Aggressive glioblastoma: what to know

Aggressive describes how readily the tumour grows into nearby brain tissue; it does not predict exactly what will happen to one person. The tumour's position, the person's health, molecular findings and how much can be removed safely all shape the care plan.

Glioblastoma cells can extend beyond the main mass seen on a scan. This makes complete surgical removal difficult because healthy brain tissue controls speech, movement, memory and other functions. Treatment therefore commonly combines approaches rather than relying on surgery alone.

Symptoms depend on the affected brain area and may include worsening headaches, seizures, weakness, changes in speech, confusion, personality changes, nausea or problems with balance. These symptoms can also have other causes, so assessment and brain imaging are needed to understand them.

Care is usually coordinated by a team that may include neurosurgery, medical oncology, radiation oncology, neurology, rehabilitation and supportive care. Brain tumour surgery may obtain tissue for diagnosis and remove as much tumour as is safely possible. Radiotherapy and chemotherapy may then target tumour cells that remain.

Keep an updated medicine list and a record of seizures, headaches, weakness, sleepiness or behaviour changes. Take prescribed anti-seizure medicines or steroids exactly as directed, and do not stop steroids suddenly unless the treating team provides a tapering plan. Rehabilitation, nutrition support and help with daily activities can be introduced alongside cancer treatment.

Call emergency services for a first seizure, a seizure that does not stop, repeated seizures without recovery, sudden one-sided weakness, new difficulty speaking, loss of consciousness or severe breathing difficulty. Keep the person away from hazards during a seizure, cushion the head and do not place anything in the mouth.

Contact the treatment team promptly for a steadily worsening headache, repeated vomiting, increasing confusion, unusual drowsiness, new balance problems, fever during treatment or a clear decline in everyday function. These changes may reflect the tumour, swelling, infection, a medicine effect or another problem that needs assessment.

Ask where the tumour is, which functions are close to it and what surgery is intended to achieve. Other useful questions cover the pathology and molecular results, the sequence of radiotherapy and chemotherapy, possible effects on thinking or movement, seizure precautions, driving restrictions, rehabilitation and whether a suitable clinical trial is available.