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What Are Gliomas?
- Astrocytomas and oligodendrogliomas are the most
common primary tumors of the adult brain. Both tumors
are types of gliomas.
- Primary brain tumors arise
from cells of the brain.
- Gliomas can
be either slow growing [low-grade, grades 1 and
2] or rapid
growing
[high-grade, grades 3 and 4].
High-grade gliomas are diagnosed by a
biopsy
Once a brain tumor is detected on a CT or MRI scan, a
neurosurgeon obtains tumor tissue for examination by
a neuropathologist (a biopsy). The neuropathologist then
gives the tumor a name and grade. The exact name and
grade of the tumor determine treatment options, and also
give important information about prognosis.
When neuropathologists analyze tumor tissue under a microscope,
there are two main questions being asked:
- What type of brain cell did
the tumor arise from?
The answer to this question
gives the tumor a name, for example, astrocytoma.
- Do the tumor cells show signs
of rapid growth?
This involves assigning
the tumor a grade, such as grade 3 or 4.
These two pieces of information are then combined, as
in "grade 4 astrocytoma". Once a tumor has been given
a name and a grade, brain tumor specialists can give
advice about treatment choices, prognosis, and provide
useful health-care information to brain tumor patients
and their families.
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Goals of Treatment
- To remove as many tumor cells as possible
(with surgery)
- To kill as many of the cells left behind
as possible (with radiation and chemotherapy)
- To place the remaining tumor cells into a
nondividing, sleeping state, for as long as possible
(with radiation and chemotherapy)
High-grade glioma cells almost always start to grow again
at some point in time. Patients receive aggressive treatment
in order to delay this regrowth as long as possible.
Regrowth does not necessarily imply loss of control of
the tumor, but it does mean that a new series of treatments
should be considered because the tumor is becoming more
aggressive.
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Types of Treatment
There are three standard types of treatment for patients
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