Presented By Mr. Pradeepsingh N B Asst.Professor HOD of Medical Surgical Nursing

1. Glioma

2. Definition
• Glioma is a type of tumor that occurs in the brain and spinal cord.
Gliomas begin in the gluey supportive cells (glial cells) that surround
nerve cells and help them function.

3. Risk factors
• Gliomas are most common in adults between ages 45 and 65 years
old.
• Certain types of gliomas, such as ependymomas and pilocytic
astrocytomas, are more common in children and young adults.
• Exposure to radiation:People who have been exposed to a type of
radiation called ionizing radiation have an increased risk of brain
tumor. Examples of ionizing radiation include radiation therapy used
to treat cancer and radiation exposure caused by atomic bombs.

4. • Family history of glioma. It's rare for glioma to run in families. But
having a family history of glioma can double the risk of developing it.
Some genes have been weakly associated with glioma, but more
study is needed to confirm a link between these genetic variations
and brain tumors.

5. Types of glioma
• Astrocytomas, including astrocytoma, anaplastic astrocytoma and
glioblastoma
• Ependymomas, including anaplastic ependymoma, myxopapillary
ependymoma and subependymoma
• Oligodendrogliomas, including oligodendroglioma, anaplastic
oligodendroglioma and anaplastic oligoastrocytoma

6. Symptoms
• The symptoms of glioma vary by tumor type as well as the tumor's size, location and rate of
growth.
• Common signs and symptoms of gliomas include:
• Headache
• Nausea or vomiting
• Confusion or a decline in brain function
• Memory loss
• Personality changes or irritability
• Difficulty with balance
• Urinary incontinence
• Vision problems, such as blurred vision, double vision or loss of peripheral vision
• Speech difficulties
• Seizures, especially in someone without a history of seizures

7. Diagnosis
• Neurology consultation
• A neurological exam. During a neurological exam, The doctor may
check your vision, hearing, balance, coordination, strength and
reflexes. Problems in one or more of these areas may provide clues
about the part of the brain that could be affected by a brain tumor.
• Imaging tests. Magnetic resonance imaging (MRI) is often used to
help diagnose brain tumors. In some cases, a dye (contrast material)
may be injected through a vein in the arm during MRI study to help
show differences in brain tissue.
• computerized tomography (CT) scan and positron emission
tomography (PET).

8. • Tests to find cancer in other parts of your body. To rule out other types of
brain tumors that may have spread from other parts of the body, the
doctor may recommend tests and procedures to determine where the
cancer originated. Gliomas originate within the brain and are not the result
of cancer that has spread (metastasized) from elsewhere.
• Collecting and testing a sample of abnormal tissue (biopsy). Depending on
the location of the glioma, a biopsy may be performed with a needle
before treatment or as part of an operation to remove the brain tumor.
• A stereotactic needle biopsy may be done for gliomas in hard-to-reach
areas or very sensitive areas within the brain that might be damaged by a
more extensive operation. During a stereotactic needle biopsy, the
neurosurgeon drills a small hole into the skull. A thin needle is then
inserted through the hole. Tissue is removed through the needle, which is
frequently guided by CT or MRI scanning.

9. Treatment
• Treatment for glioma depends on the type, size, grade and location of
the tumor, as well as your age, overall health and preferences.
• In addition to actions to remove the tumor itself, treatment for
glioma may also require using drugs to reduce the signs and
symptoms of tumor.

10. Surgery
• Surgery to remove as much of the tumor as possible is usually the
first step in treating most types of gliomas.
• In some cases, neuropathologists may analyze tissue samples
removed by a surgeon and report the results while surgery is
underway. This information helps the surgeon decide how much
tissue to remove.

12. • A variety of surgical technologies and techniques may be used to
assist the neurosurgeon in protecting as much healthy brain tissue as
possible while removing the tumor, including computer-assisted brain
surgery, intraoperative MRI, awake brain surgery and lasers. For
example, during awake brain surgery, may be asked to perform a task
with the goal of ensuring the area of the brain controlling that
function is not damaged.

13. Radiation therapy

14. • Radiation therapy usually follows surgery in treatment of glioma,
especially high-grade gliomas. Radiation uses high-energy beams,
such as X-rays or protons, to kill tumor cells. Radiation therapy for
glioma comes from a machine outside the body (external beam
radiation).
• Radiation therapy options include:
1. Using computers to pinpoint delivery of radiation treatment to the
exact location of the brain tumor. Techniques include intensity-
modulated radiation therapy and 3D conformal radiation therapy.
2. Using protons — the positive parts of atoms — rather than X-rays as
the source of radiation. This technique, called conformal proton
beam therapy, delivers radiation only once proton beams reach the
tumor, causing less damage than X-rays to surrounding tissue.

15. • Using multiple beams of radiation to give a highly focused form of
radiation treatment. While this technique is called stereotactic
radiation therapy (radiosurgery), it doesn't actually involve surgery in
the traditional sense. Each beam of radiation isn't particularly
powerful, but the point where all the beams meet — at the brain
tumor — receives a very large dose of radiation to kill the tumor cells
in a very small area.

17. Chemotherapy
• Chemotherapy uses drugs to kill tumor cells. Chemotherapy drugs can be
taken in pill form (orally) or injected into a vein (intravenously).
• Chemotherapy is usually used in combination with radiation therapy to
treat gliomas.
• The chemotherapy drug used most often to treat gliomas is temozolomide
(Temodar), which is taken as a pill.
• Side effects of chemotherapy depend on the type and dose of drugs
receive. Common side effects include nausea and vomiting, headache, hair
loss, fever, and weakness. Some side effects may be managed with
medication.

18. Targeted drug therapy
• Targeted drug treatments focus on specific abnormalities present
within cancer cells. By blocking these abnormalities, targeted drug
treatments can cause cancer cells to die.
• One targeted drug therapy used to treat a type of brain cancer called
glioblastoma is bevacizumab (Avastin). This drug, given through a vein
(intravenously), stops the formation of new blood vessels, cutting off
blood supply to a tumor and killing the tumor cells.

19. Rehabilitation
• Physical therapy can help the regain lost motor skills or muscle
strength.
• Occupational therapy, which can help get back to the normal daily
activities, including work, after a brain tumor or other illness
• Speech therapy with specialists in speech difficulties (speech
pathologists), which can help if patient have difficulty speaking
• Tutoring for school-age children, which can help kids cope with
changes in memory and thinking after a brain tumor