Glioblastoma of the Brain Surgery in New Jersey

Glioblastoma is the most common type of malignant, or cancerous, brain tumor that affects adults. It grows quickly, invading and destroying nearby tissue. This spread can be deadly if not addressed promptly by a knowledgeable neurosurgeon. Finding the right specialist can make all the difference in returning to normal life after a brain tumor operation.

Centers for Neurosurgery, Spine & Orthopedics (CNSO) features a team of specialists, including neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. They provide patients in New Jersey with comprehensive care at every step from diagnosis to surgery for a wide array of neurological conditions, including tumors of the brain. Learn more about glioblastomas, glioblastoma surgery, and the other treatment options available at CNSO.

What Is a Glioblastoma of the Brain?

Glial cells are the nervous system’s support structure. While not directly responsible for relaying information, they ensure that nerve cells work properly. Some glial cells produce myelin, a material that insulates neurons and allows signals to travel faster. Others maintain neurotransmitter levels surrounding the synapse, controlling how neurons communicate.

When a brain tumor originates in the glial cells, it is called a glioma. There are several different types of gliomas, but the most common in adults is a glioblastoma. This type of tumor is malignant, meaning that it is cancerous or fast-growing. It rapidly reproduces and may spread to other areas of the brain or spinal cord.

Because glioblastoma tumors are malignant, they can create serious health complications very quickly. This degree of growth is devastating when it occurs in the brain tissue. Glioblastomas can result in death in under six months if they are not treated by a specialist. Urgent medical attention is necessary to minimize neurological injury and provide the best prognosis and outcome possible.

What Symptoms are caused by Glioblastomas?

As a glioblastoma grows, it puts pressure on and invades surrounding brain tissue. This pressure and tissue invasion can damage and impede normal neurological function and may also destroy otherwise healthy tissue. The damage often results in a sudden onset of severe symptoms, such as:

• Headaches: Severe headaches are a common symptom of a glioblastoma. The growing tumor can cause increased pressure inside the brain, leading to severe headaches that classically will wake a patient up in the middle of the night and are most severe upon waking in the morning.
• Nausea: Patients may also experience stomach troubles, including persistent nausea, vomiting, and significant loss of appetite.
• Vision changes: Nerve damage in the parts of the brain responsible for visual processing may result in blurry vision, double vision, or loss of eyesight.
• Sensation changes: Other senses may also be affected. The patient may experience tingling or phantom sensations or become numb in parts of their body.
• Balance difficulties: Changes in sensation are often accompanied by changes in coordination, making it difficult to stay balanced or perform precise tasks.
• Muscle weakness: Sudden weakness in the face, arms, or legs may indicate a brain condition, especially when there is no other obvious cause.
• Speech difficulties: Glioblastoma often causes aphasia, a condition in which patients have difficulty speaking or understanding speech.
• Confusion: Glioblastoma patients often experience declines in brain function, leading to difficulty with thinking or understanding information.
• Personality changes: Patients may also exhibit unusual irritability or changes in their behavior. These can be indicators of a glioblastoma or other brain damage.
• Memory loss: Memory loss is a common symptom of brain damage, especially severe damage, which may be caused by a glioblastoma.
• Seizures: Glioblastoma may cause seizures in patients who have never had them before. These can be identified by sudden weakness, loss of balance, confusion, or aphasia.

The above symptoms can be caused by conditions other than brain tumors. However, individuals experiencing these symptoms should seek medical attention immediately to be diagnosed and start appropriate treatment as soon as possible.

Causes and Risk Factors

As with many forms of cancer, the cause of glioblastomas is poorly understood. Glioblastoma is most common in adults between 40 and 70 years old, with a median age of diagnosis of 64 years. Research indicates it may be possible to inherit genetic variables, including hereditary conditions such as Lynch syndrome and Li-Fraumeni syndrome, that increase the risk of developing cancer. Major exposure to radiation and certain chemicals can also increase the risk of glioblastoma and other forms of cancer.

How Is Glioblastoma Diagnosed?

Brain tumors are often diagnosed incidentally when a patient undergoes a scan for an unrelated reason, for instance, after a car accident, to evaluate for head trauma. However, when patients are suffering from the symptoms of a brain tumor, they are often seen by their primary care physician or in an emergency room. At that point, preliminary testing is often performed, indicating an abnormality in the brain, and the brain tumor specialists at CNSO are consulted to help direct further diagnostic testing and develop a treatment plan.

At that point, our team of specialist collaborate with the primary team and does a thorough review of the patient’s medical history and overall health condition. Further testing is often required to help the neurosurgical team identify the tumor and evaluate its size, growth, and location, enabling them to recommend the safest and most effective treatment method.

Diagnostic tests for glioblastoma include:

• Neurological exam: This is a form of physical exam that measures a patient’s vision, eye movements, hearing, balance, coordination, reflexes, strength, and sensation. Abnormalities in one or more of these areas may provide clues about which part of the brain the glioblastoma is affecting. It is critical for treatment planning and determining prognosis to know how the tumor is affecting the brain and what neurologic deficits it is causing.
• Imaging tests: Advanced medical imaging technology can help surgeons locate a glioblastoma, see the surrounding brain structures, and determine the tumor’s size and invasiveness. Magnetic resonance imaging (MRI) of the brain with contrast is used most frequently to image the brain. If the tumor is near critical structures for speech or movement, then a functional MRI scan will help determine the precise location of those functions and how the tumor is affecting those structures. Other tests include computed tomography (CT) and positron emission tomography (PET) scans.
• Pathological diagnosis: This is typically made during the time of surgery. Certain tumors cannot be safely removed with surgery, so a biopsy is performed to confirm the diagnosis.

