Glioblastoma multiforme, or GBM, is a type of tumor that begins in the brain or spinal cord, and these types of tumors are known as primary brain tumors. Other tumors, such as breast tumors, that travel to the brain are secondary brain tumors. It’s important to note that spinal cord glioblastomas are very rare — only about 1 to 3 percent of occurrences, according to research. Most GBMs occur in the brain.
GBM stays in the brain or spinal cord and rarely travels to other organs, but symptoms appear in parts of the body controlled by the affected parts of the brain. They tend to grow rapidly within the brain and are deadly.
The brain controls so many functions throughout the body that symptoms manifest usually far from the brain. An otherwise active person might collapse on the tennis court, for instance, while someone else might speak unclearly. (1)
Symptoms relate to the location of the tumor (usually frontal or temporal lobe if in the brain), increased pressure on parts of the brain near the tumor, and size of the tumor. Symptoms vary from person to person, depending on these factors. As the cancer grows, the symptoms will multiply, affecting more body functions. If a glioblastoma patient has surgery, radiation, chemotherapy, or other treatments, some symptoms may improve, though other symptoms may emerge related to the treatment’s side effects.
What Are the Early Signs and Symptoms of Glioblastoma?
The most common signs and symptoms of a newly diagnosed glioblastoma are:
Headaches Combined With Nausea and VomitingSometimes dizziness or vertigo occur. These tend to occur in the early morning and often become persistent or severe.
Seizures The type of seizures depends on where in the brain the tumor is located. They can be partial (limited to one part of the brain with a corresponding small part of the body affected), complex partial (short seizures that the person does not remember), or generalized (affect both sides of the brain and involve loss of consciousness).
Focal Neurologic Deficits These problems can manifest as compromised nerve, brain, or spinal cord dysfunction, and can affect many body functions. (2)
Key examples include:
- Movement difficulties, such as paralysis, weakness, loss of muscle control, and involuntary movements, such as tremors
- Balance difficulty and clumsiness
- Sensation changes, including numbness or decreased feeling in parts of the body
- Vision abnormalities, such as double vision, blurred vision, and loss of peripheral vision
- Not noticing a part of the body or surroundings, known as “neglect”
- Loss of coordination or loss of motor control
- Speech or language problems, such as aphasia (not understanding or producing words), dysarthria (difficulty saying words), poor enunciation, poor understanding of speech, trouble writing or reading, failure to name objects correctly (anomia)
- Difficulty walking because of weak arms or legs
- Loss of appetite
Glioblastoma Headaches: Different From Other Headaches
Headaches occur in almost 60 percent of glioblastoma patients.
Pain tends to start when patients wake up.
Pain is persistent, and symptoms are not like a migraine headache.
Vomiting may happen along with the headache.
Throbbing may be present, but this varies with the tumor’s location.
The headaches often get worse with coughing, exercise, or a change in body position.
Headache remedies are of no help in alleviating symptoms.
The headaches may be linked to new neurologic problems. (3)
RELATED: What Is a Migraine?
Helping a Patient With Headaches Related to a Glioblastoma
Understanding the pattern of a headache can be helpful for treatment and better understanding of the severity of the headache. Caregivers should consider the following:
- Make sure the neurologist is aware of the problem and prescribes medicine. If the medicine stops working, let the doctor know.
- Keep a headache journal that addresses the time of day, location, and type of pain, as well as other symptoms that the patient is experiencing.
- Call 911 or go to the emergency room if the headache is accompanied by a fever or stiff neck.
Importantly, “headache, by itself, is rarely a brain tumor,” according to the Johns Hopkins brain tumor website.Kaisorn Chaichana, MD, a neurosurgeon at the Mayo Clinic who is based in Jacksonville, Florida, says that the chance that your headache is a brain tumor is extremely remote. Not only are headaches extremely common in general, but without the accompanying red flags discussed here — for example, seizures, nausea and vomiting, vision problems, and speech impairment — a brain tumor is highly unlikely. For evaluation and treatment of headaches without these other symptoms, see your primary care doctor. (4)
Typical Signs of Seizures Caused by Brain Tumors
Seizures occur in about 60 percent of patients with brain tumors. Often the first sign that something is awry in the brain, seizures are especially frequent in patients with slow-growing glioblastomas and metastatic brain tumors.
