Treatment Overview
Receiving a diagnosis of glioblastoma is a life-altering event for patients and their loved ones. As the most aggressive form of brain cancer in adults, it brings immediate challenges, often presenting with symptoms like persistent headaches, seizures, or changes in personality and cognitive function. These symptoms occur because the tumor creates pressure and disrupts normal brain activity. While the diagnosis is serious, treatment plays a vital role in extending life, managing symptoms, and preserving the ability to function independently for as long as possible.
The medical community approaches glioblastoma with a sense of urgency. Treatment goals are to slow the tumor’s growth and manage the swelling and seizures that affect daily comfort. Because every tumor has a unique genetic makeup and location, the care plan is tailored to the individual. Decisions are made based on the patient’s age, overall health, and how much of the tumor can be safely accessed (National Cancer Institute, 2023).
Overview of treatment options for Glioblastoma
Managing glioblastoma requires a multimodal approach. While surgery is almost always the first step to remove as much of the tumor as safely possible, it is rarely curative on its own due to the invasive nature of the cells. Therefore, medication and radiation therapy are critical follow-up treatments designed to target the remaining microscopic cells.
The standard of care typically involves a combination of radiation and chemotherapy delivered simultaneously, followed by a maintenance period of chemotherapy. Alongside these tumor-fighting therapies, supportive medications are used extensively to control the physical symptoms caused by the tumor and the side effects of treatment. This dual approach attacking the cancer while supporting the patient’s physical stability is the foundation of care.
Medications used for Glioblastoma
The primary drug used to treat glioblastoma is an oral alkylating agent called temozolomide. This chemotherapy drug is considered the standard first-line treatment. Patients typically take it daily during radiation therapy and then continue it for several months afterward. Clinical experience suggests that adding temozolomide to radiation therapy significantly improves survival rates compared to radiation alone.
For recurrent glioblastoma, or when first-line treatment is no longer effective, doctors may prescribe bevacizumab. This is a targeted therapy administered through an intravenous (IV) infusion. It is often used to reduce the size of the tumor and alleviate brain swelling, which can help improve neurological symptoms.
Beyond tumor-targeting drugs, supportive medications are essential. Corticosteroids, such as dexamethasone, are almost universally prescribed to reduce cerebral edema (swelling) around the tumor. This helps relieve headaches and neurological deficits. Additionally, because brain tumors irritate electrical pathways, anticonvulsants like levetiracetam are frequently used to prevent or control seizures (American Society of Clinical Oncology, 2023).
How these medications work
Temozolomide damages cancer cell DNA, interfering with rapid replication and triggering cell death, which is vital as it crosses the blood-brain barrier.
Bevacizumab, an angiogenesis inhibitor, starves the tumor by blocking the protein signals needed to create new blood vessels.
Corticosteroids like dexamethasone suppress inflammation and lower blood vessel permeability in the brain, rapidly reducing intracranial pressure and relieving symptoms (Mayo Clinic, 2023).
Side effects and safety considerations
Chemotherapy with temozolomide is usually well-tolerated, causing possible nausea, fatigue, and constipation. A critical safety concern is bone marrow suppression, leading to low platelet and white blood cell counts, which increases the risk of bruising and infection. Regular blood tests are mandatory.
Bevacizumab risks include high blood pressure, bleeding, and poor wound healing, so it’s typically paused around surgical procedures. Long-term corticosteroid use has significant side effects like weight gain, insomnia, high blood sugar, and muscle weakness. Doctors aim to taper the dose to the minimum effective amount. Patients must seek immediate medical care for fever, unusual bleeding, or sudden worsening of neurological symptoms.
Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- American Society of Clinical Oncology. https://www.cancer.net
- Mayo Clinic. https://www.mayoclinic.org
- National Cancer Institute. https://www.cancer.gov
- American Brain Tumor Association. https://www.abta.org
Medications for Glioblastoma
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Glioblastoma.