WITH THE MANY NEWS REPORTS about Senator John McCain being diagnosed with glioblastoma, patients may be asking if symptoms such as headaches and vision or speech problems should signal the need for screening or diagnostic tests. “There has never been any suggestion that doing routine screening, such as [computed tomography] or [magnetic resonance (MR)] brain scanning, is of any value,” Walter J. Curran, Jr, MD, radiation oncologist and Executive Director of Winship Cancer Institute at Emory University, said in an interview with The ASCO Post.
Typical Diagnosis
MOST GLIOBLASTOMAS are diagnosed by MR imaging “following some kind of symptom, which could be a headache, seizure, or change in mental status. Fortunately, it is still rare that headaches end up being related to a brain tumor,” Dr. Curran said.
“There are situations where someone is doing well, hits his or her head in a car accident, gets a scan in the ER, and an asymptomatic tumor is found. That does happen,” he noted. “Sometimes those incidental findings end up being some of the smaller tumors that we manage.”
The National Cancer Institute Physician Data Query page on adult central nervous system tumors (patient version) notes, “the cause of most adult brain and spinal cord tumors is not known,” but “having certain genetic syndromes may increase the risk of a central nervous system tumor.” Dr. Curran said that one of those syndromes—Li-Fraumeni syndrome—is associated with glioblastoma. “Most of the others,” he said, “are connected with more rare brain cancers.”
Risk Increases With Age
GLIOBLASTOMA CAN OCCUR in individuals “from birth to the oldest age, but the risk is higher in older individuals,” Dr. Curran said. Among adults, those 20 to 44 years of age have the highest 5-year survival rates, 17% compared to 4% for those 55 and older, according to the American Cancer Society.
Dr. Curran emphasized that there is increasingly “greater understanding of this type of tumor. There are also continued efforts to make progress through clinical trials. Continuing that work is making a difference.” ■
