Symptoms, treatment, and latest medical advances in glioblastoma

Receiving a diagnosis of glioblastoma often raises many questions: what exactly does it mean, how can it affect daily life, and what options are available today to treat it? Glioblastoma is the most common primary brain tumor, with an incidence of approximately 3.2 to 4.5 cases per 100,000 inhabitants per year, according to a report by the Spanish Society of Medical Oncology (SEOM).

It is normal to feel uncertain, especially since we are talking about a diagnosis related to cancer, and the information found on the Internet is not always well explained or can be alarming. In this article, we will look at what glioblastoma is, what the most common symptoms are, how the diagnosis is confirmed, and what treatment options are currently available.

What is glioblastoma?

When we talk about glioblastoma, we are referring to a malignant tumor of the central nervous system, that is, a type of brain cancer. In medical terms, it is a type of high-grade glioma (grade 4), which implies more aggressive behavior and rapid growth.

It is usually located in the brain, which is why it is often referred to as cerebral glioblastoma. However, its appearance in the spinal cord (medullary glioblastoma) is much less common.

Another relevant aspect is that it is usually an infiltrating tumor. This means that, rather than growing as a perfectly defined mass, it can spread into the brain tissue, which influences how it is treated and the need for a multidisciplinary approach.

Causes and risk factors of glioblastoma

Another very common question after this diagnosis is why glioblastoma occurs. Today, in most cases, no single cause is identified.

That said, associated factors have been described that may increase the risk, although they do not explain most diagnoses:

Ionizing radiation: having received radiation therapy to the head for other reasons (which is rare) may increase the risk of central nervous system tumors.
Genetic factors: there are rare hereditary syndromes that may increase the predisposition to central nervous system tumors, although they are in the minority.
DNA alterations (mutations): glioblastoma is characterized by genetic and biological changes in cells (mutations) that alter their instructions, causing them to multiply faster and not die when they should. In most cases, it is not known what triggers these changes. These markers help to better classify the tumor and, in some patients, to guide treatment or access to clinical trials.

In many cases, it is not possible to pinpoint a single cause. Therefore, the most important thing is a correct diagnosis, an individualized plan, and close monitoring.

Symptoms of glioblastoma: How to detect it early

The symptoms of glioblastoma depend on the area of the brain affected, the size of the tumor, and the edema (swelling) around it. Therefore, the presentation can vary greatly between patients.

Even so, there are common symptoms that usually raise alarm bells and lead to a doctor’s appointment:

Persistent or new-onset headache (more intense, more frequent, or different than usual).
Seizures: sometimes the first symptom, even in people with no history of seizures.
Cognitive or behavioral changes: difficulties with memory, attention, language, disorientation, or personality changes.
Focal neurological deficits: weakness on one side of the body, sensory disturbances, problems with coordination, vision, or speech (depending on location).
Nausea or vomiting (especially if associated with headache or worsening over time).

These symptoms do not automatically mean glioblastoma. They can have many causes. But if they are persistent, progressive, or a seizure occurs for the first time, it is advisable to consult a professional to assess the need for tests.

Glioblastoma testing and diagnosis

The diagnosis of glioblastoma is based on two pillars: imaging and confirmation with tumor tissue.

In general, the process includes:

Clinical and neurological evaluation: the doctor examines functions such as strength, reflexes, coordination, language, sensitivity, and vision. This helps to determine the location and functional impact.
Imaging tests: the gold standard test is usually magnetic resonance imaging (MRI), because it allows for a detailed assessment of the lesion, its location, the associated edema, and its behavior with contrast.
Histological confirmation (biopsy or surgery): it is usually necessary to obtain a sample of the tumor to confirm the diagnosis and complete the study.
Molecular study: it is increasingly common to complete the diagnosis with molecular markers, because they provide relevant information for classification and, in certain cases, for therapeutic options or clinical trials.

In many patients, once the diagnosis has been confirmed, the team proposes a treatment plan and follow-up tailored to the patient’s progress.

Treatment of glioblastoma

The treatment of glioblastoma is decided on an individual basis, but there is a standard approach that combines different strategies depending on the clinical situation, the location of the tumor, and the patient’s general condition. In general, the following are considered:

Surgery (when possible): an attempt is made to safely remove as much of the tumor as possible and obtain tissue for diagnosis.
Radiotherapy and chemotherapy: after surgery or biopsy, the usual treatment includes radiotherapy and chemotherapy with temozolomide, according to protocol and patient profile. Afterwards, temozolomide is usually continued in cycles.
Alternating electric fields (TTFields) in selected patients: in some cases, this may be considered as part of the approach, always depending on clinical indications and access to the technology.
Clinical trials and research strategies: glioblastoma is a tumor that is actively being researched. New options are being studied (drugs, targeted therapies, and immunotherapy, among others), which are not always applicable to all patients, but may be considered in some cases.
Supportive care and rehabilitation: Just as important as cancer treatment is symptom control (e.g., seizures, edema, pain), neurorehabilitation when needed, and comprehensive patient support.

High-precision technologies in radiotherapy/radiosurgery

In glioblastoma, radiotherapy is part of the standard treatment. Stereotactic techniques or radiosurgery may be considered in selected situations (e.g., in recurrence or in individualized strategies), always after specialized evaluation.

In addition to the usual alternatives, there are now advanced technologies focused on high precision. IRCA has ZAP-X, a high-precision, non-invasive stereotactic brain radiosurgery system with the ability to control radiation dynamics to help protect surrounding healthy structures. The goal is to treat with the utmost precision and with an approach that prioritizes quality of life, always after a complete and individualized medical assessment.

For more related information, see: Malignant tumors

SOURCES:

SEOM (Spanish Society of Medical Oncology). Brain tumors (Information for the public).

https://seom.org/info-sobre-el-cancer/tumores-cerebrales

National Cancer Institute (NCI). Definition of glioblastoma (Cancer Dictionary, Spanish).

https://www.cancer.gov/espanol/publicaciones/diccionarios/diccionario-cancer/def/glioblastoma

OncoLink (in Spanish). Glioma in adults: classification and treatment.

https://es.oncolink.org/tipos-de-cancer/tumores-del-cerebro/glioma-en-adultos-clasificacion-y-tratamiento

JAMA (Patient sheet, in Spanish). Glioblastoma

https://sites.jamanetwork.com/spanish-patient-pages/2023/hoja-para-el-paciente-de-jama-230411.pdf

SEOM. Position statement on the Optune® device (TTFields) in newly diagnosed glioblastoma.

https://seom.org/seomcms/images/stories/Informes_SEOM/IEV_Optune.pdf