What causes Glioblastoma? Read More
How is glioblastoma diagnosed and detected? Read More
A rare tumour with less than 10 per 100,000 people affected globally Read More

Recurrent Glioblastoma

What causes Glioblastoma?

The precise risk factors of GBM is not clearly known, this being a very infrequent type of tumour. However, some factors may be derived from common features reported in a few reported glioblastoma patients.

Risk factors are those that make a person more likely to develop glioblastoma. Studies on the precise risk factors of GBM have been inconclusive, this being a very infrequent type of tumour. Majority of the cases are sporadic and no risk factor accounting for a large proportion of GBMs has been identified yet. Some factors may be derived from common features identified in a few reported glioblastoma patients, which are listed below. However, GBM risk being poorly understood, having one or more below-mentioned factors need not necessarily mean that the person will develop cancer. Also, GBM is rare in children.

  • History of prior exposure to radiation in the head or neck region
  • Men are reported to be at a slightly higher risk and some studies suggest a role for sex hormones in GBM risk
  • Being 65 years of age or older. Although GBM may occur at any age, the peak incidence is reported to occur in individuals 65 years or older
  • Having certain genetic disorders such as neurofibromatosis
  • Excessive alcohol consumption

What are the known symptoms of Glioblastoma?

Patients who have glioblastoma have been shown to develop symptoms rapidly because of the fast growing mass of tumour itself and/or from the fluid surrounding the tumour. The fluid causes the brain to swell further. So, at diagnosis, the common symptoms are related to increased pressure in the brain. Others include neurological symptoms which are dependent on the tumour location. Should any of these warning symptoms develop, they should be promptly discussed with a doctor. It should be noted that having one or more of these symptoms does not necessarily indicate cancer. Only a doctor can confirm this:

  • frequent headaches and drowsiness
  • nausea, vomiting, and severe headaches that are typically worse in the morning
  • sensory changes of face, arm or leg
  • balance difficulties
  • difficulty in remembering, which increases with time (progressive memory issues)
  • changes in ability to think and learn (cognition issues)
  • epileptic seizures
  • confusion/delirium
  • difficulty in swallowing (dysphagia)
  • speech difficulty (gradual onset and progression)
  • increasing difficulty in mobility (ability to move)
  • double or blurred vision
  • Very rarely intratumoural haemorrhage occurs and patients may present acutely with stroke-like symptoms and signs


CT/CAT scan: Computed Tomography scan GBM: Glioblastoma multiforme MRI scan: Magnetic resonance imaging scan MRS: Magnetic resonance spectroscopy PET scan: Positron emission tomography scan rGBM: Recurrent glioblastoma multiforme TMZ: temozolomide VEGF: Vascular Endothelial Growth Factor


  1. Hanif, F., Muzaffar, K., Perveen, K., Malhi, S. M., & Simjee, S. (2017). Glioblastoma Multiforme: A Review of its Epidemiology and Pathogenesis through Clinical Presentation and Treatment. Asian Pacific journal of cancer prevention : APJCP, 18(1), 3–9. doi:10.22034/APJCP.2017.18.1.3
  2. Rock, K., Mcardle, O., Forde, P., Dunne, M., Fitzpatrick, D., O’Neill, B., & Faul, C. (2012). A clinical review of treatment outcomes in glioblastoma multiforme—the validation in a non-trial population of the results of a randomised Phase III clinical trial: has a more radical approach improved survival? The British Journal of Radiology, 85(1017), e729-e733. doi:10.1259/bjr/83796755
  3. Loeffler, J., Alexander, E., Hochberg, F. H., Wen, P. Y., Morris, J. H., Schoene, W. C., … Black, P. M. (1990). Clinical patterns of failure following stereotactic interstitial irradiation for malignant gliomas. International Journal of Radiation Oncology Biology Physics, 19(6), 1455-1462. doi:10.1016/0360-3016(90)90358-q
  4. Gaspar, L. E., Fisher, B. J., Macdonald, D. R., Leber, D. V., Halperin, E. C., Schold, S., & Cairncross, J. (1992). Supratentorial malignant glioma: Patterns of recurrence and implications for external beam local treatment. International Journal of Radiation Oncology Biology Physics, 24(1), 55-57. doi:10.1016/0360-3016(92)91021-e
  5. Ansari, M., Nasrolahi, H., Kani, A. A., Mohammadianpanah, M., Ahmadloo, N., Omidvari, S., & Mosalaei, A. (2012). Pediatric glioblastoma multiforme: A single-institution experience. Indian journal of medical and paediatric oncology : official journal of Indian Society of Medical & Paediatric Oncology, 33(3), 155-60.
  6. Prasad, G., & Haas-Kogan, D. A.(2009).Radiation-induced gliomas.Expert review of neurotherapeutics,9(10),1511-7
  7. McKinley, B. P., Michalek, A. M., Fenstermaker, R. A., & Plunkett, R. J. (2000). The impact of age and gender on the incidence of glial tumors in New York state from 1976–1995. Journal of Neurosurgery, 93(6), 932-939. doi:10.3171/jns.2000.93.6.0932
  8. Eefje M. Sizoo, Lies Braam, Tjeerd J. Postma, H. Roeline W. Pasman, Jan J. Heimans, Martin Klein, Jaap C. Reijneveld, Martin J. B. Taphoorn, Symptoms and problems in the end-of-life phase of high-grade glioma patients, Neuro-Oncology, Volume 12, Issue 11, November 2010, Pages 1162–1166, https://doi.org/10.1093/neuonc/nop045
  9. Carlsson, S. K., Brothers, S. P., & Wahlestedt, C. (2014). Emerging treatment strategies for glioblastoma multiforme. EMBO molecular medicine, 6(11), 1359-70.
  10. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, et al. (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352: 987–996.
  11. Friedman, H. S., Prados, M. D., Wen, P. Y., Mikkelsen, T., Schiff, D., Abrey, L. E., … Cloughesy, T. (2009). Bevacizumab Alone and in Combination With Irinotecan in Recurrent Glioblastoma. Journal of Clinical Oncology, 27(28), 4733-4740. doi:10.1200/jco.2008.19.8721
  12. Wick, W., Weller, M., Van den Bent, M., & Stupp, R. (2010). Bevacizumab and Recurrent Malignant Gliomas: A European Perspective. Journal of Clinical Oncology, 28(12), e188-e189. doi:10.1200/jco.2009.26.9027
  13. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®: Central Nervous System Cancers, Version 2.2018, Nov 26, 2018