Glioblastoma - course of the individual stages

introduction

Glioblastoma is an advanced, malignant tumor of the brain. It does not start from nerve cells, but from the supporting cells of the brain, the star cells (Astrocytes). Accordingly, the glioblastoma is one of the Astrocytomas (Star cell tumors). Due to the poor prognosis and poor treatment options, glioblastoma is classified as a grade 4 (of four grades) astrocytoma.

Lower grades of astrocytoma are not actually glioblastomas. The classification is only a snapshot, however, as the tumors change over time and become more malignant (become higher grade). This tumor occurs most frequently in adults between 45 and 60 years of age, or in children under two years of age, although it is significantly less common in children than in adults.

Read more on the topic: Prognosis of a glioblastoma

What is grade 1 glioblastoma like?

Grade 1 glioblastomas - actually Grade 1 astrocytomas - are also called benign (benign) Called astrocytomas. Very rarely do they develop into a malignant astrocytoma. These tumors usually appear in childhood and adolescence.

A wide variety of symptoms can occur depending on where it occurs. The most common are visual disturbances (if they occur near the optic nerves), unsteady gait and dizziness with movement disorders (if they occur near the cerebellum) and facial paralysis and sensory disorders in the face (due to cranial nerve failure - if the brainstem occurs). Symptoms appear gradually and get worse over time. In some cases, they can come on very suddenly.

Grade 1 astrocytomas do not grow into the surrounding tissue, but can displace it and compress it so strongly that it is damaged. Depending on the location of the tumor and the symptoms, a different therapy can be sought. If the tumor is favorable, an operation (Resection) the method of choice. Often the tumor can be removed completely. The patient is thus cured.

If it is very unfavorable, it will continue to be monitored. If it changes significantly or is located in very sensitive areas of the brain (for example near the breathing center on the brain stem), radiation therapy is sought, which can also lead to healing.

Read more on the topic:

• Radiation therapy planning
• Effect of radiation therapy
• Behavior during radiation therapy

What is grade 2 glioblastoma like?

Grade 2 glioblastomas - actually Grade 2 astrocytomas - are also called diffuse astrocytomas designated. These tumors usually appear around the age of 30. They are generally considered to be less malignant (low grade), but the majority of these tumors become more malignant over time and progress to a higher grade.

The symptoms, in turn, are strongly dependent on the location of the tumor. General intracranial pressure symptoms, such as nausea, headache, dizziness, vomiting and lethargy, are more common than with grade 1 astrocytoma. The most common symptom is suddenly occurring epileptic seizures. The symptoms do not appear until the tumor reaches a certain size, so that the patient has no symptoms at all for a long time and the disease is diagnosed quite late.

Read more on the topic: Increased intracranial pressure - signs, causes, and treatment

Here, too, an operation is sought, whereby the tumor can usually not be completely removed. Accordingly, radiation therapy and, under certain circumstances, chemotherapy can be included in the therapy plan (especially for children). A cure is usually no longer possible. With optimal therapy, there is an average life expectancy of 11 years.

Read more on the topic: Conducting chemotherapy

What is grade 3 glioblastoma like?

Grade 3 glioblastomas - actually Grade 3 astrocytomas - are also called undifferentiated (anaplastic) Called astrocytomas. These tumors usually appear between the ages of 35 and 55 years. They are considered malicious (malignant) classified. Often they arise from grade 2 astrocytomas, but they can also appear new (de novo).

They grow very quickly and penetrate into the surrounding tissue (infiltrate). The symptoms are no different from those of grade 2 astrocytomas. General intracranial pressure symptoms and epileptic seizures belong to the classic appearance.

Here, too, the therapeutic aim is to remove the tumor as much as possible. Complete removal is not possible. Radiation therapy and chemotherapy are then carried out. Even with optimal treatment, healing is usually not possible. The average life expectancy is 9 years.

Read more on the topic: Side effect of chemotherapy

What is grade 4 glioblastoma like?

Grade 4 astrocytoma is also known as glioblastoma. The glioblastoma grows very quickly and infiltrates the surrounding tissue with microscopic, tentacle-like extensions.

Symptoms are the same as with Grade 3 astrocytoma, but here they often appear within weeks or a few months because the tumor is growing so quickly.

The aim is an operation in which as much of the tumor as possible is removed, but a complete removal is not possible because the tumor has already sent microscopic runnings into the surrounding brain. This is followed by radiation therapy and, depending on the genetic profile of the tumor, specific chemotherapy.

It is between the primary (de-novo) A distinction was made between glioblastoma and secondary glioblastoma. The primary glioblastoma occurs again and does not develop from lower precursors (e.g. astrocytoma grade 3). It mainly occurs around the age of 60 and unfortunately has a very poor prognosis. Even with optimal treatment, the average life expectancy is only 10-15 months.

Secondary glioblastoma is much rarer and develops from preliminary stages (e.g. grade 3 glioblastoma). It only makes up about 10% of grade 4 glioblastomas. It mainly occurs around the age of 45. Unfortunately, no cure is possible here either, but the average life expectancy of 2-2.5 years is slightly better than for secondary glioblastoma.

Read more on the topic:

• End-stage glioblastoma
• Life expectancy with a glioblastoma

How is the course of a relapse?

Unfortunately it is not possible to make a general statement for all recurrences. It depends much more on which tumor was present before and which is now - the same or a more developed, malignant tumor. The location of the tumor is also important, as this determines the symptoms.

Since all astrocytomas tend to become more malignant over time, the prognosis for a relapse is usually worse than for the original tumor.

What is the life expectancy?

Life expectancy depends primarily on the degree of the astrocytoma and whether therapy is being carried out.

Cure is possible in grade 1 astrocytoma. The prognosis is good. Even if a complete removal is not possible, the growth of the tumor is slow.

When treating a grade 2 astrocytoma, the average life expectancy is 11 years.

When treating a grade 3 astrocytoma, the average life expectancy is 9 years. If a grade 3 or 4 astrocytoma is not treated, the disease leads to death within a short time.

In the treatment of primary grade 4 astrocytoma (glioblastoma; approx. 90% of grade 4 astrocytomas), the average life expectancy is 10-15 months, with secondary grade 4 astrocytoma (glioblastoma; approx. 10% of grade 4 astrocytomas) 2-2.5 Years.

Read more on the topic: Palliative therapy

How do you recognize a good / slow course from a bad / fast course?

The final statement as to whether it is a rather benign tumor with a slow course or a rather malignant tumor with a rapid course is made by the radiologists (x-ray specialists) and pathologists. The radiologist can make an initial statement on the basis of MRI and CT images of the brain. The pathologist examines samples of the tumor using microscopic and genetic techniques and can thus make a very precise assessment of the type and degree of the tumor.

For the layperson, a rough assessment is possible by looking at the course over time. When did the symptoms start? Did they start suddenly or gradually? How severe are the symptoms? How long have I had symptoms? The more sudden and violent the symptoms started, the faster they got worse and the worse they are, the more likely it is that it will turn out to be malignant and vice versa.

Read more on the topic: Course of a glioblastoma