Diagnosis
To diagnose glioblastoma, you may have a physical exam and a review of your personal and medical history. You also may have tests to check how your brain is working and to take pictures of your brain.
Tests and procedures used to diagnose glioblastoma include:
- Neurological exam. This type of exam checks vision, hearing, balance, coordination, strength and reflexes. Changes in one or more of these areas might give clues about the part of the brain the glioblastoma affects.
- Imaging tests. Imaging tests can help find the location and size of a glioblastoma. A brain MRI is the imaging test used most often to diagnose glioblastoma. Sometimes, you have an IV injection of contrast material before your MRI. This helps create better pictures. Other imaging tests may include brain CT and positron emission tomography, which also is called a PET scan.
-
Biopsy. A biopsy is a procedure to remove a sample of tissue for testing. It can be done with a needle before surgery or during surgery to remove the glioblastoma. The sample is sent to a lab for testing. Tests can tell whether the cells are cancerous and whether they're glioblastoma cells.
Special tests of the cancer cells can give your healthcare team more information about your glioblastoma and your prognosis. The team uses this information to create a treatment plan.
More Information
Treatment
There are several kinds of cancer therapy that may be used to treat glioblastoma. Glioblastoma treatment may begin with surgery if the tumor can be safely accessed. But surgery isn't always an option. For example, if the glioblastoma grows deeper into the brain, it might be too risky to remove much of the cancer. If that happens, only a biopsy may be considered. Other treatments, such as radiation therapy and chemotherapy, might be recommended as the first treatment.
The treatments that are right for you depend on your particular situation. Your healthcare team considers the size of the glioblastoma and where it's located in the brain. Your treatment plan also depends on your health and your preferences.
Glioblastoma treatment options include:
Surgery to remove the glioblastoma
A brain surgeon, also called a neurosurgeon, works to remove as much of the glioblastoma as can be done safely. There are different types of brain tumor surgery that may be used to remove a glioblastoma. Glioblastoma often grows into nearby brain tissue, so it is not expected that surgery can remove all of the cancer cells. Most people have other treatments after surgery to kill the cancer cells that are left.
Radiation therapy
Radiation therapy treats cancer with powerful energy beams called radiation. The energy can come from sources such as X-rays and protons. During radiation therapy, you lie on a table while a machine moves around you. The machine aims the radiation at specific areas in your brain.
Radiation therapy is usually recommended after surgery to kill any remaining cancer cells. It might be combined with chemotherapy. For people who can't have surgery, radiation therapy and chemotherapy may be the main treatments.
Chemotherapy
Chemotherapy treats cancer with strong medicines. A chemotherapy medicine taken as a pill is often used after surgery and during and after radiation therapy. Other types of chemotherapy given through a vein may be used for glioblastoma that returns.
Sometimes thin, circular wafers containing chemotherapy medicine might be put in the brain during surgery. The wafers dissolve slowly, releasing the medicine to kill cancer cells.
Tumor treating fields therapy
Tumor treating fields therapy (TTF) is a treatment that uses electrical energy to damage glioblastoma cells. TTF makes it hard for the cells to multiply.
During this treatment, sticky pads are attached to the scalp. You might need to shave your head so that the pads can stick. Wires connect the pads to a portable device. The device generates an electrical field that interrupts the signals glioblastoma cells need to divide.
TTF works with chemotherapy. It might be suggested after radiation therapy.
Targeted therapy
Targeted therapy uses medicines that attack unique biomarkers in the cancer cells. By blocking these biomarkers, targeted treatments can cause cancer cells to die.
One targeted medicine used for some people with glioblastoma is bevacizumab (Avastin). It does not cure glioblastoma, but it may help shrink the tumor or reduce swelling and symptoms in some people, especially when the cancer comes back after treatment.
Your glioblastoma cells may be tested to see if targeted therapy might help you. Targeted therapy is sometimes used after surgery if the glioblastoma can't be removed completely. Targeted therapy also may be used for glioblastoma that comes back after treatment.
Clinical trials
Researchers are studying many promising treatments for glioblastoma. Trials may look at new medicines, new combinations of treatments or new ways of delivering treatment. Some trials are testing approaches such as immunotherapy, vaccines or cell-based therapies. These treatments are not part of standard care, but they may offer options for some people.
Clinical trials are studies of new treatments that may not yet be proved to be effective. These studies provide a chance to try the latest treatments that have the potential to help. The risk of side effects might not be known.
