Glioma is the medical term for a tumor that begins in the brain or spinal cord. Gliomas are the most common form of primary brain tumor. Treatment options depend on the specific type, size and location of the glioma. Outcomes can vary widely, even among people with similar gliomas.

Read more about brain tumor.

  • Expertise and experience. Mayo Clinic is one of the largest brain tumor treatment centers in the world. All three Mayo Clinic locations have comprehensive neuro-oncology programs with doctors who specialize in imaging, analyzing and treating brain tumors. Mayo Clinic specialists treat about 1,600 children and adults with gliomas each year.
  • Technology. Mayo Clinic specialists use state-of-the-art diagnostic tests and surgical techniques.
  • Efficient and compassionate care. Testing and treatment planning can usually be done in a few days rather than weeks. Surgery can be quickly scheduled if needed. Mayo specialists pay close attention to your quality of life as you receive glioma treatment.
  • Access to experimental treatments. Mayo specialists are conducting leading-edge studies on new treatments for glioma. Mayo Clinic is one of only three centers with a Specialized Programs of Research Excellence (SPORE) grant for brain cancer from the National Cancer Institute. Mayo Clinic patients are among the first to benefit from new findings.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Types

Gliomas are classified into four types.

Astrocytomas

Astrocytomas are the most common glioma. They can occur in most parts of the brain and occasionally in the spinal cord.

Astrocytomas are classified as:

  • Pilocytic astrocytoma (grade I). These rare tumors are more common in children than adults, and can often be surgically removed. If your surgeon is unable to remove the entire tumor, it may remain inactive or be successfully treated with radiation.
  • Low-grade astrocytoma (grade II). Grade II tumors are slow-growing tumors that penetrate the surrounding normal brain tissue, making complete surgical removal more difficult. Because these tumors may be very slow growing, your doctor may recommend simple observation, or may consider radiation or chemotherapy or both, after surgery. Most grade II tumors eventually evolve into more-aggressive tumors (grade III or IV), but this process may take many years.
  • Anaplastic astrocytoma (grade III). Grade III astrocytomas are more aggressive than grade II, but not as rapidly growing as grade IV tumors. Treatment involves removing as much of the tumor as possible, followed by radiation therapy and sometimes chemotherapy.
  • Glioblastoma (grade IV). Glioblastoma is the most common and aggressive astrocytoma. These tumors tend to infiltrate throughout the area of the brain where the tumor is located, making them more difficult to completely remove surgically. Surgery is generally followed by radiotherapy and chemotherapy. Grade IV tumors tend to recur and are rarely cured.

Ependymoma

Ependymomas begin in cells lining the passageways that contain fluid protecting the brain and spinal cord (cerebrospinal fluid). These rare tumors can be located anywhere in the brain or spine. Surgical removal is typically recommended for low-grade brain and spinal ependymomas. If the cancer cannot be completely removed surgically, radiation therapy is typically used.

Oligodendrogliomas

These tumors begin in cells that support and nourish other cells that transmit nerve impulses (oligodendrocytes). Oligodendrogliomas are normally found in the main part of the brain (cerebrum). Treatment typically consists of surgery to remove the tumor and, depending on grade and other features of the tumor, may be followed by radiation therapy, chemotherapy or both. Tests done on the cancer cells can help determine how sensitive these tumors are to chemotherapy and guide treatment recommendations.

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Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

Your Mayo Clinic specialist will start by taking a medical history and conducting a physical exam that includes your vision, hearing, balance, coordination and reflexes. Depending on those results, your doctor may request imaging tests or biopsy or both. These tests are important in determining the best treatment for glioma. At Mayo Clinic, your diagnostic testing generally can be completed in a few days.

Imaging tests

Mayo Clinic has radiologists who specialize in imaging the brain and nervous system. Imaging tests can help gauge the tumor's effect on your brain activity and function, and blood flow. Specialized imaging tests include:

  • MRI. MRI is one of the most commonly used imaging tests for brain and spinal cord tumors. A contrast dye is usually injected into the bloodstream to improve imaging of the tumor. Special MRI techniques such as perfusion, functional mapping and intraoperative MRI are available at Mayo Clinic. These tests can help identify critical brain areas involved in speech and motor activity that may be affected by the tumor.
  • CT scan. A CT scan can help identify certain types of tumors and can find signs of bleeding into a tumor. CT is especially helpful in identifying tumors close to or involving bone.
  • Magnetic resonance spectroscopy (MRS). This test can provide biochemical information to guide glioma treatment decisions.
  • Positron emission tomography (PET) and single-photo emission computed tomography (SPECT) scan. These tests can provide information about the functioning of organs affected by a tumor.
  • Angiogram. A special dye is injected into the arteries that feed the brain, making the blood vessels visible on X-ray. This test helps locate blood vessels in and around a brain tumor.

