The symptoms of a glioma vary widely depending on its type, size, location in the brain or spinal cord, and rate of growth. As the tumor grows, it can put pressure on brain tissue or interfere with its normal function. According to insights from Dr. Jaydev Panchwagh’s practice and general neurosurgical understanding, common symptoms include:

• Headaches: Often persistent, worsening over time, and sometimes accompanied by nausea and vomiting, especially in the morning.
• Seizures: New onset of seizures, which can be the first noticeable symptom for many patients.
• Neurological Deficits:
  • Weakness or numbness: Typically affecting one side of the body (e.g., in an arm or leg).
  • Vision problems: Blurred vision, double vision, or loss of peripheral vision.
  • Speech difficulties: Trouble speaking, finding words, or understanding language (aphasia).
  • Balance and coordination problems: Dizziness, unsteadiness, or difficulty walking.
• Cognitive and Behavioral Changes: Memory loss, confusion, personality changes, irritability, or a decline in overall mental function.
• Sudden Loss of Consciousness: In some severe cases, due to increased pressure within the skull.

Given that these symptoms can overlap with other conditions, a prompt and thorough evaluation by a neurosurgical specialist like Dr. Jaydev Panchwagh is essential for accurate diagnosis.

The exact cause of most gliomas remains largely unknown. However, researchers have identified certain factors that may increase the risk:

• Age: Gliomas are more common in older adults (typically between 45 and 65 years old), though certain types can affect children and young adults.
• Radiation Exposure: Previous exposure to high doses of radiation, such as radiation therapy for other cancers, can increase the risk of glioma years later.
• Genetic Syndromes: Rarely, certain inherited genetic conditions (e.g., Neurofibromatosis type 1 and 2, Li-Fraumeni syndrome, Lynch syndrome) can increase susceptibility to gliomas.
• Family History: A family history of glioma is very rare, but it can slightly increase risk in some instances.

It’s important to understand that having one or more risk factors does not guarantee that a person will develop a glioma.

Accurate and comprehensive diagnosis is the cornerstone of effective glioma management. Dr. Jaydev Panchwagh employs a multi-faceted diagnostic approach to thoroughly evaluate the tumor and plan the most appropriate treatment:

• Neurological Examination: A detailed assessment of motor skills, sensory function, reflexes, vision, hearing, balance, and cognitive abilities to pinpoint areas of brain function affected by the tumor.
• Imaging Tests:
  • MRI (Magnetic Resonance Imaging) with contrast: This is the most crucial diagnostic tool for gliomas. It provides high-resolution images of the brain, allowing Dr. Panchwagh to accurately determine the tumor’s size, exact location, its spread into surrounding brain tissue, and its relationship to critical structures. Advanced MRI techniques like functional MRI (fMRI) may be used to map vital areas (e.g., speech and motor cortex) near the tumor, aiding surgical planning. Cortical tract visualization and choline peaks may add further inputs to surgical planning.
  • CT (Computed Tomography) scan: Often used in emergency situations or as an initial scan.
  • PET (Positron Emission Tomography) scan: Can help assess the metabolic activity of the tumor, which may give insights into its aggressiveness (grade).
• Biopsy: A definitive diagnosis, including the specific type and grade of glioma, is typically made through a biopsy. This involves surgically removing a small tissue sample of the tumor, which is then examined by a neuropathologist. The biopsy may be performed as a standalone procedure (stereotactic biopsy) or during surgery for tumor removal.

Molecular Testing: Tissue samples are often subjected to advanced molecular and genetic testing. Identifying specific genetic mutations (e.g., IDH mutation, 1p/19q co-deletion) in glioma cells is increasingly important as it significantly influences prognosis and guides targeted treatment strategies.

The treatment for glioma is highly individualized, depending on the tumor’s type, grade, location, the patient’s age, overall health, and specific genetic markers. Dr. Jaydev Panchwagh believes in a comprehensive, multidisciplinary approach, combining various modalities to optimize outcomes. The primary treatment options include:

1. Surgical Resection (Craniotomy):
   • Primary Goal: To remove as much of the tumor as safely possible without causing new neurological deficits. Even partial removal can relieve symptoms and improve the effectiveness of other treatments.
   • Dr. Panchwagh’s Advanced Techniques:
     • Microsurgery: Using high-powered operating microscopes, Dr. Panchwagh performs delicate and precise tumor removal, aiming for maximal resection while preserving critical brain function.
     • Neuro-navigation: This advanced GPS-like system provides real-time, 3D guidance during surgery, enhancing accuracy and safety, particularly for tumors in sensitive areas.
     • Awake Craniotomy: For gliomas located near vital speech, motor, or sensory areas, Dr. Panchwagh may perform awake craniotomy. This allows the surgical team to continuously monitor brain function while the patient is awake, ensuring critical areas are not damaged. This technique is often crucial for maximizing tumor removal while safeguarding quality of life. The decision to perform an awake craniotomy depends on several factors and is taken after discussion with the patient and their family.
     • Intraoperative Monitoring: Electrophysiological monitoring during surgery helps to identify and protect critical neural pathways.
   • Importance: Surgical removal is often the first step and can significantly impact survival, especially for low-grade gliomas.
2. Radiation Therapy:
   • Purpose: Uses high-energy beams (X-rays, protons) to kill remaining tumor cells or slow their growth after surgery, or as a primary treatment if surgery is not feasible.
   • Commonly Used: Often combined with chemotherapy.
   • Advanced Radiation Techniques: Stereotactic Radiosurgery (SRS) or Fractionated Stereotactic Radiotherapy (SRT) deliver highly targeted radiation, minimizing damage to healthy brain tissue.
3. Chemotherapy:
   • Purpose: Uses drugs to kill cancer cells or slow their growth.
   • Common Regimens: Often given in pill form (e.g., Temozolomide) or intravenously. For aggressive gliomas like GBM, Temozolomide is frequently administered concurrently with radiation therapy and then as maintenance therapy.
   • Personalized Approach: The specific chemotherapy regimen depends on the glioma type and its molecular characteristics.
4. Targeted Therapy and Immunotherapy:
   • Newer Approaches: These therapies target specific genetic mutations or pathways within the glioma cells or harness the body’s own immune system to fight the tumor. They are increasingly becoming part of treatment protocols, especially for recurrent or specific types of gliomas.
   • Tumor Treating Fields (TTFields): For aggressive gliomas like GBM, TTFields therapy uses electrical fields delivered through adhesive pads on the scalp to disrupt cancer cell division.

Supportive Care: Medications to manage symptoms (e.g., anti-seizure drugs, steroids for swelling) and comprehensive rehabilitation (physical, occupational, speech therapy) are crucial for improving quality of life during and after treatment.