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Gliomas

What are gliomas?

Glioma is a term used to describe a group of tumors that start in the glial cells in the brain. These cells support the function of the other main brain cell type, the neuron. Gliomas often happen in the cerebral hemispheres of the brain. These are the largest, outermost part of the brain that control many functions, including movement, speech, thinking, and emotions. 

But gliomas can also first appear in the brain stem. The brain stem is the lower part of the brain that controls breathing, blood pressure, and heartbeat. Gliomas can also first appear in the optic nerves and cerebellum. The cerebellum is the part of the brain that deals with balance and other nonthinking functions. 

Gliomas can be not cancer (benign) or cancer (malignant). They make up about 3 in 10 of all tumors that start in the brain.

Gliomas come in several types. 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 come from 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 comes from the cells lining the cavities of the brain and spinal canal. They are most common in children.

  • Ganglioglioma. This is a rare glioma that can occur in the brain or spine. It forms from both glial cells and nerve cells.

What causes gliomas?

Experts aren’t sure what causes brain tumors. In a small number of people, genetic disorders such as neurofibromatosis or tuberous sclerosis can cause them. Exposure to radiation may also play a factor. No method is known for preventing gliomas or other brain tumors.

What are the symptoms of gliomas?

Symptoms of a glioma are the same as those of other brain tumors. Symptoms depend mainly on where the tumor is in the brain. These are common symptoms:

  • Headaches

  • Seizures

  • Nausea and vomiting

  • 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

Many of these may be caused by other health problems. But it’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How are gliomas diagnosed? 

Your healthcare provider will give you a nervous system exam. This exam assesses your reflexes, vision, balance, and speech. If your provider thinks you may have a glioma or another type of brain tumor, you may need an imaging test such as an MRI or CT scan.

After a diagnosis of glioma, you’ll have likely need other tests. These help your healthcare providers learn more about the cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of your body. The test results help your healthcare providers decide the best ways to treat the cancer.

Grading

Some kinds of cancer are given a number called a stage, but gliomas are not. They don't have a formal staging system. Gliomas are given a grade. This is a measure of how much the cancer cells look like normal cells. A scale of 1 to 4 is used. The grade is written using Roman numerals I, II, III, and IV. Grade I tumors grow slowly and don’t invade nearby tissues. Grade IV gliomas tend to be the fastest growing tumors. These need require the most aggressive treatment. Grades II and III fall in between.

The grade of a glioma is important to know when deciding how to treat the cancer. Ask your healthcare provider to explain the details of your cancer to you in a way you can understand.

How are gliomas treated?

The following treatments may be used for glioma:

  • Surgery. This is often the preferred first treatment for gliomas and other brain tumors. If the tumor can be removed without risking nervous system damage, your doctor may remove a part of your skull and remove as much of the tumor as possible.

  • Radiation therapy. This can be used to destroy any tumor cells that remain after surgery. In some cases glioma can’t be operated on. This means that it can’t be removed without risking brain damage. If this is the case, then radiation can also be used to treat the tumor and ease your symptoms.

  • Chemotherapy. This treatment uses medicines that stop the growth of abnormal cells. Chemo medicines can be given by mouth (oral), through an IV (intravenous line), applied in the tumor, or placed at the site of your tumor through a shunt.

Some gliomas can be hard to treat. If you or a family member has been diagnosed with a glioma, you may want to ask your doctor if there are clinical trials of newer treatments that you should consider.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision. You may want to consider getting a second opinion, if there is time. A second opinion can give you peace of mind about your treatment decision.

How do I manage a glioma?

Your chances of recovering from a glioma depend on many things. These include your age, overall health, and the size, location, and type of your glioma. If the entire tumor is removed, you may fully recover. But sometimes this is hard to do with gliomas. Your doctor is your best source of information about your prognosis. He or she knows your situation best.

If your motor skills, balance, or other functions have been affected by the treatment of your glioma, your doctor may advise physical therapy and occupational therapy. These can help you to regain your strength and relearn some skills. Occupational therapy can also help you learn new ways of doing everyday tasks.

This diagnosis carries a major emotional blow for both the person and their family. Ask your healthcare team for mental health resources to help deal with the complex emotions that go along with this condition.

Key points about gliomas

  • Glioma is a term used to describe a group of tumors that start in the glial cells in the brain.

  • Gliomas make up about 3 in 10 of all tumors that start in the brain.

  • Experts aren’t sure what causes brain tumors. In a small number of people, genetic disorders can cause them. Exposure to radiation may also play a factor.

  • Surgery is often the preferred first treatment for gliomas and other brain tumors.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

Online Medical Reviewer: Kim Stump-Sutliff, RN, MSN, AOCNS
Online Medical Reviewer: Luc Jasmin, MD
Online Medical Reviewer: Marianne Fraser, RN
Date Last Reviewed: 11/7/2018
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