What is a Glioma?

Gliomas are a type of tumour in Singapore that may grow in the brain or spinal cord. More often than not, gliomas are cancerous and require prompt and effective medical intervention. Gliomas are usually classified as:

  • Low-grade gliomas: grade I and II gliomas that are slow-spreading. These types of tumours are usually benign but can mutate into high-grade gliomas if they remain untreated at earlier stages.
  • High-grade gliomas: grade III and IV (glioblastomas) gliomas are malignant tumours that spread and grow fast and are significantly more complex to treat.

Gliomas can affect patients of any age. Gliomas are perilous as they can spread (metastasise) to other parts of the brain and other organs such as the lungs and liver. The spread to other organs is also known as distant metastasis. This brain tumour is also devastating as one can observe an apparent decline in cognitive and physical function in affected patients.  

cancer metastasis
Cancer cells spread to other parts of the body through the blood and lymph vessels

Glioma growth is a result of mutations in glial cells. Glial cells are pertinent in aiding in the communication and information processing of synapses and the signalling capabilities of neurons. Some types of gliomas include:

  • Astrocytoma: originates from astrocytes. These tumours are most common among adults and are also known to grow aggressively.
  • Glioblastomas: the outcome of developed astrocytomas (stage IV astrocytomas). Glioblastomas are malignant (cancerous).
  • Ependymoma: originates from ependymocytes. These forms of tumours are the third-most common paediatric brain tumour.
  • Oligodendrogliomas: originate from oligodendrocytes and are slow-spreading at the beginning. Oligodendrogliomas are primary central nervous system tumours.
  • Mixed glioma: these are tumours made up of astrocytomas and oligodendrogliomas.
  • Brainstem gliomas: as the name implies, they are found on the brainstem and account for over 20% of paediatric tumours. They are rarer in adults in comparison.
  • Optic pathway gliomas: found on the optic nerve, subsequently disrupting messages between the eye and brain.

What causes Glioma?

The exact cause of gliomas remains unclear. The mechanism of how gliomas are formed is attributed to genetic mutations. When said mutation occurs, the rapid growth of glial cells materialises, subsequently turning into tumours.

brain tumours
Brain tumours can either be malignant or benign, depending on the type of tumour and where it originates.

What are the common symptoms of Gliomas in Singapore?

Symptoms of glioma growth in the brain vary. The variations depend upon the type of glioma, the size of the tumour, the growth rate, and the growth location. However, some general signs may serve as warning signs of gliomas present in the brain:

  • Headaches
  • Persistent nausea
  • Vomiting
  • Confusion
  • Issues with comprehending information
  • Memory loss
  • Irritability
  • Abrupt personality change
  • Blurred vision and diplopia (double vision)
  • Onset of seizures
  • Speech impediments
  • Gait instability

The changes that occur in an individual with gliomas can cause emotional distress to themselves and the people around them. Empathy and patience are important aspects of dealing with the condition to preserve the patient’s psychological health.

Are Gliomas painful?

The pain from gliomas manifests in the form of headaches. Particularly ones that worsen in the morning, when shifting positions, coughing, and exercising. The pain is described as persistent dull aches versus a throbbing pain one may feel when dealing with regular headaches. The pain is often caused by increased brain pressure from the tumour's growth. Patients have also reported relief from pain upon vomiting.

Who is at risk of Gliomas in Singapore?

While the cause of gliomas remains uncertain, certain risk factors may predispose one to gliomas. These include:

  • History of radiation therapy: this mainly applies to those who have had abnormal growth and sought radiotherapy as a treatment. Gliomas induced by radiotherapy are also known as radiation-induced gliomas. 
  • Prior history of cancer: patients with a history of cancer, such as breast and lung cancer, may have an increased risk of cancer metastasising to the brain.
  • Dietary factors: a study has shown that those with a high intake of grains, processed meat, and processed fish have an increased risk of gliomas.
  • Family history: gliomas are prevalent among those with a family history of inherited syndromes such as neurofibromatosis and Li-Fraumeni. A family history of gliomas or brain cancer also increases the likelihood of an individual developing similar cancer.

How are Gliomas diagnosed in Singapore?

Efforts to diagnose gliomas are rather extensive and will require some sequential steps such as:

Symptoms of gliomas
Glioma growth in the brain may present symptoms such as nausea and frequent vomiting.
  • Medical review: symptoms, family history, and risk factors are evaluated in the initial stages of diagnosis.
  • Neurological examinations: a set of tests that will be administered to assess the state of your nervous system.
  • Imaging tests: computed tomography scans (CT scans) (link to service page) and magnetic resonance imaging (MRIs) (link to service page) will be requested to determine the size, location, and the possibility of increased pressure in the brain.
  • Biopsy: where possible, a biopsy will be conducted to determine the type of glioma in the brain. However, if gliomas are found in sensitive regions of the brain, the biopsy will not be attempted as it is perceived to be risky.

What are the treatment options available for Gliomas in Singapore?

Depending on the glioma's size, type, and location, the treatment approach may vary. Generally, treatment may involve:

  • Total resection or subtotal resection: if possible, your neurosurgeon will attempt to remove the glioma in its entirety. However, if deemed unsafe, your surgeon will at least attempt to partially remove the glioma.
  • Radiotherapy: radiation (also gamma rays) therapy may be administered to kill tumour cells if surgery is deemed unsuitable or insufficient.
  • Chemotherapy: if the glioma is malignant, chemotherapy will be administered to kill cancer cells and reduce the likelihood of metastasis.
  • Combination of treatment modes: a combination of two or more treatment methods may be utilised if necessary. This varies depending on the condition of each patient.
  • Oral medication: you may be prescribed some medication to manage symptoms of seizures, brain swellings, brain fog, fatigue, and to improve cognitive function.
brain CT scan
A brain CT scan will be obtained to diagnose gliomas.

Frequently asked questions  

What is the life expectancy of a person with a glioma brain tumour?

The life expectancy ranges depending on the type of glioma, location, malignancy, and the stage of progression. Where low-grade gliomas are concerned, the life expectancy goes up to 7 years upon diagnosis. Patients with low-grade gliomas generally have a better survival rate than those with high-grade gliomas.
In the case of glioblastomas (grade IV astrocytomas), the survival rate for adults is 14.6 months upon diagnosis. There are even cases of patients living up to 25 years. Patients and their loved ones need to see past the possibilities of recovery beyond the statistics. Today, more efficient treatments are available, interventions are introduced at earlier stages, and the management of gliomas (rehabilitation, diets, etc.) is more comprehensive.
Below is a table with the estimated 5-year rate of survival:

Is glioma cancer curable?

The statement “glioma cancer” indicates that the glioma has progressed to grades 3 and 4 and is subsequently diagnosed as brain cancer. Whilst curing a cancer patient is not scientifically viable (there is yet to be a singular cure for cancer) promise, there are treatments that could eventually treat you.

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Copyright © 2023 Chou Neuroscience Clinic. All Rights Reserved