The hallmarks of seizures in people with brain tumors are:
- Sudden onset
- Duration is short, between two and three minutes
- Loss of consciousness and body tone, as well as twitching and relaxing muscle contractions
- Bodily functions lose control (stool or urine incontinence)
- Tongue biting
- 30-second periods of no breathing, possibly turning blue
- Aftereffects, such as sleepiness, headache, confusion, sore muscles, brief weakness, and numbness (3)
What are the Warning Signs of an Impending Seizure?
Often, seizures come on without warning. If a person feels it coming on, he will experience what is called an “aura,” a sensation, such as flashing lights, blurred vision, numbing, or difficulty speaking.
How Can You Help a Patient Having a Seizure?
Watching a seizure can be frightening, but you can help avoid complications by responding appropriately.
According to theAmerican Brain Tumor Association, this is how you can help:
- Avoid panicking because most seizures are self-limited (stop on their own).
- Check to see that the person is breathing.
- Remove sharp objects or anything dangerous, even the patient’s eyeglasses.
- Make sure that the head is not in danger of bumping into something.
- Do not put anything in the person’s mouth.
- Although the patient’s limbs may be moving wildly, do not attempt to restrain the person.
After a seizure:
- Put the patient on his or her side and ensure that the airway is open.
- Be patient while the person recovers.
- Slowly help reorient the patient, giving your name, where you are, and tell them what happened.
- Don’t expect the person to remember what happened.
- Urge the person to rest until he feels like himself again.
- Check with the person’s doctor regarding whether the seizure medicine needs to be changed.
- Keep track of seizure symptoms.
You should call 911 or go to the emergency room when:
- Breathing seems labored or stops.
- The seizure is longer than five minutes.
- The patient injures himself during the seizure.
- The patient has diabetes or is pregnant.
- The seizure occurs in water.
- A second seizure occurs shortly after the first one. (5)
RELATED: What Is Epilepsy?
Memory Loss Is a Common Glioblastoma Symptom
Memory loss is a frequent symptom in patients with glioblastomas. It can be related to the cancer itself or treatment. Short-term memory problems interfere with daily living more than long-term memory problems. Fatigue can add to these deficits.
- Getting sufficient sleep, eating healthfully, and drinking plenty of fluids may be helpful.
- Limiting stimulation and noise may calm a person down with these problems.
- Keeping the home in order can prove helpful so that the person is not thrown by where things are.
- Other helpful aids include making lists, calendars, daily planners, and timers. (3)
A Significant Number of Brain Tumor Patients Experience Depression
Depression is common in cancer patients, and it occurs in more than 25 percent of brain tumor patients. (3)
Symptoms of major depression include sleep disorders, insomnia, lack of interest in activities of daily living, deep sadness and lethargy, feelings of worthlessness or guilt, and thoughts of suicide.
A psychiatry referral may help alleviate the depression. Both antidepressants and talk therapy may prove helpful.
RELATED: Depression Signs, Symptoms, Latest Treatments, Tests, and More
Many Glioblastoma Patients Also Exhibit Personality and Behavioral Changes
The vast majority of patients with glioblastoma eventually have behavioral and personality changes. Key difficulties include problems with speech and language, attention and concentration, executive functioning, disinhibition, and general intellectual activities.
A comprehensive neuropsychological examination can help point to therapies that might be useful.
Focal Neurologic Deficits: When Tumors Affect a Specific Body Part
Focal deficits occur because of problems with the nerve, spinal cord, or brain function. Such deficits typically affect a specific location, such as the left side, right leg, or ear. The patient can develop a useless arm or leg or become unaware of a part of the body. Changes in movement and sensation are common. Speech, vision, and hearing changes are also focal deficits. Swallowing difficulties, poor gag reflex, and frequent choking can also occur. What makes these problems focal is that the part of the body that is affected tracks back to the part of the brain affected by the tumor. (6)