs can slow the growth of cancer.

Recovery from glioblastoma can depend on many factors, including the size and location of the tumour, the patient's age and overall health, and the type of treatment received.

Generally, recovery time can range anywhere from weeks to months or even longer, depending on these factors. It is important for patients to follow their doctors' orders during this time, as proper rest and nutrition are essential for recovery.

The tumour can recur despite treatment and progression of the disease is common in many cases.

Patients may go into remission after treatment and experience a period of improved health, however this is often temporary as the cancer can return at any time.

• Regular follow-up visits with a healthcare provider to monitor for recurrence of the tumour.
• To identify any changes in the tumour, imaging techniques like as MRIs or CT scans might be used.
• Blood tests to check for markers that indicate recurrent glioblastoma or other tumours in the brain or elsewhere in the body.
• Treatment options such as radiation therapy and chemotherapy, which may be recommended depending on the type and stage of the cancer, as well as an individual’s age, health, and other factors.
• Participation in clinical trials and/or support groups to stay informed about new treatments and research findings that may be beneficial for managing glioblastoma symptoms and side effects associated with treatment.

Generally, Glioblastoma treatment can cost anywhere from Rs. 35,000 to Rs. 2 lakhs for basic treatments such as surgery, radiation and chemotherapy.

For more advanced treatments such as immunotherapy, radiosurgery and targeted therapies, the cost can range from Rs. 3 lakhs to Rs. 6 lakhs or more.

• Physical side effects of Glioblastoma treatments may include fatigue, nausea, vomiting, hair loss, and decreased appetite.
• Cognitive side effects may include memory loss, confusion, and difficulty concentrating.
• Neuropsychological side effects may include headaches, balance problems, seizures, language difficulties and vision changes.
• Psychological side effects may include depression or anxiety due to the diagnosis and treatment of the disease.

Consult a doctor if you are experiencing any glioblastoma-related symptoms since they may lead to seizures, changes in speech, vision, and memory, difficulty with coordination and balance, and other issues for which the length of the therapy will depend on how severe the problem is.