Glioblastoma

Glioblastoma is the most common malignant brain tumour in adults. It grows from the supporting (glial) cells of the brain and is classed as grade 4, the fastest-growing grade. Under current definitions it is an IDH-wildtype tumour, which separates it from slower IDH-mutant astrocytomas.

Its cells spread microscopically into the surrounding brain, so no operation can remove every one, and with today's treatments it nearly always returns. Treatment aims to control it for as long as possible while protecting speech, movement and independence. Any offer of a cure should be treated with suspicion.

Symptoms

• Headaches that are new, persistent and often worse in the morning
• Seizures
• Progressive weakness or numbness on one side
• Speech or word-finding difficulty
• Personality change, confusion or memory problems
• Visual field loss
• Nausea and drowsiness as pressure rises

Causes and risk factors

In almost all patients no cause is found. The only established environmental risk is previous radiotherapy to the head. Rare inherited syndromes such as Li-Fraumeni, Lynch syndrome and neurofibromatosis type 1 raise the risk. Mobile phones, head injury and diet have not been shown to cause it. It is slightly more common in men and most often diagnosed between 55 and 75.

How it is diagnosed

• MRI with contrast: Shows a ring-enhancing mass with surrounding swelling. Functional MRI and tractography map speech and movement pathways for planning.
• Surgery or biopsy for tissue: Diagnosis requires tissue. There is no reliable blood test.
• Molecular pathology: IDH status, MGMT promoter methylation (which predicts benefit from temozolomide), and further markers that may open trial options.
• Post-operative MRI within 72 hours: Measures how much tumour remains and serves as the baseline.

Treatment options

• Maximal safe resection: Removing as much enhancing tumour as can be done without new deficits, using neuronavigation, fluorescence guidance (5-ALA), brain mapping and sometimes awake surgery.
• Radiotherapy with temozolomide: Six weeks of daily radiotherapy with chemotherapy, then six monthly cycles of temozolomide. Shorter courses are used for older or frailer patients.
• Tumour treating fields: A scalp device delivering alternating electric fields, added to maintenance chemotherapy in some countries.
• Treatment at recurrence: Repeat surgery, re-irradiation, lomustine, bevacizumab for swelling, or clinical trials.
• Supportive care: Steroids for swelling, anti-seizure medicines, rehabilitation and early palliative care input, which improves quality of life.
• Unproven therapies: Dendritic cell vaccines, high-dose vitamin infusions and similar offers lack reliable evidence. Ask for published trial data before paying for anything.

When it is urgent

A prolonged seizure, sudden severe headache with vomiting, rapid drowsiness, or sudden new weakness needs emergency care at the nearest hospital. Swelling or bleeding in the tumour can be treated quickly and must not wait for travel.

Travelling to Türkiye for treatment

Surgery is usually needed within days to two weeks of diagnosis, so most patients are operated on locally. Flying with an untreated large tumour and brain swelling carries risk and needs medical clearance. Travel may be reasonable for a second neurosurgical opinion on an apparently inoperable tumour, for surgery where advanced mapping is unavailable at home, or for molecular testing and trial advice. Six weeks of chemoradiotherapy abroad means long separation from home at a time when time matters. A visit can offer expertise and technology. It cannot alter the nature of the disease.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

الأسئلة المتكررة