Glioma

There are three kinds of glial cells that can potentially turn into tumours and it is on the basis of this that these tumours are classified. A few have been mentioned below : 

• Astrocytoma: The tumour begins in cells called astrocytes that support nerve cells. It may grow very quickly or it could be slow-growing. The grade of aggressiveness determines the treatment route that needs to be followed.
• Oligodendroglioma: The tumour begins from cells in the brain and spinal cord called oligodendrocytes that produce a substance that protects nerve cells. The treatment route followed is often surgical removal.
• Glioblastoma: The most common and aggressive type of glioma, glioblastoma tends to occur more often in adults. There is no cure for this condition yet as it is very difficult to treat.

The symptoms may vary depending on the type and location of the tumour. However, since these tumours press down upon the brain and spinal cord, given below are the most common symptoms:

• Persistent headaches
• Problems with vision such as blurred vision, double vision or loss of peripheral vision
• Irritability and changes in personality
• Nausea and vomiting
• Confusion or a decline in brain function
• Loss of memory 
• Difficulty in maintaining balance and coordination
• Seizures, especially in someone without a history of seizures
• Urinary incontinence, i.e loss of bladder control 
• Difficulties with speech

While there are no known causes of gliomas, there are certain factors that could put you at risk of developing it. These include:

• Family history: While certain gene variations have been associated with gliomas, more studies need to be done to confirm a link between these variations and brain tumours. Even though it is extremely rare for gliomas to get transferred genetically, a family history of this health condition doubles one's risk of developing it.
• Age: It is a well-known fact that brain tumours can happen at any age. Gliomas are, however, most common in adults between 40 years and 65 years of age. Certain kinds of gliomas are more common in children. So, if you have a family history of gliomas and are experiencing the above-mentioned symptoms, it is important to get a medical check up done.
• Exposure to radiation: Exposure to radiation is an occupational hazard for some people. The risk of developing brain tumour increases when one has been exposed to a type of radiation called ionizing radiation. Examples of ionizing radiation include radiation therapy used to treat cancer. It is also caused by the radiations emitted from atomic bombs.

While some of the symptoms of glioma are associated with a lot of diseases and conditions, one must consult a medical practitioner immediately in case these symptoms persist. If your neurologist suspects brain cancer, he/she may recommend the following:

• A neurological exam: The doctor may check your vision, coordination, strength, hearing, balance and reflexes. Anomalies in one or more of these may provide clues about where the tumour could be located in the brain.
• Imaging tests: Magnetic resonance imaging (MRI scan) is often used to help diagnose brain tumours. At times, dyes are injected during the MRI study to help show differences in brain tissue, which may go a long way in helping your doctor evaluate the tumour, thereby coming up with an effective treatment plan. Apart from MRI, common imaging techniques include PET scan (positron emission tomography) and CT scans (computerized tomography)
• Biopsy: A biopsy is the most definitive way to diagnose a brain tumour. Based on the information gathered in a biopsy, the specialist can determine the grade or stage of a brain tumour.

The treatment plan varies from person to person, depending on factors like age, the kind of tumour, overall health of the patient and their preferences. Some of the treatment options are:

• Surgery: More often than not, gliomas are easily removable as there is a clear distinction between the tumour and surrounding healthy tissue. However, if they are located near sensitive areas of the brain, getting the surgery done becomes very risky. Hence, partial removal is done so as to reduce the tumour and treat the rest with chemotherapy and radiation. Even removing only a portion of your tumour can help reduce the symptoms.
• Radiation therapy: The term radiation usually refers to external beam radiation therapy that uses high energy beams. Most commonly used are X-rays, but other types of energy beams can also be used.
  There are various kinds of beam radiation currently being used for the treatment of glioma, depending on the type of glioma, its size and its grade. The specialist also makes sure that radiation is given for the specific time period suitable to the patient as this greatly alters the kind of side effects that one sees. The most common side effects include headaches, nausea and irritation in the scalp (itchy scalp). Radiation is often seen as a suitable form of treatment for recurrent tumours as well as tumours in sensitive areas.
  What is stereotactic radiotherapy?
  This type of therapy targets a strong, calculated dosage of radiation at a small area, to kill cancer cells. This technique is undertaken by doctors when they cannot operate due to various reasons (overall health, location of tumour, etc.). Stereotactic radiotherapy is an extremely precise method that addresses the problems which cannot be solved by conventional surgery. No cutting is involved in it. This method is usually recommended as it is not invasive and at the same time, it helps preserve healthy tissues.
• Chemotherapy: The use of drugs to kill cancerous/ tumour cells is called chemotherapy. In this form of therapy, the drugs can be given intravenously (IVs) or orally. In most cases, chemotherapy is done in combination with radiation therapy. For gliomas, temozolomide is used in the form of a pill. Common side effects of chemotherapy include loss of hair, fatigue, fever and weakness, among others. 
• Medication: The doctor will likely prescribe drugs to manage the side effects of chemo and radiation therapy. One may also be prescribed certain steroids, which will help in reducing swelling/ inflammation which further helps in relieving pressure in the affected areas of the brain. Seizures are a common symptom of gliomas. To manage this symptom, anti-epileptic drugs may be prescribed.

The journey of battling a chronic ailment does not end with its medical treatment. When the body goes through physical as well as emotional traumas, it requires assistance and time to get back to its optimal performance. Since with gliomas, the tumour develops in certain parts of the brain, rehabilitation is necessary. 

• If one is facing difficulties in speaking, there are speech therapists who can help by providing speech therapy.
• The muscles can lose their strength while fighting gliomas or any other tumours for that matter. In order to get back on one’s feet or regain lost motor skills, physical therapy is often suggested.
• Occupational therapy is also gaining popularity as one of the rehabilitation methods. In this type of therapy, specialists help the patients through the therapeutic use of everyday activities. This can help people settle down in their daily lives and go back to their old routines.

Like most primary brain tumours, the cause of gliomas is not known. However, medical science is advancing every day—with researchers coming up with new diagnostic techniques and drug trials. If you or someone you know has been showing symptoms that have been discussed above, it is crucial to pay a visit to a neurologist to clear any doubt that may have arisen in your mind.

As with all types of cancer, early detection is key to improving the outcome in glioma patients.