Glyoblastoma

Glioblastoma is considered the most dangerous malignant brain tumor that develops from glial cells. The main distinguishing criteria include the disorderly arrangement of cells that have undergone a malignant process, a change in the configuration of the vessels, widespread edema and the presence of necrotic areas in the brain. In addition, glioblastoma is characterized by rapid progression, involving the surrounding tissue in the process, resulting in the tumor has no clear boundaries.

The only place of its localization is the nervous system. The most common malignant neoplasm is located in the temporal and frontal regions. However, cases of locating the focus in other structures of the brain, such as: trunk, cerebellum and even in the spinal cord, are not excluded. The composition of glioblastoma can include different types of cells, for example, astrocytes and oligodendrocytes. According to statistical data, about 50% of all neoplasms of the brain are glial tumors, of which the majority are glioblastomas.

[1], [2], [3], [4], [5], [6]

Causes Glyoblastoma

Causes of glioblastoma

The causes of glioblastoma are insufficiently studied and have no evidence base. However, in spite of this, some factors, which stimulate its appearance, are still singling out. They include sex and age - most often glioblastoma occurs in males from 40 to 60 years old, the presence of other associated tumors, for example, astrocytoma, which can become the primary focus of the spread of altered cells. In addition to internal factors, it is worth paying attention to working conditions, since harmful production using chemicals or rubber has a negative impact on human health. Genetic predisposition and craniocerebral trauma can also become a starting point in the development of glioblastoma.

[7], [8], [9]

Symptoms Glyoblastoma

Symptoms of glioblastoma

Clinical manifestations of glioblastoma depend on the site of its localization and the destruction of certain structures of the brain. Glyoblastoma has a large number of manifestations, which are inherent not only to this tumor, but also to other diseases. Such symptoms of glioblastoma are called nonspecific. In addition, they can be focal and cerebral. Focal symptomatology is caused by the defeat of brain structures responsible for certain functions in the human body, as a result of which there is a violation in the work of the relevant body or system. The general cerebral clinic is characterized by signs of involving more of the brain in the process.

Glyoblastoma can manifest as headaches. This symptom is considered quite common and one of the earliest symptoms that causes people to consult a doctor. Painful sensations in the temporal and frontal region disturb more than half of people who have a tumor. Of course, glioblastoma is not the only cause of headaches, but nevertheless, in the presence of this symptom over a long period and with the exclusion of another pathology, it is recommended to conduct additional tests for the presence of neoplasm in the brain. Headaches are of a permanent nature, high intensity, able to increase with physical exertion, tilt, sneezing, coughing and do not decrease after taking painkillers, spasmolytic or vascular drugs. A characteristic feature of headaches in brain tumors is an increase in their intensity in the morning, as there is an accumulation of fluid in the brain tissues. This is due to a violation of the outflow of blood from the head in a horizontal position. Glyoblastoma is characterized by intensive growth, which causes a large number of toxic substances to have a negative effect on the structures of the brain, including veins. As a result, the affected vessels can not cope with their function and ensure a normal outflow of blood.

The next symptom is dizziness, which does not depend on a change in the position of the head or body. It refers to cerebral manifestations and appears due to a sharp increase in intracranial pressure. If the glioblastoma affected the cerebellum, bridge, bridge or the posterior cranial fossa, then the vestibular apparatus will suffer. In this case, dizziness will be considered a focal symptom.

In addition, glioblastoma symptoms such as nausea and vomiting are noted, which are of central origin, as a result of which they are not associated with food intake and vomiting does not bring relief. Most people report general weakness, fatigue and drowsiness. Disturbance of visual function and hearing can be a consequence of increased intracranial pressure or compression of the optic or auditory nerve by tumor formation or swollen tissues. Violation of the speech function, as well as the loss of the ability to transform their thoughts into related speech, are noted when the speech center is affected. Thus, memory and mental abilities may deteriorate. In addition, a change in the frequency of breathing, or even its suppression, is most often a one-way process.

Mental disorders manifest themselves in the form of inhibition, general weakness and apathy. Sometimes there is confusion, during which a person does not quite clearly realize where he is and does not react to the events surrounding him. Some symptoms of glioblastoma are manifested by paralysis of a certain part of the body or the whole side, and sensitivity disorders are also noted. The horizontal nystagmus can manifest itself in the form of floating movements from side to side, which are not visible to the person himself. If there are cases of hallucinations, but they are mostly not visual, but tactile or auditory. It can be barely audible sounds, single touches or smells. The likelihood of epileptic seizures is about 10% of all people diagnosed with glioblastoma.

