Glioblastoma Surgery in New Jersey

G

lioblastoma (GBM) is a type of malignant tumor that can develop in the brain or spine. Surgery often is the first step in treating glioblastoma and slowing its spread. The neurosurgeons and rehabilitation specialists at Centers for Neurosurgery, Spine & Orthopedics (CNSO) have extensive experience in glioblastoma surgery and post-surgical rehabilitation.

CNSO has multiple locations in northern New Jersey, serving patients throughout Bergen, Passaic, Essex, Morris, and Hudson counties. Learn more about what to expect before, during, and after glioblastoma surgery.

What Is Glioblastoma (Otherwise Referred to as a GBM)?

Glioblastoma multiforme (GBM) is one of the most common types of cancerous brain tumors, affecting thousands of patients in the United States each year. GBM develops in astrocytes, star-shaped cells found in the central nervous system. It is a fast-growing and aggressive form of cancer, although it usually does not spread beyond the brain.

Preparing for Glioblastoma Surgery

Glioblastoma can cause symptoms such as headaches, vision changes, and memory problems. To rule out other underlying causes and confirm a diagnosis of GBM, a provider will order imaging tests, such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan. This reveals whether a brain tumor has developed.

As with other types of cancer, malignant brain tumors are staged from I to IV. A biopsy of the growth will confirm the type of brain tumor and stage classification. Because glioblastoma is an aggressive brain cancer, it is always classified as Grade IV. Neurosurgeons will consider the size and location of the glioblastoma to formulate each individual’s treatment plan.

Types of Glioblastoma Surgery Procedures

Treatment for GBM focuses on halting the cancer’s growth so the patient can live longer. Often, the treatment plan is for the patient to undergo brain surgery to remove as much of the tumor as possible, followed by radiation therapy or chemotherapy. Unfortunately, there is no permanent cure for glioblastoma.

Surgical options for slowing the growth of GBMs include:

Craniotomy

The most common approach for surgical resection of a glioblastoma tumor is a craniotomy. In this procedure, a neurosurgeon makes an incision in the patient’s scalp and removes a portion of bone from the skull to access the tumor. In some cases, a brain surgeon can use minimally invasive techniques, such as a keyhole craniotomy, which results in less bleeding and scarring.

Endoscopic Surgery

Endoscopic brain surgery is a minimally invasive procedure that shortens a patient’s recovery time and minimizes the size of a scar. An endoscopic approach means the neurosurgeon accesses the patient’s brain tumor through their nose, mouth, or a very small surgical incision on the skull. This allows a neurosurgeon to eliminate the need for making a larger incision on the patient’s skull.

Laser Interstitial Thermal Therapy (LITT)

A minimally invasive surgical technique, LITT is used to help with hard-to-reach tumors. The surgeon uses a laser catheter to heat the tumor and destroy the cancerous cells. Also known as MRI-guided laser ablation, LITT is most effective on tumors smaller than three centimeters.

The Glioblastoma Surgery Process

Before brain surgery, a patient will receive instructions to follow before their procedure, such as avoiding eating or drinking the night before or stopping certain medications. On the day of the surgery, an anesthesiologist will administer anesthesia medication that will allow the patient to sleep throughout the surgery.

If the patient is having a craniotomy, the neurosurgeon will shave any hair in the area where the surgeon intends to make an incision. After the neurosurgeon makes an incision, they will need to remove a small portion of the skull bone. The surgeon will have direct visualization of the brain and remove or resect as much of the glioblastoma tumor as possible.

Surgeons use different techniques and navigation systems to visualize the tumor during surgery and protect the surrounding brain tissue. These include:

Intraoperative MRI (iMRI)

An iMRI is a type of imaging technology that allows surgeons to see detailed, real-time images of the brain, making surgeries safer and more precise.

Stereotactic Radiofrequency Surgery

The neurosurgeon can identify the specific locations and structure trajectory during the surgery using CT or MRI imaging and radiologic markers.

Neuronavigation

Using CT or MRI imaging and radiologic markers, neuronavigation allows for real-time imaging throughout the surgery.

When the surgery is complete, the surgeon will place the skull bone back into its original position, secure it in place, and close the skin over the top of the skull with sutures.

Recovery and Postoperative Care

Immediately after brain tumor surgery, a patient will be monitored throughout their hospital stay and may have additional imaging tests. Rehabilitation may include working with a physical therapist, occupational therapist, or speech-language pathologist. Once a patient is released from the hospital, they will continue to have follow-up appointments to monitor their progress and track their recovery.

Complications and Side Effects of Glioblastoma Surgery

All forms of surgery carry risk, and glioblastoma treatment is no exception. Possible complications of brain surgery include:

• Infection
• Swelling
• Bleeding
• Adverse reaction to anesthesia medication

Depending on the location of the tumor, there is also a risk of change in a patient’s motor skills or cognitive function. The patient’s surgical team will review any possible risks and side effects before the procedure and answer any questions the patient has.

Integrative Approaches and Supportive Care in Glioblastoma Treatment

Patients undergoing glioblastoma treatment can benefit from integrative medicine and other forms of supportive care. This can include:

• Nutrition: Cancer treatment can take a toll on the body, so a patient may be referred to a dietitian or nutritionist to ensure they eat a balanced diet with enough vitamins and minerals.
• Counseling: Working with a social worker or a therapist can help patients with glioblastoma navigate their end-of-life care and tend to their mental health.

Cancer treatment can also be a challenge for a patient’s family members and friends. Support groups and online resources are available to help loved ones navigate caregiving and the treatment process.

Frequently Asked Questions About Glioblastoma Surgery

Some common questions from patients and caregivers regarding glioblastoma include:

What is the Survival Rate for Glioblastoma Patients?

In the United States, the five-year relative survival rate for patients aged 20 to 44 with glioblastoma is 22%. For patients aged 45 to 54, the rate is 9%.

How Long Does it Take to Recover from Glioblastoma Surgery?

A patient will need to stay in the hospital for a few days after glioblastoma surgery. Most patients can return home after three to 10 days. Complete recovery can take several weeks. Patients must be cleared by their neurosurgeon before returning to driving or work.

Are there Alternative Treatments to Surgery for Glioblastoma?

Surgery is usually the first line of defense and the best option for slowing the progression of glioblastoma. Following surgery, many patients will have a combination of radiation and chemotherapy.

Can Glioblastoma Surgery be Performed on Elderly Patients?

Glioblastoma surgery may not be recommended for certain older adults with underlying health issues. In other cases, an elderly patient may have surgery but will have a shorter course of chemotherapy and radiation. They may also be treated with just one of these two therapies.

What Ongoing Research is Being Conducted for Glioblastoma Treatment?

Cancer research is always advancing. Patients interested in participating in clinical trials or experimental therapies should talk with their oncology provider for more information about ongoing glioblastoma research.

Find Compassionate, Comprehensive Care at CNSO

Patients diagnosed with glioblastoma multiforme or other types of brain tumors can find expert, compassionate care at CNSO. Serving patients in locations throughout northern New Jersey, CNSO takes a conservative approach to treating brain and spine conditions, offering a wide range of non-surgical and surgical treatment options.

As the state’s most comprehensive brain and spine center, CNSO boasts expert medical staff at all stages of treatment and rehabilitation, including board-certified neurosurgeons, orthopedic spine surgeons, physiatrists, pain management physicians, rehabilitation specialists, and physical therapists. For more information about treatment options or to schedule a consultation, contact CNSO today.