What is a glioma?

The generic term glioma refers to a group of neurological oncological diseases. These are brain tumors, often malignant, that originate in glial cells, the cells that form the nervous system along with neurons and blood vessels. The role of glial cells is to nourish and support neurons, thus protecting nervous tissue in case of injury due to external factors.

Gliomas can develop in any part of the central nervous system, but those that form in the brain are much more frequent than those that originate in the spinal cord. They are most often malignant neoplasms whose grade can vary and which generally tend to spread within the central nervous system, but very rarely outside the brain.

What are the causes and risk factors for glioma?

The specific causes leading to the development of gliomas are not yet clear. A number of risk factors have been identified, i.e., conditions that increase the likelihood of developing the tumor.

First, having one or more gliomas in the same family increases the risk of developing a gliomatous tumor, which is estimated to be twice as high as in the absence of a family history.

Another known risk factor is exposure to ionizing radiation, particularly in the case of radiotherapy performed to treat tumors during childhood. These individuals have a higher risk than the rest of the population of developing a glioma, even decades after the initial treatment.

Finally, certain rare hereditary syndromes can increase the risk of developing a glioma. These include Cowden, Turcot, Lynch, Li-Fraumeni syndromes, and type I neurofibromatosis.

 

What are the symptoms?

The symptoms of gliomas depend on the type of tumor and its location, and are therefore very variable. However, certain signs and symptoms are present in the majority of cases, alone or in combination, at the time of diagnosis and persist throughout the disease.

The most common symptoms are epileptic seizures, which can affect the limbs but also spread throughout the body and lead, in severe cases, to fainting. Gliomas are often associated with various neurological problems, depending on the areas of the brain affected by the tumor. There may be deficits in vision, speech and understanding, function or sensitivity of certain parts of the body, motor coordination and memory. In addition, changes in behavior and personality may occur.

In some types of gliomas, symptoms related to the pressure exerted on the skull by the growing tumor mass are frequent: headaches, nausea and vomiting, drowsiness and visual disturbances (usually double vision) may appear in this situation.

In addition, thromboembolic events, i.e., the formation of thrombi (blood clots) in blood vessels, are also frequent, often due to motor deficits related to the tumor or treatment.

 

How to diagnose glioma

The diagnosis of glioma begins with the observation of symptoms, which the doctor then examines in more detail, including specific neurological tests.

If suspected, the diagnosis is made using radiological examinations, computed tomography scans and especially MRI of the brain, both performed with contrast agents.

Brain MRI not only allows the detection of gliomas, but also determines their size and whether they can be safely removed by surgery.

To confirm the diagnosis and study the characteristics of the tumor, a histological examination is performed by taking a sample of the tumor and analyzing it in the laboratory, which is also useful in determining the best treatment for each specific case.

 

Treatment of glioma

For most gliomas, the treatment of choice, if possible, is surgical removal of the tumor, which is the most effective treatment for all types of glioma and offers the best results. After surgery, possible treatments are radiotherapy and/or chemotherapy, depending on the grade of the tumor.

In some types of gliomas, patients who are at high risk of tumor recurrence are also generally treated with radiotherapy. Chemotherapy, on the other hand, may be useful in patients who cannot undergo surgery or in whom the disease recurs.

Anaplastic gliomas are generally treated with radiotherapy followed by chemotherapy.

Finally, glioblastomas, i.e., the most aggressive gliomas, are treated with radiotherapy and concomitant chemotherapy in patients deemed suitable for polytherapy according to their age, condition and certain genetic characteristics. Other patients may be treated with either therapy, depending on the doctor's assessment.

 

Can you survive a glioma?

Survival depends on the type of glioma and especially its degree of malignancy, but also on the therapies received.

For low-grade gliomas, survival after surgery is long if there are no particular risk factors and there is no recurrence, which is quite rare.

For grade III gliomas, such as anaplastic astrocytomas, if surgery allows complete removal and is followed by chemo-radiotherapy, the average survival is estimated at 30 months.

Finally, for glioblastomas, the most aggressive malignant brain tumors, studies indicate an average survival of about 15 months, with a percentage of surviving patients after treatment of 50% at 1 year, gradually decreasing to reach 10-15% at 5 years.

 

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