Glyoblastoma of the brain

Glioblastoma of the brain, depending on its inherent characteristics, can be divided into several types. Among them, a giant cell is distinguished, which consists of huge cells that have several nuclei; multiform, isolated due to pronounced polymorphism of cells and tissue structures, as well as a high risk of hemorrhage and necrotic processes. The third type of neoplasm is called gliocarcinoma, characterized by its aggressiveness and speed of development.

Depending on the affected area, the brain glioblastoma can manifest itself with various symptoms, ranging from loss of appetite and ending with a coma.

Glioblastoma of the brain stem

This type of neoplasm differs in its poor prognosis in terms of treatment, since it is considered an inoperable pathology. This is due to the presence of important structures in the brain stem responsible for the vital functions of the body. The trunk is a junction of the brain and spinal cord. It has nucleus of cranial nerves, as well as respiratory and vasomotor centers. In this regard, if glioblastoma of the brainstem is detected, then the symptoms will manifest as a violation of breathing and palpitation. The disease can begin both in the trunk itself and in another part of the brain. Glyoblastoma has a high rate of development and spread, as well as a significant atypicality of cells.

Glioblastoma multiforme

Multiform glioblastoma has its own distinctive features. Among them, a large number of different cells and tissues can be distinguished, as well as the appearance of new structures. The disease belongs to the most aggressive forms of brain tumors and accounts for almost a third of all intracranial neoplasms. The source of tumor development is glial cells, which under the influence of provoking factors begin to degenerate into atypical cells. Most often glioblastoma is localized in the cerebral hemispheres, however, cases of damage to the malignant process of the spinal cord or trunk are recorded.

Polymorphocellular glioblastoma

The polymorphic cell form of the disease is diagnosed quite often. In a cytological study, tumor cells have a different size and shape. Their cytoplasm occupies little space relative to the rest of the structures and weakly stains during research. Cell nuclei also differ in their polymorphism, you can find bean-shaped, oval, round and irregular shapes. Polymorphic cell glioblastoma also has giant-sized cells, in the middle of which there is one nucleus.

Isomorphous cell glioblastoma

Glyoblastoma, which has an isomorphous cell composition, is extremely rare. Tumor cells are characterized by monotony, but nevertheless there are some insignificant differences in the size and shape of the nuclei in the cells. The most common are rounded and oval forms. The isomorphous cell glioblastoma consists of cells, the cytoplasm and thin cellular processes of which are not clearly contoured, and the fission sites are quite common.

Glyoblastoma of the 4th degree

Depending on the presence of certain signs of a brain tumor have four degrees of malignancy. The first degree is considered the boundary between benign and malignant processes. Such neoplasms have no signs of malignancy. The second degree already contains one of the signs, which is most often a cellular atypia. Tumors of these degrees grow slowly and belong to the least malignant neoplasms. The third degree includes two signs, but without necrotic processes. Tumors grow faster than in previous degrees and are related to malignancies. As for the fourth degree, but it is characterized by all signs of malignancy, including necrosis. Thus, grade 4 glioblastoma is characterized by a high growth rate, and is considered to be the most malignant of all primary neoplasms of the brain. The outlook for life is unfavorable.

Relapse of glioblastoma

Despite the considerable progress in the field of medicine, in particular in neurosurgery, the question of the rapid development of glioblastoma and its frequent relapses remains open. Glyoblastoma refers to those tumors with irregular shapes that do not have clear boundaries. In this regard, the removal of the tumor is completely impossible, so the recurrence of glioblastoma is observed quite often. Cells of neoplasm have a high resistance to radiation, as a result of which the possibilities of using radiation therapy are limited due to the sensitivity of surrounding healthy cells. In addition, chemotherapy courses also can not guarantee tumor reduction, as not all drugs can penetrate the blood-brain barrier. A complex of therapeutic measures, including surgical removal of glioblastoma, radiation and chemotherapy, can not guarantee complete recovery.

The main cause of rapid progression and development of relapses is micro-RNA-138. Glioblastoma, namely stem cells are capable of producing this miR-138. It can be used as a tumor biomarker. There is an assumption that if this indicator is neutralized, the probability of slowing the progression of the disease increases, as well as an increase in the survival rate of people diagnosed with glioblastoma. Thanks to this discovery, a recurrence of glioblastoma can be observed as an exception, not a rule, as in our time.

