Glioblastoma Multiforme

A Statistic of One: My Walk with Glioblastoma Multiforme traces Stephen Hatraks life from his diagnosis of glioblastoma multiforme, the deadliest of malignant brain tumors, to the present. He chronicles the trials and tribulations he faced and the losses he suffered along his journey. Faith and inner strength are formidable allies in overcoming any tragedy in ones life, and they played vital roles in his struggle. He was told from the start that the he might have twelve months to live; even so, he defi ed the odds and, six years later, is telling his own story. Despite the dire statistics associated with a diagnosis of glioblastoma, there are several stories of long-term survival; these stories gave him hope that this cancer could be tamed. To overcome this challenge in his life, he had to believe in himself and fi nd his inner sixth sense to strengthen his resolve. Along the way, he learned that life with brain cancer could be tough, but that he could be even tougher. What cancer cannot do.separate me from my soul, squash my spirit, and stop the sun from rising in the east and setting in the west; creating new tomorrows and new opportunities. A Statistic of One is an uplifting story of faith and perseverance; how we cope with challenge will determine how we move forward and live life to its fullest.

Glioblastoma is the most malignant brain tumor that still remains incurable. It is such a deadly disease that patients do not survive more than a few months after diagnosis. Our understanding of the histopathology and molecular mechanisms of formation of glioblastoma is rapidly advancing so as to provide us clues for devising rational therapeutic strategies for treatment of this malignancy. It is important that we continue to improve our knowledge about the pathogenesis of this devastating disease and explore new areas to find successful therapeutic strategies. Various approaches such as sophisticated imaging techniques, improved surgical procedures, ground-breaking strategies for radiotherapy, chemotherapy, immunotherapy, chemoimmunotherapy, and photodynamic therapy are being used for eradicating glioblastoma. Hopefully, this book will be an important source of information on glioblastoma and therefore be highly useful to the students, postdoctoral fellows, principal investigators, and clinicians involved in this field.

Treatment of malignant glioma remains a major challenge for neurosurgeons, neurologists, medical oncologists, and radiation oncologists caring for patients with these tumors. Glioblastoma multiforme, the most common type of brain tumor, is also the most deadly -- only five percent of patients or fewer will be alive at five years after diagnosis. This comprehensive new reference is edited by a renowned team consisting of a neurosurgeon, medical oncologist, oncologic surgeon, and radiation oncologist. The book provides basic researchers and clinicians with a contemporary review of the epidemiology, diagnosis, and treatment of glioblastoma multiforme, and also imparts to experienced investigators outside of the field sufficient background to apply their skills to the treatment of this deadly disease. Expert malignant glioma researchers and clinicians provide state-of-the-art chapters on important topics such as molecular genetic classification of glioblastoma, surgical management, stem cell therapy, chemotherapy, angiogenesis, and more.

Genetic alterations in cancer, in addition to being the fundamental drivers of tumorigenesis, can give rise to a variety of metabolic adaptations that allow cancer cells to survive and proliferate in diverse tumor microenvironments. This metabolic flexibility is different from normal cellular metabolic processes and leads to heterogeneity in cancer metabolism within the same cancer type or even within the same tumor. In this book, we delve into the complexity and diversity of cancer metabolism, and highlight how understanding the heterogeneity of cancer metabolism is fundamental to the development of effective metabolism-based therapeutic strategies. Deciphering how cancer cells utilize various nutrient resources will enable clinicians and researchers to pair specific chemotherapeutic agents with patients who are most likely to respond with positive outcomes, allowing for more cost-effective and personalized cancer therapeutic strategies.

Cancer is a major worldwide public health problem and is the second leading cause of death in the United States. In 2018, there were seventeen million new cancer cases and 9.5 million cancer deaths worldwide. Seemingly, everyone has been affected by or knows of someone who is affected by the disease. In 2004, doctors discovered that Carmen Rice had a stage 4 Glioblastoma Multiforme brain tumor, one of the deadliest of all cancers—the same cancer which killed John McCain, Edward Kennedy, and Beau Biden. After being diagnosed with a glioblastoma tumor, twenty-nine-year-old Brittany Maynard made headline news when she moved to Oregon to die with dignity. Carmen’s doctor gave her six months to live, but with her faith in God and tenacious spirit, Carmen just kept beating the odds. After all these years, Carmen is “off the map” and into uncharted territory. They Call Me "The Miracle" is her story.

