Behind the Tumor: Glioma

Types

There are three main types of gliomas, grouped by the type of glial cell they start in. Some gliomas contain multiple types of cells. Healthcare providers call these mixed gliomas. They categorize each type of glioma as low-, mid- or high-grade based on how fast they grow and other features.

There are different types of gliomas. The category that a glioma falls into depends on the type of glial cell it comes from. These are types of gliomas:

• Astrocytoma. This type of glioma is a tumor that comes from astrocytes, the star-shaped glial cells in the brain. The fastest-growing astrocytomas are called glioblastomas.
• Oligodendroglioma. These gliomas start in oligodendrocytes. These are glial cells that normally form a cover for nerve fibers in the brain.
• Oligoastrocytoma. These gliomas are a mix of abnormal oligodendrocytes and astrocytes.
• Ependymoma. This type of glioma starts in the cells lining the cavities of the brain and spinal canal. They are most common in children and rare in adults.
• Ganglioglioma. This is a rare brain tumor with both glial cells (responsible for providing the structural support of the central nervous system) and neuronal cells (the functioning component of the central nervous system). Ganglioglioma is a low-grade glioma.

Location

In children, most ependymomas occur near, or in, the cerebellum and spinal cord. In adults, ependymomas are more commonly found in the spine. Ependymomas are usually located along, within, or next to the ventricular system (spaces in the brain filled with cerebrospinal fluid).

The various types of ependymomas appear in different locations. Subependymomas usually appear near a ventricle. Myxopapillary ependymomas tend to occur in the lower part of the spinal column. Ependymomas are most commonly found in the spinal column in adults and in the lower back part of the skull (posterior fossa) in children.

Population

Anyone can develop a glioma, but the following factors may increase your risk:

• Age: Gliomas are most common in older adults (over 65) and children (under 12).
• Ethnicity: White people may be more likely to develop gliomas than other races.
• Family history: Some inherited genetic disorders may increase your risk of gliomas.
• Gender: Gliomas are slightly more common in men than women.
• Radiation or toxin exposure: Repeated or prolonged exposure to radiation or certain chemicals may increase your risk.

Symptoms

Symptoms of a glioma are the same as those of other brain tumors. Symptoms largely depend on where the tumor is in the brain and how big it is. These are some common symptoms:

• Headaches
• Seizures
• Nausea and vomiting
• Appetite loss
• Vision or hearing problems
• Balance problems, such as dizziness and trouble with walking
• Slurred speech
• Muscle or nervous system problems such as weakness or paralysis
• Mood, personality, or behavior changes

It’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have a brain tumor.

Treatment

Various treatments may be employed for glioma:

1. Surgery: Often the initial choice, especially for low-grade tumors. If the tumor can be safely removed without risking nerve damage, surgery aims to extract as much as possible. In some cases, surgery may be the sole necessary treatment.

2. Radiation Therapy: Utilized to eliminate any remaining tumor cells post-surgery. In instances where complete removal poses a risk of brain damage, radiation helps slow or halt tumor growth and alleviate symptoms.

3. Chemotherapy (Chemo): Involves potent medications that impede the abnormal cell growth. Administered orally, intravenously, applied during surgery, or introduced into the brain’s fluid via a shunt. Typically used for faster-growing tumors.

4. Targeted Therapy: Certain gliomas may be treated with targeted therapy, focusing on specific aspects of cancer cells that differentiate them from normal cells. This approach minimizes damage to healthy cells.

Often, a combination of treatments is employed. For example, surgery may be followed by radiation directed at the tumor-removed brain area.

Some gliomas pose challenges in treatment. If diagnosed with a glioma, exploring clinical trials for newer treatments could be beneficial. Clinical trials not only offer current top-tier treatments but may also provide access to advancements considered superior.

Discuss your treatment options with healthcare providers, compile questions, weigh benefits, and consider potential side effects. Address your concerns before making a decision, and obtaining a second opinion, if time allows, can provide reassurance about your chosen treatment path.

Questions To Ask Your Doctor

It may be helpful to ask your healthcare team the following questions:

• What is the cancer’s type and grade?
• What treatments are right for me?
• Will treatment affect my cognitive function?
• Are there clinical trials I can take part in?
• Can the cancer come back after treatment?