Diagnostics Glyoblastoma

Diagnosis of glioblastoma

Diagnosis of gliblastoma is carried out using modern methods of examination. Among them, the most commonly used are computer and magnetic resonance imaging. MRI performed in the course of surgical intervention is used to control tissue biopsy and neoplasm resection. A glybioblast with its own character and chemical profile can be determined using magnetic resonance spectroscopy. As for tumor recurrence, positron-emitting tomography is considered the most effective here. The glioblastoma does not have a homogeneous structure and sometimes takes various forms. As a consequence, a single study can reveal a low level of malignancy, which does not correspond to the entire tumor. The most reliable data are obtained as a result of stereotactic biopsy with further histological examination.

[10], [11], [12], [13], [14], [15], [16]

Treatment Glyoblastoma

Treatment of glioblastoma

Giloblastoma refers to those diseases, the treatment of which takes an extended period of time and does not always result in success. However, despite this, nevertheless there are certain methods of fighting the disease. The method of treatment depends on the stage of the process, the location of the malignant neoplasm and the shape of the tumor.

Treatment of glioblastoma includes compliance with a certain method of nutrition. So, it is necessary to reduce consumption of table salt, and to increase products with a high content of calcium, sodium and magnesium. Algae should be used to restore mineral balance. In addition, from the diet should be removed cheese, sauerkraut, mustard and various dried fruits - in a word foods with large amounts of sodium. Difficult to digest and causing increased gassing in the intestines should be forgotten during treatment, such as red meat, legumes, kefir and kvass.

Conditionally treatment of glioblastoma can be divided into several stages: surgical, radiation and chemotherapy.

Chemotherapy with glioblastoma

Glyoblastoma can be at different stages of development, so dosage of drugs must be selected depending on the age and health status of a person. Chemotherapy includes the taking of certain drugs, the mechanism of action of which is aimed at the death of malignant neoplasm cells. These drugs are derivatives of temozolimide, known as "Temodal." Chemotherapy with glioblastoma is included in the international standards of treatment. The drug should be taken concomitantly with the course of radiation therapy. Usually conducted from 6 to 8 cycles with a duration of up to 5 days. Chemotherapy can raise the survival rate of people diagnosed with glioblastoma, but only 20% of the cases have a positive effect. Children are often prescribed chemotherapy courses instead of radiation treatment due to the fact that the latter has a negative effect on the development of the brain at this age. This type of treatment should be used only after careful weighing of all the pros and cons, taking into account the state of health, the age of the person, the form and degree of malignancy of the tumor.

In addition to the main courses of treatment, glioblastoma requires maintenance therapy. The drug of choice should be considered Temodal. Supportive chemotherapy with glioblastoma begins four weeks after the end of radiation courses. Basically apply 6 short courses using Temodal. The duration of one course is 5 days, and a break between them should be at least 23 days. This scheme is called "5/28", that is, the drug is taken during 5 days of each 28-day cycle.

The latest development of effective drugs offers a new tool "Avastin." It is considered a unique drug for combating tumors, due to its specific mechanism of action. Avastin was obtained as a result of the work of genetic engineering and is an antibody to the growth factor produced by the endothelium of the vessels of a malignant neoplasm. This factor is, in fact, a protein substance secreted by glioblastoma. Thanks to him, a vascular network forms in the tumor for its favorable blood supply and development. The larger and bigger the vessels, the faster the malignant focus will grow. Avastin is able to block this process of vascular network formation, thereby suppressing tumor development.

Avastin was released on sale relatively recently. Already in 2005, the first results of the drug in the treatment of glioblastomas were published. For several years, studies were conducted on the use of Avastin in relapses of the disease. The results confirmed the effectiveness of this drug.

[17], [18], [19]

Radiation therapy with glioblastoma

Radiotherapy with glioblastoma is used mainly after the already performed surgical intervention to completely remove the malignant neoplasm. With the operation, it is not always possible to achieve 100% tumor resection, so small accumulations of cancer cells could remain in the source. In some cases, radiotherapy replaces the surgical method of treatment due to the inoperability of the neoplasm. Like all treatments, radiation therapy also has some side effects that can manifest itself to a greater or lesser degree in a person. They include nausea, fatigue, general weakness and hair loss. In addition, frequent cases of swelling of the brain tissue, resulting in headaches, as well as necrotic processes in healthy tissues under the influence of radiation. The goal of radiation therapy is selective destruction of malignant cells, without affecting the healthy areas of the brain. Radiation therapy with glioblastoma includes several sessions. The irradiation area should cover the areas of the brain located at the periphery of the focus for more effective treatment. Each session has a destructive effect not only on malignant neoplasm cells, but also on healthy structures. The subsequent treatment stimulates the restoration of healthy tissues, while the cancerous ones die. A glioblastoma can manifest itself in several forms, so the whole irradiation process can include 10 to 30 treatments depending on the degree of the process. Radiation therapy increases the likelihood of increasing the life expectancy of each cancer patient.

