Glioblastoma is a brain cancer that happens in astrocytes. Astrocytes are a type of glial cells, the most abundant cells in the CNS. According to the National Brain Tumor Society, 13,000 Americans get diagnosed with GBM. Their next factoid is that 10,000 Americans “succumb” to Glioblastoma each year. Succumb really sticks out for a Medical National Society to use. With GBM’s current treatment plans and outlook, it is very fitting. Even in today’s day and age, treatment is very limited. Surgery, radiation, and chemotherapy have been the only approved treatment. Yet survival rates are trending up. Although the extension of 2-4 years may not be ideal, it is something. Especially for the diagnosis.
Why is it so limited?
The human body is just amazing and so complex. It almost has its own security or fail-safe plans. When everything is going as planned it is wonderful. When things aren’t, our body’s own security systems may interfere with external care that needs to happen.
Glioblastoma is very difficult to treat. Functions of glial cells are to maintain (promote formation of blood vessels for nutrition) and add structure to neurons in the CNS. Their spider web shape allows for them intwine in the brain to deliver proper nutrients. Which are vital for survival. Yet when cancer happens in these cells, the natural functions aids for this cancer be so aggressive and resilient. The shape of the tumors makes clean safe surgical removal of the tumor toilsome and dangerous. A 2021 article done by Stanford’s Neurology and Oncology departments found that there is a correlation between size of tumor removed to length of survival. The extent of surgical possibilities must be uniquely planed out. Glioblastomas are surrounded by brain matter patients physical or cognitive functions may be a risk.
The blood brain barrier is like a filtration system which allows only small fat-soluble molecules or ones that can bind to membrane proteins can bind. Transportation is only limited to certain areas of the brain. It is a great defense system, it’s your brain. You don’t want just anything to be able to get into your brain. Unless you have cancer and need treatment. Temozolomide is a very common medication the treat GBM, is it small and has fat like properties. TMZ targets the cancers DNA and adds a methyl group to DNA’s bases which stops its ability to replicate. Radiation is also used to disrupt the DNA and can shrink the tumors.
Ongoing Plans
Yet there is hope, many clinical trials are happening as we speak. According to a 2022 article, there hasn’t been a new drug approved as treatment since 2009. This article used ClinicalTrials.gov to find at the time 157 clinical trials. Currently in the US there are 231 studies happening right now focusing on glioblastoma from just over the 25,000 clinical trials currently happening.
Medical treatment advances do still happen, but we are starting to catch up with our capabilities in this technology era. Over the last 10 years, success rates of clinical trials have dropped. Why you might ask. Well without more major advances, only certain minor advancements can happen. I kind of like to think of it like when the first microscope was created, I believe in the 1600s. There was only a limited things we can learn (at the time they were huge advancements.) Yes, it opened doors and caused a cascade allowing technology and science to be what it is today. In a way there is always a fluctuating limit of what we can advance at a given time. Still it is happening it just may need a miraculous discovery first to help. New clinical trials for treatments are looking into Nano therapy, inhibitor therapy, and immunotherapy. A neurosurgeon believes that the “groundbreaking” discoveries in treatment will be with immunotherapy
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