1. GBMs usually evolves from an astrolytic tumor in the star shaped brain cells called astolytes.
These cells help keep the nerve cells healthy and are a type of glial cell. From this the disease
gets its name, glioblastoma multiforme (GBM). GBM is an extremely aggressive form of brain
cancer, one of the few cancers that are truly of the brain and not metastases from another part
of the body. They are more common in adults and can spread across brain tissue and the spinal
cord. These are some of the most lethal cancers and life expectancy is 15 months from
diagnosis. There are few treatment options available and those that are are palliative in nature.
There are currently 338 clinical trials underway for brain cancer treatments. GBMs were recently
in the popular media due to research at Duke University. In a Phase 1 trial researchers were
able to show some progress in slowing the growth of the tumor by a single injection of an
altered polio virus. This discovery led to much media hype but has not been rigorously tested at
other labs. There is also interest in the genetic markers for glioblastomas. The EGFR gene may
play a role in the development of the tumor. Also, the GBM alters genes that encode for ion
channels. By upregulating these channels there is an increase in the movement of fluid over a
cell membrane. This increases fluid available for the tumor to grow rapidly.
GBM is so deadly because of its location. There is little room for a growth in the solid skull.
Tumors press against brain tissue and cause significant neurological symptoms. GBMs are also
lethal because of: tumor resistance to convention treatment,the limited capacity of the brain to
repair itself, malignant migration into adjacent brain tissue and capillary leakage causing fluid
around to tumor creating even more pressure on the brain. Most tumors are considered a Grade
IV on the World Health Organization Tumor Grading System. The WHO grading system goes
from I to IV in tumor severity. Grade IV are usually not treatable.
Symptoms are neurological in nature and result from increasing pressure on the brain and the
overall disruption of brain function. The extent of disability depends on the location of the tumor
with GBMs often appearing in the frontal and temporal lobes. Frontal lobe involvement leads to
bowel and bladder control problems and progressive personality changes. Temporal lobe
involvement can cause hallucinations and memory difficulty(hypocampus). Motor neuron
damage can cause ataxia and hemiparesis. Sensory neurons can be infringed on and cause a
person to lose the ability to recognize familiar places. Nausea and vomiting are hallmark
features of brain tumors and can be difficult to treat.
Through study during this course I have learned how to approach a disease or disorder from
several aspects. I worked from the cellular level up to the grosser motor and neuronal functions
in my research for this paper. I understand both the nature of the cancer described here as well
as why the tumor has proven so difficult to treat, I also felt comfortable reading the research of
the early Duke trials
My best friend when I was a child had glioblastoma mulitforme. He was bald and blind relatively
early in his journey. As a kid it didn't matter to me. I also did not understand what would happen.
He died a year after he was diagnosed. I will always remember him, not because of the cancer
but because his mother gave us Spaghetti-os for lunch and didn't tell my mom.