Glioblastoma Surgery at CNSO

Unless a tumor is not safe to remove, surgery is always the first and most important step of treatment. Patients are best served by highly skilled and experienced surgeons who can safely remove the majority, if not all, of the tumor. In general, more than 85% of the tumor must be removed to give the patient the best prognosis and outcome. The highly skilled neurosurgeons at CNSO perform a craniotomy or brain operation, which involves removing bone to create a small hole in the skull. This allows direct access to the brain. The surgeon then uses precise tools to remove as much of the tumor as they can without damaging the healthy brain tissue.

By partnering with the best neuroscience hospitals in New Jersey, the team at CNSO can leverage their experience using the latest advanced technology during brain tumor surgery. These advanced technologies include neuronavigation (“GPS” for the brain), use of augmented and virtual reality technology, advanced brain mapping, and use of special fluorescence, technologies that maximize patient safety and outcomes during complex brain surgeries.

As an adjunct to surgery, in certain circumstances, thin wafers that release chemotherapy or localized radiation may be placed inside the brain during surgery. Once placed, the wafer dissolves slowly, allowing the release of the medication or radiation gradually over time, killing any remaining cancer cells.

After the surgery is complete, the bone flap is replaced, and the skin is stitched back into place. The recovery period depends on the extent and location of the tumor. Continued checkups will also be recommended to monitor the patient’s recovery and check for new tumor growth. Glioblastoma surgery is a proven treatment that can extend a patient’s life prognosis by several years or more.

Non-Surgical Treatments for Glioblastoma

Surgery is always the first step in the treatment of glioblastomas, unless the tumor cannot be safely removed. Following surgery, a patient will require further cancer treatment. These therapies include:

Laser treatment (Laser Interstitial Thermal)

For tumors that are inoperable, meaning the tumor cannot be removed safely, a biopsy is performed to confirm the diagnosis. This is followed by a minimally invasive procedure, during which a probe is placed into the tumor, and Laser energy (Laser Interstitial Thermal Therapy, LiTT), controlled by an MRI, is used to destroy the tumor.

Radiation Therapy

Radiation therapy is commonly used after surgery to kill remaining cancer cells. It may also be used alongside other methods as a primary treatment for those who cannot have surgery. This approach uses a powerful X-ray or photon beam. While the patient lies on a table, the beam is pointed at key locations in the brain to kill glioblastoma cells without damaging healthy brain tissue.

Chemotherapy

This approach kills glioblastoma cells using strong medicines. Chemotherapy medicine may be taken as a pill or administered through an injection. Temodar is often the first chemotherapy agent used in the treatment of glioblastoma.

Targeted Therapy

Like chemotherapy, targeted therapy is medicine-based. This treatment, however, attacks specific chemicals found only in cancer cells. By blocking these chemicals, targeted therapy can kill off the cells. It can reduce treatment side effects but is only effective on certain tumors. The patient’s glioblastoma cells must be tested in advance to ensure they will respond to the treatment.

Tumor-Treating Fields Therapy

Tumor-treating fields therapy, also called TTF, is another tool commonly used with chemotherapy or after radiation therapy. It uses a series of adhesive pads that are applied onto a shaved section of the scalp. Their placement corresponds to the tumor location. The pads create an electrical field that disrupts the growth of cancer cells, making it easier for other treatments to kill what remains.

Palliative Care

Palliative care is a special type of care that does not focus on treating a condition. Rather, it is designed to help patients with serious illnesses relieve their pain and improve their quality of life while undergoing treatment. It is often administered along with radiation therapy or chemotherapy.

Care specialists work with the patient and their family to provide an extra level of support that is personalized based on the patient’s unique needs and goals. Treatments may include medication, physical or rehabilitative therapy, psychiatry, or social support and advice. The palliative care team may also refer the patient to other services in their area.

Receive Treatment for Glioblastoma of the Brain at CNSO

Glioblastoma of the brain is the most common form of primary brain tumor in middle-aged and older adults. The knowledgeable team at Centers for Neurosurgery, Spine & Orthopedics (CNSO) delivers compassionate treatment to patients with glioblastoma, providing comprehensive care from diagnosis to surgery and rehabilitation. With multiple locations across New Jersey, including Bergen, Passaic, Essex, Middlesex, Morris, and Hudson counties, CNSO patients can find comprehensive care near them. To learn more about glioblastoma treatment, contact the doctors at CNSO today.

Frequently Asked Questions About Glioblastoma Surgery

What is a glioblastoma?

Glioblastoma is a tumor in the brain. It is formed from glial cells, which support and enable neuronal function. Glioblastomas are graded as malignant or cancerous, meaning they grow quickly and can spread to healthy tissues and, rarely, other areas of the body.

What causes glioblastoma?

The exact cause of glioblastoma is unknown. However, there may be genetic or hereditary elements that influence an individual’s risk of developing a tumor. Exposure to radiation and chemicals may also play a role.

What are the symptoms of glioblastoma?

The symptoms of glioblastoma depend on the tumor’s size, aggressiveness, and location within the brain. They frequently include:

• Headaches, which often feel worse in the morning
• Nausea, vomiting, or loss of appetite
• Blurred or double vision
• Loss of peripheral vision
• Tingling or numbness
• Difficulties with balance or coordination
• Difficulties speaking
• Muscle weakness
• Confusion or difficulty thinking
• Memory loss
• Personality changes and irritability
• Seizures

Is surgery always the treatment for glioblastoma?

Surgery is typically the recommended treatment for glioblastoma. Surgeons cut a small hole in the skull to access the brain, then use precise tools guided by computer imaging to remove the tumor. Follow-up treatments such as radiation therapy or chemotherapy may be recommended to destroy any cancer cells that could not be removed.