Brain cancer: Glioblastoma multiforme of the brain

• What is Brain Cancer (Glioblastoma Multiforme of the Brain)
• Statistics on Brain Cancer (Glioblastoma Multiforme of the Brain)
• Risk Factors for Brain Cancer (Glioblastoma Multiforme of the Brain)
• Progression of Brain Cancer (Glioblastoma Multiforme of the Brain)
• Symptoms of Brain Cancer (Glioblastoma Multiforme of the Brain)
• Clinical Examination of Brain Cancer (Glioblastoma Multiforme of the Brain)
• How is Brain Cancer (Glioblastoma Multiforme of the Brain) Diagnosed?
• Prognosis of Brain Cancer (Glioblastoma Multiforme of the Brain)
• How is Brain Cancer (Glioblastoma Multiforme of the Brain) Treated?

What is Brain Cancer (Glioblastoma Multiforme of the Brain)

Glioblastoma multiforme is a cancer of astrocytes. Astrocytes support the nerve cells of the brain.

The brain is the control centre for the body. It is comprised of millions of individual nerve cells which are all interconnected. It is located at the top of the spinal cord and is encased in hard bone. The brain tissue is composed of white matter (nerve tracts) as well as grey matter (neurones and glial cells). The neurones are surrounded by glial cells – cells which are important for support of the neurones, synthesis of myelin, and forming the blood-brain barrier. One type of glial cell is the astrocyte.

Statistics on Brain Cancer (Glioblastoma Multiforme of the Brain)

This type of brain cancer is uncommon. May occur in children and adults.

Risk Factors for Brain Cancer (Glioblastoma Multiforme of the Brain)

Ionizing radiation and genetics are proven risk factors for brain cancer (glioblastoma multiforme.)

Progression of Brain Cancer (Glioblastoma Multiforme of the Brain)

This brain cacer tumour tends to spread from a central mass outwards. It sends out small projections which grow along nerve tracts and infiltrate brain tissues. It can metastases along the spinal cord late in disease. Metastases outside the CNS is rare.

How is Brain Cancer (Glioblastoma Multiforme of the Brain) Diagnosed?

Blood tests may be performed to assess general health but they do not diagnose brain cancer tumours.

Prognosis of Brain Cancer (Glioblastoma Multiforme of the Brain)

The prognosis depends on the age and stage at which the brain cancer tumour is diagnosed. Unfortunately the prognosis for glioblastoma mulitforme is poor. Survival rates are low with less than 10% of patients surviving more than 2 years.

How is Brain Cancer (Glioblastoma Multiforme of the Brain) Treated?

Brain cancer treatment usually involves biopsy and resection of as much tumour as possible. This is generally followed by a combination of radiotherapy, chemotherapy and glucocorticoid treatment.

Chemotherapy protocols include:

1) PCV:
Lomustine (CCNU) 110mg/m2 oral day 1 (capsules are 100, 40, 10mg)
Vincristine 1.4mg/m2 ( max 2 mg) I.V. Day 1
Procarbazine 60mg/m2 oral Days 8 to 21 (capsules are 50 mg) (repeat every 4 weeks)

2) Temozolamide 200 mg/m2/day p.o. for 5 days every 4 weeks if no prior chemotherapy, 150 mg/m2/day p.o. for 5 days every 4 weeks if prior chemotherapy.

3) Thalidomide given as a single agent or in combination with chemotherapy (needs ethics committee and SA Govt issued license to prescribe)
100 mg/day starting dose, increase by 100 mg/day each week until 500 mg/day p.o.

PCV is the most common chemotherapy drug regime. Lomustine and temozolamide are other chemotherapy agents that are used.

Further treatment is targeted at the symptoms that are encountered. Commonly this includes anticonvulsants (for seizure activity), antinauseants (for nausea and vomiting), analgesics (for pain), dexamethasone (reduces swelling surrounding tumour and improves neurological function), seizures and heparin prevent deep vein thrombosis.