Glioma

A glioma is a tumor that forms when your body’s glial cells grow out of control. Glial cells support your nerves and help your central nervous system work. If they grow uncontrollably, they can form tumors in your brain or spinal cord.

Gliomas are primary tumors. This means they form directly in your brain or spinal cord. They’re serious tumors that can be life-threatening. But treatments are available to help manage the disease.

Your care team will make a treatment plan that’s unique to your body, health and needs. They’ll help you understand the best next steps.

Types of gliomas

Healthcare providers grade gliomas by how quickly they grow. They define grade by:

• How fast the tumor grows
• How abnormal the cells look
• How likely it is to spread

Four grades range from grade 1 (the slowest growing) to grade 4 (the most aggressive that grow fastest). Providers also group grades together as low (grades 1 and 2) or high (grades 3 and 4). Early detection and treatment of low-grade gliomas may slow or prevent them from becoming high-grade.

Another way to classify gliomas is by the type of glial cells they form in, including:

• Astrocytomas: These tumors start in star-shaped brain cells called astrocytes. They range from slow-growing (low-grade) to aggressive (high-grade).
• Glioblastomas (WHO grade 4): These are the most aggressive type of glioma. They’re considered a distinct diagnosis, not just a subtype of astrocytoma. They’re also the most common type of malignant brain tumor in adults.
• Ependymomas: Ependymomas affect children more than adults. They’re usually low-grade gliomas.
• Oligodendrogliomas: Oligodendrogliomas are rare, low-grade gliomas. They affect adults more than children.

All these terms help providers communicate to each other exactly what’s happening inside your body. Your provider will help you understand everything you need to know.

Symptoms of a glioma

A glioma can cause different symptoms depending on where it forms. Some of the most common glioma symptoms include:

• Changes in your vision or sudden vision loss
• Difficulty walking or keeping your balance
• Dizziness
• Headaches
• Nausea and vomiting
• New depression or anxiety
• Personality changes or sudden mood swings
• Seizures
• Trouble speaking or communicating (aphasia)
• Trouble thinking, learning or remembering (cognitive problems)
• Weakness or numbness on one side of your body (hemiparesis)

Glioma causes

Genetic changes in glial cells cause gliomas. Providers don’t always know why these changes occur.

While you can’t prevent gliomas, staying informed and seeking care early if you notice symptoms may improve outcomes.

Risk factors

Anyone can develop a glioma. But some factors may increase your risk, including your:

• Age: Gliomas are most common in adults after age 65 and in children before age 12.
• Family history: Some genetic disorders that you can inherit from your biological family may increase your risk.
• Race: People who are white may be more likely to develop gliomas than other races.
• Radiation or toxin exposure: Repeated exposure to radiation or certain chemicals may increase your risk.

If brain or spinal cord tumors run in your biological family, you may want to consider genetic testing for cancer risk. Talk to a healthcare provider about genetic counseling.

But you don’t need to worry because most gliomas aren’t linked to clear risk factors.

How doctors diagnose a glioma

A healthcare provider will diagnose a glioma by reviewing your medical history and running tests. They’ll give you a physical and a neurological exam.

You’ll need imaging tests like an MRI or a CT scan. These tests will show the tumor in your brain or spinal cord. If your provider sees signs of a tumor on imaging tests, they’ll do a biopsy. This will tell them which type of tumor it is and its grade.

Molecular testing on biopsy tissue is a standard to make a glioma diagnosis.

You may see a neuro-oncologist, a specialist in brain and spinal cord cancers, to manage this condition.

How is a glioma treated?

The best treatments for you will depend on a few factors, like:

• The glioma’s type, size and location
• Your age
• Your overall health
• If you’ve had brain or spinal cord cancer treatment in the past

You’ll need a combination of:

• Surgery
• Radiation therapy
• Chemotherapy

Surgery

Surgery is often the first treatment for gliomas, when the tumor is accessible. A surgeon may be able to remove all of the tumor. But gliomas can be hard to remove completely because they may form in hard-to-reach areas.

A craniotomy (open brain surgery) is the most common type of removal brain surgery. If the glioma is in your spinal cord, you may need stereotactic radiosurgery or another type of spinal surgery.

Depending on the size and location of the tumor, you may be a candidate for laser ablation. This minimally invasive surgery uses heat from a laser to destroy all or part of the tumor.

Radiation and chemotherapy

You’ll probably need radiation therapy and chemotherapy (chemo) after surgery. These treatments destroy any remaining cancer cells or parts of the tumor your surgeon couldn’t safely remove.

Radiation kills cancer cells. You may get radiation from an external beam machine. It uses high-powered X-rays to target cancer.

Chemo is a group of medications your providers will give you that stop cancer cells from growing and multiplying.

Your providers might use radiation and chemo as your main treatments if it’s not safe to surgically remove the glioma.

What are the side effects of glioma treatment?

Almost everyone has side effects from cancer treatments. Some treatments cause side effects that last for years. Ask your providers about palliative care that can help you manage glioma symptoms and treatment side effects. The most common treatment side effects are:

• Anemia
• Cancer fatigue
• Cognitive changes
• Hair loss (from radiation)
• Nausea and vomiting
• Pain
• Risk of infection (from chemo)

When should I see my healthcare provider?

You’ll need to visit your healthcare providers for follow-up visits to monitor for any changes. Your provider will order regular imaging scans to see if the cancer spreads or comes back (recurs).

You might need physical therapy to strengthen your body during and after treatment. Your providers may suggest occupational therapy to help you adjust to changes in your body.

Glioma survival rate

Survival rates for gliomas vary. It depends on the tumor type, grade and your age. Usually, the younger you are when you’re diagnosed and treated, the better the outlook.

The five-year survival rate is how many people with a type of cancer are alive five years after diagnosis.

Glioblastoma has the lowest five-year survival rate compared to other gliomas. Low-grade ependymomas, oligodendrogliomas and astrocytomas tend to have the highest five-year survival rate.

Your healthcare providers will tell you what to expect. Your case may or may not match statistics.