Glioma - Early Signs, Risk Factors, Diagnosis, and Treatment Explained

Overview: What Is a Glioma?

Gliomas are tumors that start in the brain or spinal cord in cells called glial cells. They can range from slow-growing (low-grade, sometimes non-cancerous) to fast-growing and aggressive (high-grade, cancerous). Gliomas account for about 25% of all brain tumors and nearly 80% of malignant brain tumors in adults.

Because the brain controls movement, memory, speech, and other vital functions, gliomas can cause serious health problems even when small. Early detection and treatment are critical in improving survival rates and maintaining quality of life.

What Are the Types of Gliomas?

Gliomas are classified based on the specific glial cells where the tumor starts:

• Astrocytomas: Tumors that begin in star-shaped cells called astrocytes. They can be low-grade or develop into aggressive glioblastomas.
• Oligodendrogliomas: Arise from oligodendrocytes, which form the protective covering around nerves. These usually grow more slowly than astrocytomas.
• Ependymomas: Form in the lining of the ventricles (fluid-filled spaces in the brain) and the spinal cord.
• Glioblastoma: Glioblastoma is the most aggressive type of astrocytoma and is classified as Grade IV by WHO.
• Mixed Gliomas (Oligoastrocytomas): Contain more than one type of glial cell.

What Are the Causes of Glioma?

The exact cause of gliomas is not fully understood. Scientists believe it develops from genetic mutations in glial cells that cause uncontrolled growth. These mutations may affect how cells repair DNA or control cell division. While no single cause is proven, both inherited and environmental factors likely play a role.

What Are the Risk Factors for Gliomas?

Several factors can increase the likelihood of developing glioma:

• Age: Most gliomas are diagnosed in adults between ages 45–65, though they can occur at any age.
• Gender: Men are slightly more likely to develop gliomas than women.
• Family history: While rare, a small number of cases are linked to inherited genetic syndromes such as Li-Fraumeni syndrome or Turcot syndrome.
• Radiation exposure: People who received radiation therapy to the head during childhood may have a higher risk.
• Weakened immneu system: Long-term immunosuppression, such as after organ transplant, may increase the risk.

What Are the Symptoms of Glioma?

The symptoms of glioma depend on the size, type, and location of the tumor. They may appear slowly or suddenly.

Early symptoms may include:

• Persistent headaches (especially in the morning)
• Seizures
• Nausea and vomiting
• Fatigue or weakness

Advanced symptoms may include:

• Difficulty speaking or understanding speech
• Changes in vision or hearing
• Memory problems
• Trouble with balance or coordination
• Personality or behavioral changes

If you experience persistent headaches or neurological symptoms, it is important to consult a doctor promptly.

How Is Glioma Diagnosed?

Diagnosing glioma requires a combination of neurological exams, imaging, and tissue analysis:

• Neurological exam: A doctor performs a thorough neurological exam to assess your reflexes, muscle strength, coordination, vision, hearing, and balance.
• MRI Scan: MRI is the most common scan to detect gliomas. This is the most sensitive and definitive imaging technique for brain tumors, providing detailed information about the tumor's location, size, and characteristics, including enhancement patterns that help determine the tumor's grade.
• CT Scan: CT scans are sometimes used in emergencies or when MRI is not available, but MRI is the best test to see brain tumors.
• Biopsy: A small sample of tumor tissue is removed for laboratory testing. This confirms the diagnosis and determines the tumor type and grade.
• Molecular testing: Identifies genetic mutations like IDH mutation and 1p/19q codeletion, which guide treatment decisions.

Staging of Gliomas

Unlike many cancers, gliomas are not staged by how far they spread throughout the body. Instead, they are graded by the World Health Organization (WHO) system:

• Grade I: Low-grade, slow-growing, least aggressive.
• Grade II: Still relatively slow but can invade nearby tissue.
• Grade III: Anaplastic cells (no longer resembling the cells they originated from), faster-growing and more aggressive.
• Grade IV: Glioblastoma, very aggressive, spreads quickly, and requires urgent treatment.

The higher the grade, the faster and more aggressive the tumor. The grade of glioma strongly influences prognosis and treatment planning.