Radiation therapy is fed fractionally at 2 Gy per day for 5 days. The whole course lasts 6 weeks. The total dose of irradiation is 60-65 Gy. Such indicators correspond to the norms, while a weaker irradiation does not lead to the desired result, and a high dosage contributes to the development of complications. Parallel to radiation therapy, you must take Temodal throughout the course.

Removal of glioblastoma

Glioblastoma in some cases is an inoperable tumor. However, in case of a certain location, it can be surgically treated. The purpose of surgery is to remove the tumor, which provides an increase in life expectancy. This is due to the use of an integrated approach to treatment. Thus, radiation and chemotherapy have a greater effect if they were preceded by the removal of glioblastoma.

However, not always surgical treatment can save from malignant neoplasm. Glioblastoma in most cases has an infiltrative character and its contours are difficult to determine. Even when using a microscope, a neurosurgeon can not always distinguish cancerous tissues from swollen brain tissue. In order to better visualize tumor formation, a modern method of fluorescent detection of altered cells using 5-aminolevulinic acid is used. It is necessary to begin preparation for the operation 4 hours prior to its beginning. To do this, you should drink a special solution with this drug. Then in the body, as a result of certain transformations, protoporphyrin accumulates in the tumor cells. Thus, the glioblastoma acquires more distinct contours under the influence of a certain illumination. In order for the neurosurgeon to clearly see the object to be removed, a special light source should be used. Due to the wavelength of 375-400 nanometers and the blue emitted light, fluorescence of malignant cells occurs.

Complete removal of glioblastoma was previously considered a fantastic fact, as neurosurgeons, fearing damage to the functional areas of the brain, cut out the formation in part. As a result, the effect of surgical intervention was minimal with a high rate of relapse. Nowadays, thanks to the latest developments and modern technologies, glioblastoma can be completely removed.

Treatment of glioblastoma by alternative means

Glyoblastoma has rapid progressivity and high lethality, however, despite this, some still prefer to use alternative agents for treatment. There are quite a few recipes, here are some of them.

It is necessary to take a small unpeeled radish and finely grate it. Then add the salt, mix and leave for 20 minutes to soak with juice. After this, the resulting mixture must be rubbed into the head and covered with a warm kerchief. There will be a feeling of heat for 25 minutes, which will later change to heat. The procedure is carried out in the evening, and in the morning the head should be rinsed under the water. The following procedures should be repeated after 3 weeks and 1 month after the previous one.

Treatment of glioblastoma with alternative means involves the use of various decoctions and infusions. In order to prepare a decoction of Siberian cones you need to take 30-40 grams of foliage and flowers and pour 200 ml of boiling water. Then the mixture should be insisted on a water bath for half an hour. The course of treatment includes taking the tincture up to 5 times a day for a third of the glass for several months.

Tincture of a small vinca is prepared from fresh grass, which is poured with alcohol (70%) and insists 1-2 weeks. The resulting solution should be taken with caution in 15 drops up to 3 times a day for 2-3 months.

Treatment of glioblastoma in Germany

Glyoblastoma requires a comprehensive treatment approach. The difficulty lies in the localization of the malignant process, as well as the resistance to treatment. Treatment of glioblastoma in Germany includes simultaneously several ways to fight the disease. Among the well-known clinics is the Heidelberg University Hospital, RINEKKER's Proton Therapy Center in Munich, and university clinics in Düsseldorf and Freiburg.

One of the most common methods is surgical intervention to remove neoplasm. The difficulty lies in the complete resection of the focus due to the presence of fuzzy contours. In connection with this, the next stage is radiation or chemotherapy. Radiosurgery, namely a cyber-knife and gamma-knife is used in the absence of the possibility of conducting a routine operation or as a supplement to it.

High efficiency was shown by protein therapy, used exclusively in German clinics. This type of treatment can reduce the rate of development of malignant formation and reduce the ability to defeat healthy surrounding tissues. Treatment of glioblastoma in Germany is carried out with the help of protein therapy with drugs that are safer than with chemotherapy, since they act selectively on cancer cells.

Treatment of glioblastoma in Israel

Among the most popular clinics in Israel is the Tel-Aviv medical center, Rabin clinic and Ishilov hospital. An integrated approach for treating such an oncological disease as glioblastoma, proves its effectiveness for many years. Surgical treatment of glioblastoma in Israel is certainly accompanied by radiation therapy, which is mainly performed before and after surgery. In cases where complete removal is not possible, then a partial resection with intraoperative high-dose irradiation of the focus is carried out. To reduce the risk of recurrence, Gliadel capsules are widely used, which act as chemotherapy during surgery, acting locally. Systemic chemotherapy is used only for the purpose of the occurrence of relapses and metastases.

New methods of treatment for glioblastoma

Glioblastoma is considered a complex malignant tumor, which in most cases does not lend itself to the available methods of treatment. In connection with this, recently new methods of treating glioblastoma and effects on tumor cells have been actively developed. Thus, the head of the clinical association of the German Cancer Center Professor Huber, suggested that blocking the ways of TGF-β signaling can reduce the possibility of regenerative processes and increase the effect of radiation therapy. TGF-β is a growth factor that is produced by the tumor and makes it more aggressive. For blocking, the drug LY2109761 developed by them is used. Information on clinical trials is not yet available, but samples at a remote site of glioblastoma have been successful.

New methods of treatment for glioblastoma were suggested by scientists from Israel. They invented a special device for treating people with such a terrible diagnosis as glioblastoma, which has a regulated electromagnetic field. The spectrum of such a field is capable of selectively leading to the death of cancer cells. While the permission is received only for treatment of people with the most widespread and aggressive forms of tumors of a brain. This includes glioblastoma.

Prevention

Prevention of glioblastoma

Prevention of glioblastoma is almost impossible in our time. Due to lack of information on the causes of the onset and development of the disease, it is impossible to avoid the diagnosis of "glioblastoma" using any methods of prevention. One can only try to avoid the influence of unfavorable factors. The only possibility to prevent the further development of the disease is considered to be a timely call to the doctor with a subsequent examination with the purpose of early diagnosis of oncological pathology. In addition, regular examination reduces the risk of developing other less life-threatening diseases.

Forecast

Prognosis with glioblastoma

The prognosis for glioblastoma is unfavorable. This is due to the localization of the oncological process in the cerebral hemispheres, cerebellum, trunk or spinal moss. In addition, glioblastoma has several forms of manifestation. A high probability of survival is noted under the condition of timely and early diagnosis. Glioblastoma can be overcome after complete removal of the tumor surgically, followed by a full course of radiation and chemotherapy. Also, do not forget about the maintenance course of chemotherapy, which increases the duration of life.

Life expectancy with glioblastoma

Glyoblastoma has a two-year survival rate of approximately 10% of all cases. Depending on the localization, prevalence, the form of the oncological process and the damage to the structures of the brain, the survival percentage may vary. Especially difficult are tumors, the location of which is the trunk of the brain, since there are respiratory and vasomotor centers. As a result, surgical intervention does not lead to the desired results, the hope remains for radiation and chemotherapy. In this regard, life expectancy with glioblastoma remains an unresolved issue of our time.

Life expectancy after surgery

Life expectancy after the operation is about a year, an average of 40 weeks. This depends not only on the operation performed and further therapy, but also on the initial state of health and the age of the person, which is of no small importance in people diagnosed with glioblastoma. Concomitant pathology can significantly reduce the possibility of certain stages of treatment, which is undesirable in this disease. Among the most common concomitant conditions, it is worth paying attention to decompensated stages of diabetes mellitus, renal, respiratory and cardiovascular insufficiency, as well as the presence of a history of heart attacks and strokes.

How to die from glioblastoma?

Glyoblastoma is a terrible oncological disease, which has a mass of symptoms. The larger the tumor size and the duration of the process, the more clinical manifestations become brighter and the intensity increases. Thus, the last months of life can be very difficult. How to die from glioblastoma? Among the most common signs should be noted strong persistent headaches, frequent epileptic seizures, mental disorders, paralysis, mental disorders, as well as the loss of certain functions, depending on the affected area of the brain. This all happens against the background of general weakness and lack of strength.