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Low-grade Gliomas

What are low-grade gliomas?

  • Low-grade gliomas (glee-O-mahs) are tumors (lumps) in the brain and spinal cord. The brain and spinal cord are made up of neurons (nerve cells). Neurons carry and transmit electrical signals (messages) within the nervous system. Glial cells support and nourish the neurons. Gliomas form when glial cells grow and divide without control or order. Gliomas may be grouped into grades based on how the tumor cells look under a microscope. The grade of glioma will tell how many abnormal cells are present in the tumor. Abnormal cells may range from grades 1 and 2 (low-grade) to grades 3 and 4 (high-grade).

  • In low-grade gliomas, tumor cells may look like normal brain cells. Most low-grade gliomas are benign (noncancerous), but may become malignant (cancerous) over time. These tumors often grow very slowly over a long period of time, and are not likely to spread. Low-grade gliomas usually affect those between 35 and 45 years of age. Diagnosing and treating gliomas as soon as possible may relieve your symptoms, prevent life-threatening problems, and improve your quality of life.

What causes low-grade gliomas?

The exact cause of low-grade gliomas is still not known. The following may cause or increase your risk of having a low-grade glioma:

  • Diseases: You or a family member may have a certain disorder that may increase your risk for low-grade gliomas. These disorders may include neurofibromatosis, tuberous sclerosis, or tumors of the eye.

  • Genetic: You may have been born with problems in your genes. A gene is a little piece of information that tells the body what to do or what to make.

  • Radiation: Radiation therapy, such as that used to treat tumors of the head, neck, or brain may cause a low-grade glioma.

What are the types of low-grade gliomas?

Low-grade gliomas may be any of the following:

  • Astrocytoma: This is the most common type of low-grade glioma. This forms from a star-shaped cell called an astrocyte. Astrocytomas may be formed in any part of the brain or spine, but are most commonly found in the cerebrum. The cerebrum is the main part of the brain that controls vision, speech, thought, and memory.

  • Central neurocytoma: This is a rare (not common) tumor that may arise from the ventricles (fluid-filled spaces in the brain).

  • Ependymoma: Ependymomas that form in the back of the head are more common among children 10 to 20 years of age. Ependymomas of the spine are more common among adults. This tumor forms from the ependymal cells that line the ventricles.

  • Mixed glioma: A mixed glioma is a tumor that is made of more than one type of tumor cell, such as astrocyte and ependymal cells. A mixed glioma may have the same characteristics as the tumor cells that are present.

  • Oligodendroglioma: This type of low-grade glioma comes from cells called oligodendrocytes. These cells produce the fatty layer that covers nerve cells. Oligodendroglioma are usually found on the front and sides of the cerebrum.

  • Optic nerve glioma: An optic nerve glioma affects the nerve that supplies the eyes. This tumor is common among patients with a disease called neurofibromatosis.

  • Subependymal giant cell astrocytoma: This type of low-grade glioma is common in patients with a disease called tuberous sclerosis. Tuberous sclerosis is a rare disease that forms tumors in the kidneys, brain, eyes, heart, lungs, and skin. This disease can cause seizures (convulsions), mental problems, and skin lesions.

What are the signs and symptoms of low-grade gliomas?

The signs and symptoms of low-grade gliomas are related to the size and location of the tumors. Signs and symptoms of low-grade gliomas may be different depending on the part of the brain or spinal cord the tumors are pressing on. Low-grade gliomas are slow growing, so people who have a low-grade glioma may not know it and may not have any signs or symptoms. Those who do, may have any of the following:

  • Seizures (convulsions)

  • Headaches, especially right after waking up.

  • Drowsiness or fatigue ( tiredness).

  • Nausea (upset stomach) and vomiting (throwing up).

  • Numbness, weakness, paralysis (unable to move a part of the body), or problems moving the limbs, such as a leg.

  • Personality or behavior changes, such as confusion (unclear thinking).