What Are the Treatment Options for Glioma?

Treatment depends on tumor type, grade, size, and the patient’s overall health. A multidisciplinary team usually combines several methods:

• Surgery: Surgical removal of the tumor is often the first step. The goal is to remove as much of the tumor as possible without damaging vital brain functions. Advanced techniques like awake craniotomy and intraoperative MRI improve safety and outcomes.
• Radiation Therapy: High-energy beams target tumor cells that remain after surgery. Radiation helps slow tumor growth and improve survival.
• Chemotherapy: Drugs like temozolomide (TMZ) are commonly used to kill cancer cells. Chemotherapy may be given orally or through an IV, often in combination with radiation.
• Targeted Therapy: Drugs designed to attack specific genetic mutations in glioma cells. Bevacizumab (Avastin) is sometimes used to slow tumor growth by cutting off blood supply.
• Immunotherapy: Still being studied, but some patients may benefit from experimental vaccines or immune checkpoint inhibitors.

Proton Therapy: When Is It Applicable?

Proton therapy is a type of radiation therapy that uses protons instead of X-rays. It is more precise and may reduce damage to surrounding brain tissue, making it useful for children or tumors in sensitive brain areas. It spares healthy brain tissue and potentially reduces side effects like neurocognitive decline and lymphopenia.

It is used in the treatment of gliomas as it offers high precision for sensitive areas, reduced neurocognitive decline, and improved quality of life.

What Is the Prognosis for Glioma?

Prognosis depends on tumor grade, patient age, overall health, and genetic markers.

• Low-grade gliomas: Many patients live 10+ years with proper treatment and follow-up.
• High-grade gliomas: Average survival is about 15–18 months, but outcomes are improving with new therapies.

Molecular markers like IDH mutation and MGMT promoter methylation are linked to better survival. Ongoing clinical trials continue to bring hope for longer survival and better quality of life.

Screening and Prevention of Glioma

Currently, there is no standard screening test for glioma in the general population. However, people with a strong family history or genetic syndromes may benefit from regular monitoring with MRI scans.

Prevention strategies:

• Avoid unnecessary radiation exposure to the head.
• Protect overall health through a balanced diet, regular exercise, and not smoking.
• Seek early medical evaluation for persistent neurological symptoms.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of gliomas. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
  • Pre-arrival medical review of reports and imaging.
• Travel and logistics
  • Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
  • Dedicated international patient coordinators to guide through each step.
• Language and cultural support
  • Interpreter services in multiple languages.
  • Clear, simple explanations at every stage with written care plans.
• Financial coordination
  • Transparent treatment estimates and packages when possible.
  • Support with international payment methods and insurance coordination.
• Continuity of care
  • Shared records, imaging, and treatment summaries for home doctors.
  • Telemedicine follow-ups for convenience after returning home.

Frequently Asked Questions (FAQs)

1. What is the survival rate for glioma? 

Survival depends on the tumor grade. Low-grade gliomas may have a survival rate of 10 years or more, while glioblastoma has an average survival of 15–18 months. New therapies continue to improve outcomes.

2. Can glioma be cured?

Complete cure is difficult, especially for high-grade gliomas. However, surgery combined with radiation and chemotherapy can control the disease and help patients live longer with a good quality of life.

3. What are the side effects of glioma treatment?

Common side effects include fatigue, hair loss, nausea, memory or concentration problems, and increased risk of infections. Rehabilitation and supportive care can help manage these effects.

4. What is the recovery time after surgery?

Recovery varies by patient and surgery type. Most patients stay in the hospital for 3–7 days and may take several weeks to return to normal activities. Rehabilitation may be needed.

5. Can gliomas come back after treatment?

Yes. Gliomas, especially high-grade ones, often recur. Regular follow-up with MRI scans is essential. If recurrence happens, additional surgery, radiation, or clinical trial therapies may be considered.

6. How much does glioma treatment cost in India?

Costs vary depending on type, hospital, and treatment plan. At Apollo, costs are significantly lower compared to the US or Europe, while maintaining international standards.

7. Is glioma hereditary?

Most gliomas are not inherited. However, rare genetic conditions may increase risk. If multiple family members are affected, genetic counseling is recommended.