Glioma Recurrence: What to Know
- Unfortunately, the risk of recurrence is quite high for glioma patients — and low-grade gliomas may progress or transform into higher grade.
- Because recurrence is so common, glioma patients should be monitored regularly after treatment.
- Life-long follow up with MRI and/or CT surveillance will likely be needed.
- While the science is moving forward in an exciting way, it’s still critically important to monitor for glioma recurrence — as early detection may give the best chance of controlling the tumor and allow for more treatment options.
“When we think of low-grade gliomas, we have to remember that just over 80% of these tumors will either progress or transform to higher grades,” Dr. Ashley Ghiaseddin, a neuro-oncologist at University of Florida Health, tells SurvivorNet, stressing that it’s important for patients to know that life-long follow up with MRI and/or CT surveillance will likely be needed.
Read MoreGlioma Recurrence: What to Know
Facing a glioma diagnosis is tough, and the possibility of recurrence can make it even harder. Gliomas, which are brain tumors, can come back after treatment. But the good news is that understanding your specific situation—your tumor type, treatment history, and personal factors—can help you and your medical team manage the road ahead.Gliomas are categorized into grades based on how aggressive they are. Low-grade gliomas (LGGs) are usually less aggressive, while high-grade gliomas (HGGs), like glioblastomas, tend to grow and spread more quickly. These grades help predict how likely it is for the tumor to come back, but there’s more to the story.
Tumor Grade and Recurrence Risk
High-grade gliomas tend to come back faster, often within five years of treatment.
While low-grade gliomas grow more slowly, they can still recur years later—sometimes even a decade or more after diagnosis.
Certain genetic features of your tumor can also affect how likely it is to come back.
Here are some key ones to be aware of:
- IDH Mutations: If your tumor has an IDH mutation, it’s generally a good sign. Tumors with these mutations tend to come back more slowly. For example:
- TP53 and ATRX Mutations: These mutations are more common in astrocytomas and are linked to a higher chance of recurrence.
- MGMT Promoter Methylation: This determines how well your tumor might respond to certain chemotherapies. If your tumor has a methylated MGMT promoter, it may stay under control longer after treatment.
There are several other important risk factors to be aware of when it comes to the likelihood that glioma will come back. These include:
- Extent of Surgery: If your surgeon was able to remove all visible tumor tissue, you may have a lower risk of recurrence compared to someone who had only part of their tumor removed.
- Your Age: Younger patients, especially those under 40, tend to have tumors with better genetic profiles and a lower risk of recurrence.
- Tumor Size: Larger tumors (over 6 cm) can be harder to treat completely, which may increase the chance of them coming back.
The Challenge of Glioma Recurrence
After treatment, your care team will recommend regular imaging, like MRI or CT scans, to check for any signs of the tumor coming back. This lifelong follow-up is essential because catching a recurrence early gives you the best chance at controlling it and exploring more treatment options.
If you have a low-grade glioma, there’s a possibility it could transform into a more aggressive form over time. That’s why regular monitoring is so critical—it helps your doctors spot any changes as soon as possible.
While there’s no guaranteed way to prevent a glioma from coming back, there are steps you and your doctors can take to reduce the risk and improve your outcomes, including:
- Maximizing Surgery – If possible, having your tumor completely removed during surgery can significantly lower the chances of recurrence. Advances in surgical techniques—like imaging during the operation—can help surgeons remove as much tumor tissue as safely possible.
- Additional Treatments – Radiation and chemotherapy are often recommended after surgery to kill any remaining tumor cells. For certain tumors, targeted therapies or immunotherapies might also be an option.
Questions to Ask Your Doctor
If you’ve been diagnosed with glioma and are nervous that you may have to deal with a recurrence, consider bringing up these questions to your doctor.
- How will I know if my cancer is gone?
- What can we do to reduce the risk of recurrence?
- How often should I be monitored after treatment?
- What sort of symptoms should I look for that may indicate recurrence?
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