Treatment of glioblastoma in Germany
Glioblastoma is a brain tumour with a high level of malignancy. This disease affects 2-3 cases per 100 thousand people a year. This pathology is not very wide-spread as compared to the cancers of the other location. But if we talk about just the central nervous system cancer pathologies, the incidence of glioblastomas accounts for over 50% of all malignant brain tumours.
Causes of Glioblastoma
It is believed that one of the main causes of glioblastoma is the activity of some viruses. Among them are:
Other risk factors of the disease are:
- Occupational hazards (such as lead)
- Ionising radiation
- Malaria (malaria vectors parallel to infect human viruses that can trigger the occurrence of glioblastoma)
Males get glioblastoma more often than females. The genetic factor is excluded as all the cases carry only the sporadic character.
Glioblastoma - Symptoms
If the malformation is of the small size, the disease is asymptomatic at the early stages. Furthermore, glioblastoma manifests itself with the clinical signs, character and expressiveness of which depends on the location of the pathological process.
The following symptoms are often observed:
- Vomiting without nausea
- Mental disorders
- Decreased visual acuity
- Hallucinations, most often – olfactory ones
- Speech disorder
- Memory disorders
- Numbness of extremities
- Paresis and paralysis
As well as the majority of the malformations, glioblastoma is characterised by the general symptoms also. Fever, weight loss, nervousness, asthenia, fatigue, pain in the muscles and bones are among them
Glioblastoma - Diagnostics
Non-invasive instrumental methods detect the tumour in the brain.The following ways are applied for this purpose:
- CT scan
Biopsy is needed to establish the diagnosis. Stereotactic biopsy is usually performed as it allows you to obtain tissue samples for research from different areas of the tumour, which makes it possible to significantly reduce the likelihood of diagnostic error.
Treatment of Glioblastoma abroad
Glioblastoma is poorly treated, and survival rate remains low. The tumour grows rapidly and affects the vital functional areas of the brain.
Currently, conventionally used methods of treatment are as follows:
Surgical resection is an opened surgery that presupposes the craniotomy performance and the glioblastoma is removed. The complexity of such operations is the inability to remove tissue with a margin, as this affects key functional areas of the brain. For the accuracy of the operation, doctors use a variety of high-tech equipment: neurorouters, operating microscopes, ultrasonic aspirators-destructors. The better equipped the clinic, the higher are the chances of success after the operation.
Radiation therapy is held both intraoperatively (contact radiotherapy), or remotely. Irradiation can slow the tumour growth.
Radiosurgery and proton surgery. Tumour is influenced by the focused beam of ionizing particles. Radiosurgical methods are cheaper, but they are less accurate. Proton therapy is more accurate, thereby allows avoiding damage to the adjacent healthy brain tissue, but requires expensive equipment. It is therefore available only at certain hospitals.
Chemotherapy. The effectiveness of the medications used remains low. This is connected with the impossibility of the drugs to cross the blood-brain barrier. But doctors continue to struggle with this issue. The possibility of the chemotherapy injection into the brain through a small hole left after the operation with a pipe is being researched.
Latest treatment methods of Glioblastoma
New techniques of glioblastoma treatment are constantly investigated. In the recent years the use of new medications that allow to slow down the tumuor growth, has been started:
- Inhibitors of angiogenesis (bevacizumab when used glioblastoma)
- Growth factor inhibitors
- Hypoxic cell sensitizers (they help to increase the effectiveness of radiation therapy due to oxygenation of the tumour cells)
The latest surgical methods of glioblastoma treatment:
Fluorescent diagnostics is used within the surgical treatment. The patient drinks the fluid, which is selectively accumulated in the tumor tissue. As a result, the surgeon sees glioblastoma cells in a special light during the operation provided by an operating microscope. Fluorescence diagnostics gives the physician a chance to distinguish healthy tissue from pathological changes.
Endoscopic surgery. If the tumor is of small size and its location is near the ventricles or the pituitary gland, an operation without opening the skull is possible. If the location of the glioblastoma is near the pituitary gland then surgical instrument access is performed through the nasal cavity. Similarly some tumours located on the ventricles of the brain can be removed with access to the small holes in the skull made on the border of hair growth.
Latest techniques of radiation therapy provide the accurate rays effect at the tumour without affecting healthy tissue. Advanced clinics use the following methods of treatment:
- Stereotactic conformal radiotherapy (3D-CRT) rays are pointed precisely at the tumour cells
- Intensity Modulated Radiation Therapy (IMRT) allows you to create a high-intensity stream of rays, forming the radiation field of some form (corresponding to the shape of the tumour)
- Image-Guided Radiation Therapy (IGRT). During therapy the computer tomography is used, which allows the visualisation of the tumour and more accurately direct radiation
Tumour Treating Fields (TTFs) is the latest glioblastoma treatment method. The electric field triggers the apoptosis (death) of the brain tumour cells, but healthy cells are not affected. The device for generating an alternating electric field is used constantly, 18 hours a day. The third research phase of this glioblastoma treatment method ended only in 2016. Tests have shown that the life expectancy of patients with this aggressive form of cancer increases approximately twice: from 1-2 years to 2-4 years.
Glioblastoma - Prognosis
Glioblastoma is characterised by a poor prognosis. Although it does not go beyond the cranium, malignant formation is characterised by:
- Rapid growth
- Infiltrative growth (tumour affects surrounding brain tissue)
- Poor response to chemotherapy
Without treatment, the patient's death can occur as early as 2-3 months after diagnosis establishment. When surgery, radiation and chemotherapy were used, two-year survival is 40-50%. Life expectancy of patients after diagnosis is 1-2 years. Prognosis depends to the greatest extent on the stage of the tumour and its location.
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc