Glioblastoma Awareness Day: Confronting the Challenges of a Devastating Brain Tumor

The third Wednesday of each July is Glioblastoma Awareness Day. Glioblastoma (GBM) is a complex and invasive form of brain cancer, presenting difficulties in its treatment. Notably, it has come to public attention in the past years with Beau Biden, Ted Kennedy, and John McCain, succumbing to the disease shortly after diagnosis.

In this article, we sat down with Santosh Kesari, MD, PhD, acclaimed neuro-oncologist and a co-founder of Pacific Neuroscience Institute®, and Akanksha Sharma, MD, board-certified neurologist and neuro-oncologist, to discuss this complex brain tumor.

What is Glioblastoma?

Types of GBM

According to Dr. Kesari, “There are two types of glioblastomas: primary, originating de novo, and secondary, evolving from lower-grade gliomas.” Patients diagnosed with these tumors generally have a difficult prognosis and poor quality of life as the disease progresses. In the United States, an estimated 13,000 patients are diagnosed with GBM annually, with a life expectancy of about 14 months, and a 5-year survival rate of 5%. The incidence increases significantly after the age of 54 and reaches a peak incidence at age 75-84 years.

Symptoms of GBM

“One of the most common symptoms is a headache, which differs from a typical tension or migraine headache. Other symptoms which may occur alone or in combination include persistent weakness, numbness, blurred vision, balance issues, seizure, changes in memory, or alteration of language,” Dr. Kesari notes.

“In a vast majority of patients, there is no cause of the disease, but we presume there is an initial molecular event in a cell that starts to become cancerous,” Dr. Kesari adds. The only well-established causative factor for GBM is exposure to ionizing radiation, but this accounts for only a small minority of cranial tumors. Currently, MRI imaging provides the most sensitive tool for the initial detection of GBM; however once a GBM is identified, the tumor is already at an advanced state.

The standard of care therapy consists of debulking surgery, followed by radiation and temozolomide chemotherapy. The radiation and chemotherapy agent damages the DNA in tumor cells that are actively dividing.

Why is glioblastoma difficult to treat?

• Heterogeneity: There is a high degree of variation (heterogeneity) within the same tumor cells that makes each individual glioblastoma molecularly distinct. This can be challenging when predicting prognosis and treatment
• Location of tumor: If the tumor is located in a region that is hard to reach, or too near vital blood vessels or crucial brain regions, it can render surgery high-risk or impossible.
• Recurrence: GBM tumors have a tendency to come back aggressively.

Dr. Kesari explains that the challenge in treating brain tumors lies in addressing inactive tumor cells, which are dormant. These cells, known as cancer stem cells, evade radiation and chemotherapy by remaining inactive.

Coping with a Glioblastoma Diagnosis 

Few cancers are as challenging as glioblastomas. Although no cure currently exists for these brain tumors, patients and care partners can take steps to enhance their quality of life after receiving a diagnosis. Palliative care physicians like Dr. Sharma possess extensive knowledge in this area.

Everything happens very fast, and it’s very overwhelming, so you are fine one day, you have a seizure and a big mass in your head. You’re being rushed into surgery…There is so much information, so many different things to consider.

Dr. Sharma

As a specialist in palliative medicine, her objective is to create an open and safe environment where patients can engage in meaningful conversations and candid dialogue with their loved ones. Her goal is for patients to cherish and create new memories while maximizing their time. Furthermore, Dr. Sharma strives to align treatment with patient goals and provide comprehensive care, which encompasses thorough symptom assessment and management, as well as support for the patient’s family and friends.

Clinical Trials and Research for Glioblastoma

Dr. Kesari has significantly advanced research and treatment for glioblastoma by developing methods that target and destroy cancer cells. Currently, there are several active clinical trials being conducted at Saint John’s Cancer Institute and Pacific Neuroscience Institute. These are new treatment approaches for those who are newly diagnosed with glioblastoma, and those who have recurrent disease.

There is a need for better therapies in brain cancer patients, and by studying the molecular genetic of patients, I believe we are on the verge of getting there. Many of these challenges are currently being studied in clinical trials and by having an understanding of glioblastoma we hope to soon have a cure.

Dr. Kesari

One of Dr. Kesari’s main objectives is to help cancer patients gain access to promising clinical trials based on thorough research and evaluation of published data. With experience in areas such as immunotherapy, which modifies the immune system to recognize and combat cancerous cells, as well as precise therapeutic approaches that focus on brain tumors at the molecular level, he holds the belief that there is hope in the battle against GBM.

>>Learn more about Brain Tumor clinical trials and research at PNI.

The Cancer Moonshot

The Cancer Moonshot was launched in 2016 by National Cancer Institute to accelerate scientific discovery in cancer research, foster greater collaboration, and improve the sharing of cancer data. It has brought together a large community of patients, advocates, researchers, and clinicians who are dedicated to advancing research to end cancer as we know it. At Pacific Neuroscience Institute, Dr. Kesari is in alignment with this goal. For many years, he has been exploring and offering a research treatment alternative to people who have been newly diagnosed.

The Precision Immunotherapy In the Neoadjuvant setting (PNI) method uses targeted treatments based on the patient’s tumor genetics before administering chemotherapy and radiation, when the immune system is stronger. The aim is to prime the body to recognize and target the cancer as a foreign entity, enabling the body’s own immune system to combat the disease before it is weakened by chemotherapy and radiation. Dr. Kesari’s hope is to provide patients with longer and better quality of life.

GBM Awareness Day

The aim of Glioblastoma Awareness Day is to honor those who live with glioblastoma and showcase the fortitude of patients and caregivers. Additionally, it is an opportunity to support and acknowledge the tireless efforts of medical professionals and researchers in seeking a cure.

For GBM Awareness Day, Dr. Kesari encourages using the #GBMAwareness hashtag to amplify the need for increased research funding. In addition, Dr. Sharma, along with care partners Art Krueger and Kathy Savits, discuss the challenges of GBM, and emphasize support for patients and care partners in a video with the National Brain Tumor Society.

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Relevant Links

• Pacific Brain Tumor Center
• Glioma & Glioblastoma
• Glioma & Glioblastoma Treatment
• Research & Clinical Trials

About Dr. Santosh Kesari

Neuro-oncologist Dr. Santosh Kesari, MD, PhD, is a board-certified neurologist and is currently Chair and Professor, Department of Translational Neurosciences, Saint John’s Cancer Institute. He is the regional medical director of Providence Southern California’s Research Clinical Institute. Dr. Kesari is also Director of Neuro-oncology at Pacific Neuroscience Institute, Providence Saint John’s Health Center, and Providence Little Company of Mary Medical Center Torrance, and leads the Pacific Neuroscience Research Center at Pacific Neuroscience Institute.

About Dr. Akanksha Sharma

Akanksha Sharma, MD, is board certified in neurology, neuro-oncology and palliative medicine. She is experienced in the treatment of primary/metastatic brain tumors, neurological complications of cancer, and disease-related burden and symptoms. Her clinical and research interests lie in helping patients maximize their time and quality of life. She aims to align treatment with patient goals and to provide holistic care that includes careful symptom assessment and management, as well as support for the patient’s loved ones.

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