The Abramson Cancer Center and Penn Brain Tumor Center have a full arsenal of medical and surgical approaches to treat your glioblastoma. These include traditional treatments with some innovative twists. They can also include new modalities of immunotherapy. These are studies of how your body’s immune system can help fight a tumour, including cancer cells.
Glioblastoma is the most common type of primary brain tumour. It can be very difficult to treat. The tumours grow rapidly, and can have a lot of different types of cells. This means it’s hard to kill all the cancer cells. Glioblastoma also grows into and through the brain tissue around it, so any surgery or radiation may affect normal brain function.
Treatment for glioblastoma typically begins with surgery to remove as much of the tumour as possible. However, this is almost always difficult to do. The tumour often has very few edges, and it can be hard to tell the difference between the tumour and the brain tissue. The cancer cells can also be scattered in different parts of the brain. This is called a diffuse glioblastoma.
The next step is usually a combination of radiotherapy and chemotherapy to kill any remaining tumour cells. Doctors use the chemotherapy drug temozolomide (Temodar) for glioblastoma, and it is often used with other drugs to improve results, such as lomustine (BCNU), bevacizumab (Avastin, Mvasi), or carmustine (CCNU). Radiation can slow the growth of any remaining tumour cells.
Other treatments for glioblastoma can include a type of chemotherapy that uses targeted radiation to very specific areas of the tumour, and a device called convection-enhanced delivery (CED), which is designed to release chemotherapy slowly through a small pump implanted in the scalp. Another option is a wafer called Gliadel, which releases a small amount of chemotherapy directly into the tumour. It can be used for both newly diagnosed glioblastomas and those that have come back after surgery and radiation.
Glioblastomas are not caused by lifestyle choices, but some risk factors can be controlled. People who have been exposed to low doses of radiation are at higher risk for this type of tumour, as are those with a family history of brain tumors. Some genetic diseases, such as Li-Fraumeni syndrome and Turcot syndrome, can also increase the chances of getting a glioblastoma.
Supportive care can help with symptoms of the tumour, such as headaches and changes in mood or energy levels. Steroids are sometimes used to reduce brain swelling, but can cause side effects such as weight gain, increased risk of infection and changes in blood pressure. Other treatments include acupuncture, meditation and massage. Clinical trials of other treatments, such as dendritic cell vaccines and heat shock protein vaccines are being investigated. More research is needed to find more ways to treat glioblastoma, and better ways to prevent it. If you are interested in trying an experimental therapy, ask your health care provider if you can take part in a study.