Biopsy

Your surgeon will typically remove a small tissue sample (biopsy) from the tumor for further study that can confirm its type. Mayo Clinic has doctors who specialize in assessing brain tissue tumors (neuropathologists) to categorize the type of tumor, which is critical in determining the appropriate treatment for you.

At Mayo Clinic, your treatment team works with you to create a treatment plan appropriate for your needs. Mayo specialists can work with your primary care doctor to coordinate your care close to home. They pay particular attention to your quality of life as they treat glioma.

Treatment of gliomas involves a multispecialty team. A doctor who specializes in brain cancers (neuro-oncologist) usually leads the team. Your care is coordinated with specialists in neurosurgery, medical oncology, radiation oncology, neuropathology, neuroradiology and brain rehabilitation if needed.

Treatment options include surgery, radiation therapy, chemotherapy and experimental therapies.

Surgery

Mayo Clinic neurosurgeons have experience in performing a wide range of tumor removal surgeries. You generally can be scheduled for surgery quickly at Mayo Clinic.

At Mayo Clinic, neuropathologists can analyze tissue samples removed by a surgeon and report the results while surgery is underway. This information can help the surgeon decide how much tissue to remove while preserving as much surrounding healthy brain tissue as possible.

Mayo Clinic offers the latest surgical technologies and techniques, including:

Radiation therapy

Radiation therapy can prolong survival for most people with glioma and provide a cure for some. Mayo Clinic radiation oncologists are experienced in the full spectrum of radiation treatments. The options include:

  • External beam radiation, including techniques that can shape radiation beams to match the tumor's form (3-D conformal).
  • Stereotactic radiosurgery (Gamma Knife), which is used only for certain types of gliomas, such as small tumors confined to a limited area. Treatment typically is done in a single session.
  • Fractionated stereotactic radiotherapy (FSR), a form of radiation therapy that delivers focused radiation in small doses (fractions).

Chemotherapy

Chemotherapy may be used at the same time as radiation, or by itself, depending on the tumor type and your specific condition. Mayo Clinic is a research leader in treating brain tumors with chemotherapy, and Mayo Clinic patients may be eligible to participate in chemotherapy clinical trials that are appropriate for their condition.

Experimental therapies

Some people receiving regular treatment for glioma at Mayo Clinic also may choose to receive experimental therapies. Your treatment team can help determine if you qualify to participate in a glioma clinical trial. Specific options may include:

  • Vaccine and viral therapies. These treatment approaches include altering the immune system to try to control the glioma with vaccines, infusion of immune cells into your body and the use of modified viruses to attack the tumor.
  • Molecular targeted therapies. These new drugs can target certain molecules, blocking the growth and spread of tumors.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in neurology usually manage care for adults who have glioma.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in neurology usually manage care for adults who have glioma.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in neurology usually manage care for adults who have glioma. Specialists in adolescent and child neurology usually manage care for children with pediatric brain tumors.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic has a history of brain cancer treatment and research stretching back more than 100 years. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment. The Mayo Clinic Cancer Center is one of three cancer centers to receive a National Cancer Institute-sponsored SPORE grant for brain cancer research.

Scientists in Mayo's Neuro-oncology Program are working to:

  • Identify cellular pathways of brain tumor development and progression
  • Find and assess proteins (biomarkers) that indicate the presence of tumors and that help predict response to treatments
  • Develop new treatment approaches that reduce symptoms and improve survival and quality of life

New treatment approaches include gene therapy to target and kill cancer cells and to disrupt signaling pathways, as well as combination strategies to augment traditional chemotherapy, surgery and radiation therapy.

A central goal is translating research from the laboratory to the clinic, so people can benefit as soon as possible from new discoveries. At Mayo Clinic, you have access to potential leading-edge glioma treatment discoveries through clinical trials.

Publications

See a list of publications by Mayo Clinic authors on glioma on PubMed, a service of the National Library of Medicine.

Jun. 27, 2013