  • Problems with memory and mental function.

  • Problems with talking, eye pain, or seeing, such as decreased vision, blurring, or double vision.

How are low-grade gliomas diagnosed?

Your caregiver will take your past and current health history. He may also want to know if other family members have had tumors or cancers. You may have any of the following:

  • Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

  • Biopsy: Caregivers may need to remove a small part of your tumor and other brain tissue during stereotaxy or open surgery. Stereotaxy uses three-dimensional (3-D) pictures to help your caregiver know the exact location of the tumor. The tissue samples will then be sent to a lab for tests.

  • Blood tests: Samples of your blood are sent to a lab for tests. These tests may check how well your body is doing. The amount of tumor markers (substance released by tumor cells) that are present in your blood may also be checked.

  • EEG: This test is also called an electroencephalogram. Many small pads or metal discs are put on your head. Each has a wire that is hooked to a machine. This machine prints a paper tracing of brain wave activity from different parts of your brain. Caregivers look at the tracing to see how your brain is working.

  • Imaging studies: You may be given dye through an IV in your vein during one of your tests. The dye helps tumors show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.

    • Angiography: This test looks for problems with the arteries (blood vessel) supplying the low-grade gliomas. Before the x-ray, a dye is put into a thin tube through a small cut in your groin. The groin is the area where your abdomen (stomach) meets your upper leg. The dye helps the arteries show up better on these x-ray pictures.

    • Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.

    • MRI: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

    • Positron emission tomography scan: This test is also called a PET scan. A PET scan shows how much blood and oxygen is flowing to an area of the brain. It may also show areas where there is a tumor.

How are low-grade gliomas treated?

Treatment of low-grade gliomas will depend on the signs, symptoms, location, and type of tumor that you have. Caregivers may also consider your age, condition, and the presence of other conditions. You may have any of the following:

  • Watchful waiting: Watchful waiting may be all that is needed for low-grade gliomas that are small and not causing any signs and symptoms. Your caregiver may want you to have regular checkups to see how your low-grade glioma is doing.

  • Medicines:

    • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.

    • Steroids: Steroid medicine may be given for many reasons, such as to decrease inflammation (swelling) in the brain. This medicine may be very important for your disease, but may have side effects. Be sure you understand why you need steroids. Do not stop taking steroids without your caregivers OK. Stopping on your own can cause problems. Ask your caregiver for more information about steroids.

  • Surgery: Surgery called craniotomy (open brain surgery) or stereotaxy using a CT scan or MRI may be done to remove a part or all of your low-grade glioma. Brain mapping may be done during your surgery to check the activities in the different areas of the brain. These areas of the brain include those used for speaking, moving, seeing, smelling, and understanding. Surgery may also be done to place a shunt (tube) or remove a blockage so the fluid around your brain and in your spine can flow properly.

  • Additional treatments:

    • Chemotherapy:

      • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

      • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

    • Radiation: This is a treatment using x-rays or gamma rays to treat tumors. Radiation kills tumor cells and keeps them from spreading. It also keeps tumor cells from dividing into new cells, which is one way tumor cells spread. Radiation may also be given after surgery to kill any tumor cells that were not removed. Radiation may help decrease pain, control bleeding, and shrink tumors.

Where can I get support and more information?

Having a low-grade glioma is a life-changing condition for you and your family. Accepting that you have a low-grade glioma is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group. This is a group of people who also have low-grade gliomas and other tumors. Contact the following for more information:

  • American Brain Tumor Association
    8550 West Bryn Mawr Avenue, Suite 550
    Chicago , IL 60631
    Phone: 1- 800 - 886-2282
    Web Address: http://www.abta.org
  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
  • National Brain Tumor Foundation
    22 Battery Street, Suite 612
    San Francisco , CA 94111-5520
    Phone: 1- 415 - 834-9970
    Phone: 1- 800 - 934-CURE
    Web Address: http://www.braintumor.org

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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