Glioblastoma multiforme is a form of cancer in which the brain cells start to divide rapidly and uncontrollably, creating a malignant tumour. These cells are also very good at escaping the site of the original tumour and migrating to other parts of the brain, where they start the process all over again.
Glioblastoma is very aggressive; and its effect is to cause chaos in the brain. As it works its way through the brain it develops different characteristics depending on the new locations. Drug penetration varies depending on the density of the tissue and the interaction between the cancer cells with blood vessels and surrounding tissue, and is also impeded by the blood-brain barrier.
The brain naturally protects itself from the entry of toxins by not allowing ‘foreign’ or ‘large’ elements through via the bloodstream. Unfortunately this means that the brain itself prevents medicinal drugs given orally or intravenously entering in large enough quantities to even begin to tackle glioblastoma.
No one knows! It may be that the brain is still developing (it continues to mature in physiological terms up to the age of around 25 years). What is known is that if a child under the age of 3 is diagnosed with a brain tumour survival rates are up to 60%, while over the age of 3 the prognosis is much bleaker. The plasticity of the brain as it develops during adolescence means that enormous changes are taking place. Teenage growth is fast, and cancer cells grow fast at the same time. Because of these change, any treatment for glioblastoma becomes even more challenging. Glioblastoma kills 5,000 people under the age of 40 in the UK every year.
Current treatment includes surgery, although it is hardly ever possible to remove glioblastoma cells completely, and radiotherapy. Chemotherapy is largely ineffectual, provides minimal benefit and can be highly toxic in terms of its effect on the patient’s quality of life. After diagnosis current treatment is designed to minimise the symptoms for as long as possible and to provide effective pain relief.
Because glioblastoma is relatively rare, it is often missed. However, a combination of any two or more of these symptoms should always lead to glioblastoma being considered:
- morning headache relieved by vomiting
- unexplained deterioration in school performance or behaviour
- double or blurred vision
- seizures not necessarily accompanied by a raised temperature
An in-depth neurological examination will take place, plus either a CT (computed tomography) brain scan, or an MRI (Magnetic Resonance Imaging) brain scan. CT uses specialised x-ray techniques to obtain pictures of the tumour, while MRI uses magnetism instead of x-ray to obtain the pictures. Depending on the location of the tumour within the brain a biopsy (surgical removal of a small sample of tumour tissue) may also take place.
There are several reasons:
- brain cancer in general only receives 1% of UK research funding annually
- because glioblastoma is so rare there is no statistically significant data
- lack of statistically significant data means there is no evidence of cost-effectiveness for any current forms of treatment
In our view, all these factors combine to create a vicious circle in which there is no cure for glioblastoma, and there is little treatment because there is no cure!
Charlotte’s BAG is currently funding scientific research, based at Charlotte’s Lab in the neuropathology department at King’s College Hospital, London. The work involves close collaboration with the neurosurgeons and oncologists – The Charlotte’s BAG Team at King’s College Hospital are evaluating different approaches for mutation detection. This will be useful for monitoring patients after a diagnosis has been made. The Team is investigating a highly sensitive means of mutation detection which, it is hoped, will permit the detection of one molecule in 10,000-100,000. Such a means of detection enables oncologists to understand if surgery or therapy has been effective. Staff have been employed, consumables have been ordered and a company has been contacted for the acquisition of an instrument with which to carry out the research. The Team will use the research to assess further whether it is possible to classify tumours from cerebrospinal fluid without removing tumour tissue. As a member of the Team stated, though very early days, ‘this technology could be the future of brain tumour diagnostics.’
We are now in 2023 and so far we have raised £280,000 thanks to the generosity of people all over the world, we have funded a five-year scientific research position at Charlotte’s Lab.
Now 2024 so far raised £290,000