Glioma: Definition, Symptoms, Causes, Types & Treatment

A glioma is a tumour that originates in the glial cells of the brain or spine. Glial cells are the supportive nervous system tissue that helps nerve cells function. The treatment responses and prognoses may vary depending on their type and grade.

Gliomas are categorised based on the form of glial cells from which it originates. The primary types of glioma are as follows:

1. Astrocytomas: These are the most common glioma types in adults. They arise from brain cells called astrocytes and are graded on a scale from I to IV. 

2. Ependymomas: Developing from ependymal cells lining the ventricles (fluid-filled spaces) in the spinal cord and brain. They rarely metastasise outside the brain and are more common in children than adults. 

3. Oligodendrogliomas: Originating from oligodendrocytes (a type of glial cell), these tumours are often slow-growing but can become aggressive over time. They are more common in adults than children. 

Gliomas are also classified based on the location. These may include: 

1. Optic Nerve Glioma: A slow-growing tumour affecting the optic nerve, often leading to vision problems. 

2. Brainstem Glioma: These tumours are located in the brainstem and are generally difficult to treat due to their critical location.

3. Insular Glioma: It is located in the insular cortex (grey matter tissue that lies deep to the lateral brain surface). 

4. Frontal Glioma: Tumours in the frontal lobe of the brain, potentially affecting behaviour.

Glioma Grades

Gliomas are classified into grades based on their appearance under a microscope growth rate. The World Health Organization (WHO) categorises the tumours into four grades:

1. Grade I: These low-grade gliomas are the least malignant and slow-growing tumours. Examples include pilocytic astrocytomas, which are more common in children. 

2. Grade II: Slow-growing tumours that tend to become more malignant over time. Low-grade oligodendroglioma is one example. 

3. Grade III: They are high-grade, malignant tumours that grow more quickly. Examples include diffuse infiltrating brainstem glioma and anaplastic oligodendroglioma. 

4. Grade IV: As high-grade gliomas, they are the most aggressive and fast-growing type. The most common example is glioblastoma.

Glioma symptoms can vary widely depending on the size, location, and type of tumour. Generally, they result from pressure on the brain or spinal cord and interference with regular functions. Some common symptoms associated with the condition are as follows:

1. Headaches, especially in the morning  

2. Nausea and vomiting 

3. Seizures 

4. Cognitive changes like difficulty thinking or remembering 

5. Double or blurred vision

6. Loss of balance or trouble walking 

7. Personality and/or mood changes 

8. Hemiparesis (weakness or paralysis in one side of the body) 

9. Aphasia (problems with speaking or understanding language)

The exact glioma causes are not known. Recent advancements suggest tumours can develop in the brain and spinal cord due to genetic mutations. Normally, the DNA in an individual’s genes regulate cell growth, division, and death. 

However, changes or mutations in the DNA can cause cells to multiply uncontrollably. This unregulated cell growth can lead to the formation of a tumour. 

Risk Factors of Glioma

Anyone can develop gliomas. However, certain factors can increase the risk in some individuals. The risk factors of glioma cancer are as follows: 

1. Age: The condition is most common in adults between 45 and 65 and children under 12. 

2. Gender: Gliomas are generally more common in males than in females. However, the reasons for this difference are not known.

3. Family History: Certain inherited genetic syndromes, such as neurofibromatosis and tuberous sclerosis syndrome, can increase the risk of gliomas.

4. Exposure to Radiation: Individuals exposed to ionising radiation, like during cancer treatment, have a higher risk of the condition. This is the only modifiable risk factor for glioma. 

Gliomas cannot be prevented completely because the significant risk factors for the condition are non-modifiable. However, some general strategies can help reduce the risk or aid in early detection. These include:

1. Minimise Radiation: Limit exposure to ionising radiation, particularly from medical imaging of the head, unless necessary, as per doctor’s advice. 

2. Lifestyle Choices: Adapt a balanced diet rich in fruits and vegetables, regularly exercise, and avoid tobacco and excessive alcohol consumption. This can support immune function and general well-being.  

3. Regular Check-ups: Reporting glioma tumour symptoms like persistent headaches and changes in vision can lead to earlier diagnostic imaging. 

4. Genetic Tumour Testing: It can provide insights into the risk of gliomas for individuals with a family history. 

Diagnosing a glioma involves a team of medical professionals, including neurologists, neurosurgeons, radiologists, and pathologists. The process involves a series of tests to help understand the presence, type, and extent of the tumour:

1. Medical History and Physical Examination: The doctor inquires about symptoms, family history, and other health conditions. Neurological exams check for impairments in vision, balance, coordination, strength, and reflexes. For optic nerve glioma, the doctor may examine the eyes to check for papilledema (optic nerve swelling).

