Recurrent Gliomas: What You Need to Know
- Gliomas can return months or even years after surgery, and the prospect of recurrence is naturally concerning for patients.
- Fortunately, recurrent gliomas can often be detected early through continued MRI surveillance. This allows for timely intervention and a wider range of treatment options.
- If your glioma returns, your doctor will carefully evaluate the new imaging results to determine if the grade has changed and what the best course of action is.
- Treatment options at recurrence may include additional surgery, radiation, chemotherapy, targeted therapy or immunotherapy, and/or quality of life/palliative care.
When faced with the news of a glioma recurrence, many patients ask the same important question: “What do I do now?” The thought of going through treatment again can feel overwhelming, but understanding your options and working closely with your medical team can help you take the next steps with confidence. Thankfully, advancements in medical research and personalized treatment approaches mean that there are multiple options available for managing recurrent gliomas.
Read MoreHow Will I Be Monitored After Treatment?
The recurrence of a glioma is usually identified through regular MRI scans, which are an essential part of post-treatment monitoring. Since gliomas can be unpredictable, ongoing imaging is critical for detecting any changes early. If your glioma does return, your doctor will carefully evaluate the new imaging results to determine the best course of action.Some common signs that a glioma has returned include:
- Changes in the appearance of the tumor on MRI scans
- Worsening or new neurological symptoms, such as headaches, seizures, or cognitive difficulties
- Increased pressure in the brain, which can cause nausea or vision problems
If your doctor suspects a recurrence, additional tests such as a biopsy or advanced imaging techniques may be performed to confirm the diagnosis and assess the tumor’s behavior.
“If the thing stays quiet, and they’re doing well, we’re going to keep you off further active treatment for as long as we can get away with it,” Dr. Newton says. “It’s likely within two to three to four years, depending on the tumor type … it’s going to wake up and come back and start growing again in there somewhere — and we have options.”
What Are My Treatment Options?
As Newton noted, if your glioma has returned, there are multiple treatment options available. The best choice will depend on several factors, including the type of glioma, how aggressive it is, your overall health, and what treatments you have already undergone. Some of the most common treatment options include:
Repeat Surgery
If the tumor is accessible and the benefits outweigh the risks, a second surgery (re-resection) may be recommended. Surgery can help remove as much of the tumor as possible, relieve pressure on the brain, and improve symptoms. However, repeat surgery is not always an option, especially if the tumor is in a critical or difficult-to-reach area.
Radiation Therapy
If surgery is not feasible, or if there are remaining cancerous cells after surgery, radiation therapy may be considered. Techniques such as stereotactic radiosurgery (SRS) or intensity-modulated radiation therapy (IMRT) allow for precise targeting of the tumor while minimizing damage to healthy brain tissue.
Chemotherapy
Chemotherapy can help slow the growth of recurrent gliomas. Depending on the individual case, doctors may recommend different chemotherapy drugs, including temozolomide (TMZ) or other targeted agents. In some cases, a combination of chemotherapy and radiation may be used.
Targeted Therapy and Immunotherapy
Advancements in glioma research have led to new targeted therapies and immunotherapy options. These treatments work by attacking specific molecular pathways that fuel tumor growth. Immunotherapy, which boosts the body’s immune response against cancer cells, is also being explored in clinical trials and may be an option for some patients.
Clinical Trials
Many patients with recurrent gliomas choose to participate in clinical trials, which offer access to cutting-edge treatments that are not yet widely available. These trials may involve new drug combinations, novel radiation techniques, or experimental therapies. Your doctor can help determine if you are eligible for a clinical trial and whether it may be a good option for you.
Supportive and Palliative Care
In cases where aggressive treatment is not suitable, supportive and palliative care can help manage symptoms and improve quality of life. This may include medications to relieve headaches and seizures, physical therapy, and psychological support to help cope with the emotional impact of a recurrence.
Weighing Treatment Options
Your doctor will take a personalized approach when determining the best treatment for your recurrent glioma.
Several factors will be considered, including:
- The tumor’s characteristics: The type, grade, and location of the tumor will play a key role in deciding the most effective treatment.
- Previous treatments: The treatments you have already received (such as surgery, radiation, or chemotherapy) will influence what options are available.
- Your overall health: Your age, general health, and ability to tolerate certain treatments will be taken into account.
- Your preferences and goals: It is important to discuss your priorities with your medical team. Some patients may prioritize aggressive treatment to extend survival, while others may focus on maintaining the best possible quality of life.
Your doctor will work closely with you to review all available options and create a treatment plan that aligns with your individual needs and goals. Open communication with your medical team is key—don’t hesitate to ask questions, seek second opinions, or explore different treatment avenues.
Navigating Recurrence: Finding Hope & Support
A glioma recurrence can be a challenging and emotional experience, but it is important to remember that you are not alone. Advances in medical research continue to provide new treatment options, and many patients find hope in the progress being made.
Here are some steps you can take to empower yourself during this journey:
- Stay informed: Educate yourself about gliomas and the latest treatment options. Knowledge can help you make more confident decisions about your care.
- Build a strong support system: Lean on family, friends, and support groups for emotional and practical support. Connecting with others who have faced a glioma recurrence can be reassuring and inspiring.
- Consider seeking a second opinion: If you are uncertain about your treatment plan, consulting with another specialist can provide additional insights and options.
- Take care of your mental and emotional health: Dealing with a recurrence can be overwhelming. Counseling, meditation, or engaging in activities you enjoy can help manage stress and maintain a positive outlook.
Every patient’s journey is unique, and while a glioma recurrence can be daunting, there are many options available to help you move forward. By working closely with your healthcare team, exploring all treatment possibilities, and focusing on your well-being, you can navigate this challenge with strength and hope.
Questions to Ask Your Doctor
- How can I be proactive after treatment to monitor for recurrence?
- How often will I need to come in for scans?
- Are there any clinical trials I should consider enrolling in?
- What are the risks vs. benefits of starting treatment up again?
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