This atlas is a detailed guide to the imaging appearances of gliomas following treatment with neurosurgery, radiation therapy, and chemotherapy. Normal and pathological findings are displayed in detailed MR images that illustrate the potential modifications due to treatment. Particular emphasis is placed on characteristic appearances on the newer functional MR imaging techniques, including MR spectroscopy, diffusion-weighted imaging, and perfusion imaging. These techniques are revolutionizing neuroradiology by going beyond the demonstration of macroscopic alterations to the depiction of preceding metabolic changes at the cellular and subcellular level, thereby allowing earlier and more specific diagnosis. A key section comprising some 40 clinical cases and more than 500 illustrations offers an invaluable clinical and research tool not only for neuroradiologists but also for neurosurgeons, radiotherapists, and medical oncologists.

Glioblastoma (also known as glioblastoma multiforme) is a malignant intrinsic tumor thought to arise from populations of stem/progenitor cells in the brain. It is the most common aggressive intrinsic brain tumor in adults, with the potential to spread rapidly within the brain. Patients with glioblastoma face a poor prognosis, with median overall survival of approximately 15 months. However, our growing understanding of the molecular biology of gliomas means that this outlook may be improving. The identification of clinically relevant subgroups defined by specific genetic mutations is challenging the traditional delineation between low- and high-grade gliomas that has been based on histological appearance and imaging. Indeed, it is becoming clear that, as a molecular entity, a glioblastoma, which by traditional classification is a grade IV glioma, may present with a lower grade initially and then become more aggressive – an important addition to the established concept. The care of a patient with a glioblastoma requires a coordinated approach delivered by a multidisciplinary team, with the aim of maintaining quality of life for as long as possible. Here, we provide a concise overview of the diagnosis and management of glioblastoma, as well as discussion of our emerging understanding of the molecular drivers that are helping us to delineate different patient subgroups. These subgroups will, hopefully, allow more targeted treatments in the future. This resource will be of interest to all those involved in caring for patients with this aggressive brain tumor, including neurologists, neurosurgeons, neuro-oncologists, radiation oncologists, palliative care specialists, specialist nurses and medical students. Contents: • Epidemiology, pathophysiology and classification • Clinical presentation • Diagnosis • Management • Treatment of associated conditions • Emerging research and treatment

This book, now in its second edition, provides a comprehensive overview of current re-irradiation strategies, with detailed discussion of re-irradiation methods, technical aspects, the role of combined therapy with anticancer drugs and hyperthermia, and normal tissue tolerance. In addition, disease specific chapters document recent clinical results and future research directions. All chapters from the first edition have been revised and updated to take account of the latest developments and research findings, including those from prospective studies. Due attention is paid to the exciting developments in the fields of proton irradiation and frameless image-guided ablative radiotherapy. The book documents fully how refined combined modality approaches and significant technical advances in radiation treatment planning and delivery have facilitated the re-irradiation of previously exposed volumes, allowing both palliative and curative approaches to be pursued at various disease sites. Professionals involved in radiation treatment planning and multimodal oncology treatment will find it to be an invaluable aid in understanding the benefits and limitations of re-irradiation and in designing prospective trials.

Advantages and limitations of biomarkers in gliomagenesis are described. Molecular subtypes of gliomas are detailed. The role played by TP53 gene mutation in the deadliest brain tumor, glioblastoma multiforme, is pointed out. The role of mutations of IDH1 and IDH2, and isocitrate dehydrogenases in malignant gliomas are presented. Metabolic differences in different regions of the glioma tumor are clarified. Various types of imaging modalities, including PET and SPECT, to diagnose gliomas in general and glioblastoma in particular in patients are explained in detail. Both low-grade and high-grade gliomas are discussed. Conventional as well as fluorescent-guided resection techniques for high-grade, recurrent malignant gliomas are detailed. Impact of resection extent on outcomes in patients with high-grade gliomas is clarified. The advantage of the use of intraoperative low-field MRI in glioma surgery is explained.

This book provides basic researchers and clinicians with a contemporary review of personalised medicine for the diagnosis and treatment of Glioblastoma Multiforme (GBM), the most common and most aggressive type of brain tumor. Over the past decade, there has been an explosion of basic and clinical research revolving around GBM, resulting in improved outcomes and, most importantly, significant advances in our ability to better understand this disease to formulate personalised medical treatment for each patient. It is important to note that the word multiforme means "of many forms or appearances", implying that "one treatment will not fit all". Data from a variety of sources show that medical decisions and interventions must be tailored to the individual patient to obtain the greatest outcome. In this book, the diagnostic techniques and treatment options for patients with GBM are reviewed in state-of-the-art chapters written by expert researchers and clinicians in the field focusing on molecular genetic classification, surgical management, chemotherapy, radiation, nutrition, immune-therapy, and more. Many new therapeutic options are described and reviewed, confirming that not only does each patient needs to have personalised treatment, but also that a single treatment alone will not be sufficient; multiple mechanisms are involved and tumor biology changes over time. Hopefully, this book will educate and stimulate readers' knowledge and lead to new avenues of investigation and therapeutic success.