2. Imaging Tests: Glioma radiology tests include MRI and CT scans, which help assess the location and size of the tumours. 

3. Biopsy: It removes a small tissue sample from the glioma for microscopic examination. Depending on the tumour location, biopsies can be performed as part of surgical removal. 

How to prepare for a doctor consultation?

Preparing for a doctor consultation involves several steps to ensure that patients get the most out of the visit. Here’s how they can prepare effectively: 

1. Collect all previous medical records and any relevant test results.

2. Prepare a list of all the current medications, including prescriptions, over-the-counter drugs, and supplements.

3. Note the symptoms, their frequency, and their impact on daily life. 

4. Write down questions for the doctor. 

Questions to Ask the Doctor 

When consulting a doctor about a glioma diagnosis, having a well-prepared list of questions is essential. This helps individuals understand their condition and the treatment options available. Some questions that they can ask include: 

1. What type of glioma do I have? 

2. What are the treatment options and recommended course of action? 

3. What are the potential side effects of these treatments? 

4. How will this affect my daily life? 

5. What is my prognosis? 

The treatment for the condition varies based on the type, location, size, and grade of the tumour. The patient’s age and overall health are also important considerations. Commonly performed glioma treatments include: 

1. Surgery: The primary treatment for gliomas is surgical removal with procedures like craniotomy. The goal is to remove all the tumours that are easily accessible without damaging healthy brain tissue. Complete removal can be challenging if the glioma is near sensitive areas that control vital functions.

2. Radiation: Often used after surgery to eliminate any remaining cancer cells. It can also be used as a primary treatment for gliomas that cannot be surgically completely removed. Techniques like brachytherapy allow precise tumour targeting, reducing exposure to surrounding healthy brain tissue.

3. Chemotherapy: It uses oral or intravenous drugs to kill cancer cells. Like radiation, it follows surgery to destroy remaining malignant cells. Temozolomide is a commonly used chemotherapeutic drug for gliomas. 

4. Tumour Treating Fields Therapy: A device that creates an electric field to hurt cancer cells is used to treat high-grade gliomas like glioblastoma. This treatment is used in combination with chemotherapy. 

5. Targeted Therapy: These treatments target specific abnormalities within cancer cells. They cause the malignant cells to die by blocking these chemicals or irregularities. 

Note: The treatment approach is selected based on the patient’s condition and the doctor’s opinion. 

Estimated Cost of Glioma Treatment 

The cost of glioma tumour surgery in India depends on several factors, including the hospital facilities and the surgeon's expertise. The approximate expenses are mentioned below:

Note: Patients should speak with HexaHealth consultants for up-to-date pricing information.

Delaying treatment for a glioma can lead to various risks, which may significantly impact a patient’s prognosis and quality of life. The rapid disease progression can cause life-threatening complications, such as: 

1. Brain haemorrhage (bleeding in the brain) 

2. Brain herniation (brain tissue shifts from its usual position within the skull)

3. Increased intracranial pressure (pressure inside the skull) 

4. Hydrocephalus (accumulation of fluid in the brain) 

5. Seizures 

When to call a doctor?

Early evaluation and diagnosis can significantly affect the management and outcome of the condition. Patients should call a doctor promptly if they experience the following symptoms: 

1. Worsening or persistent headache 

2. Seizures 

3. New neurological symptoms like changes in vision, speech, balance, or coordination 

4. Nausea and vomiting 

There is no evidence that a specific diet can cure gliomas or other types of brain tumours. However, certain dietary considerations can support overall health and aid in managing symptoms or side effects of treatments. These guidelines are as follows: 

1. Whole Grains: provide essential nutrients and fibre that aid in maintaining digestive health and overall well-being. Examples include whole wheat, oats, and barley. 

2. Fruits and Vegetables: are rich in antioxidants that help reduce oxidative stress and inflammation.

3. Plant-Based Protein: Besides proteins, sources like lentils, nuts, and beans also provide fibre. 

4. Fish and Fish Oil: High in omega-3 fatty acids, these have anti-inflammatory properties and offer benefits for brain health.

Foods that one should avoid during brain tumour treatment are as follows: 

1. Red meat 

2. Processed foods 

3. Unpasteurised milk 

4. Rare or undercooked poultry or shellfish

A glioma is a type of brain tumour that arises from glial cells. Its aggressiveness and prognosis vary widely. Treatment strategies for gliomas involve surgery, radiation, and chemotherapy tailored to the individual’s specific tumour characteristics. Early detection and advanced medical intervention are key to managing these tumours effectively.

At HexaHealth, we specialise in assisting patients who experience glioma symptoms, connecting them with expert doctors for optimal care. We help facilitate timely diagnoses and personalised treatment strategies. Our team ensures that each individual receives comprehensive support throughout their treatment.

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