Treatments such as chimeric antigen receptor (CAR)-T cell therapy are being studied in clinical trials for glioblastoma but are not part of standard treatment. CAR T-cell therapy is a type of immunotherapy that changes a person's own immune cells so they can better recognize and attack cancer. Researchers are studying whether this approach could help treat glioblastoma, but it is only available in clinical trials at this time.
Treatments to control symptoms
If your glioblastoma is causing symptoms, you might need medicine to help you feel more comfortable. Which medicines you need depends on your situation. Options might include:
- Medicine to control seizures.
- Steroid medicines to reduce brain swelling.
- Medicine to help with headaches.
Palliative care
Palliative care is a special type of healthcare that helps someone with a serious illness feel better. If you have cancer, palliative care can help relieve pain and other symptoms. Palliative care does not try to cure the cancer. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team's goal is to improve quality of life for you and your family.
Palliative care specialists work with you, your family and your care team. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time you're getting strong cancer treatments, such as surgery, chemotherapy or radiation therapy.
The use of palliative care with other medical treatments can help people with cancer feel better and live longer.
More Information
More Information
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Alternative medicine
Alternative medicine therapies can't cure glioblastoma. But some integrative treatments can be combined with your healthcare team's care to help you cope with cancer treatment and side effects, such as distress.
People with cancer often feel distress. If you're distressed, you may have difficulty sleeping and find that you are thinking about your cancer all the time.
Discuss your feelings with your healthcare team. Specialists can help you come up with strategies for coping. For some people, medicines may help.
Integrative medicine treatments that may help you feel better include:
- Art therapy.
- Exercise.
- Massage therapy.
- Meditation.
- Music therapy.
- Relaxation exercises.
- Spirituality.
Talk with your healthcare team if you're interested in these treatment options.
Coping and support
With time, you'll find what helps you cope with the uncertainty and worry of a cancer diagnosis. Until then, you may find it helps to:
Learn enough about glioblastoma to make decisions about your care
Ask your healthcare team about your cancer, including your test results, treatment options and, if you like, your prognosis. As you learn more about glioblastoma, you may become more confident in making treatment decisions.
Keep friends and family close
Keeping your close relationships strong can help you deal with glioblastoma. Friends and family can provide the practical support you may need, such as helping take care of your home if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by having cancer.
Find someone to talk with
Find someone who is willing to listen to you talk about your hopes and worries. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your healthcare team about support groups in your area. Other sources of information include the National Cancer Institute and the American Cancer Society. Some support groups and online communities focus specifically on brain tumors or glioblastoma.
Preparing for your appointment
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
If your healthcare professional thinks you might have a brain tumor, such as glioblastoma, you may be referred to a specialist. Specialists who care for people with glioblastoma include:
- Doctors who specialize in brain nervous system diseases, called neurologists.
- Doctors who use medicine to treat cancer, called medical oncologists.
- Doctors who use radiation to treat cancer, called radiation oncologists.
- Doctors who specialize in brain and nervous system cancers, called neuro-oncologists.
- Surgeons who operate on the brain and nervous system, called neurosurgeons.
Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.
What you can do
- Be aware of anything you need to do ahead of time. When you make the appointment, be sure to ask whether there's anything you need to do in advance, such as restrict your diet.
- Write down symptoms you have, including any that may not seem related to the reason for the appointment.
- Write down important personal information, including major stresses or recent life changes.
- Make a list of all medicines, vitamins and supplements you're taking and the doses.
- Take a family member or friend along. Sometimes it can be very hard to remember all the information you get during an appointment. Someone who goes with you may remember something that you missed or forgot.
- Write down questions to ask your healthcare team.
Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For glioblastoma, some basic questions to ask include:
- In what part of the brain is my cancer located?
- Has my cancer spread to other parts of my body?
- Will I need more tests?
- What are the treatment options?
- How much does each treatment increase my chances of living longer?
- What are the possible side effects of each treatment?
- How will each treatment affect my daily life?
- Is there one treatment option you believe is the best?
- What would you recommend to a friend or family member in my situation?
- Should I see a specialist?
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
- What will determine whether I should plan for a follow-up visit?
Don't hesitate to ask other questions.
What to expect from your doctor
Be prepared to answer questions, such as:
- When did you first begin having symptoms?
- Do you always have symptoms or do they come and go?
- How bad are your symptoms?
- What, if anything, seems to make your symptoms better?
- What, if anything, seems to worsen your symptoms?