Talk:Glioblastoma/Archive 1

One
One thing: I don't know that glioblastoma has a tendency for a "butterfly", bihemisphere quality. This certain does happen from time to time, but its not exclusive to GBM, nor is it necessarily common.

"Butterfly" GBM are rare, probably less than 5%. Lymphoma also can give a "butterfly" appearance, so that is the main alternative. —Preceding unsigned comment added by Jpoozler (talk • contribs) 06:28, 25 January 2010 (UTC)

Causes?
Can somebody add a section about causes of such tumours, or link to such information?
 * Primarily the causes are unknown, but they're getting closer. Details here under "Causes". --Arcadian 18:04, 14 January 2006 (UTC)
 * Terrence McKenna was an author of several books and was also known as someone who was a 'DMT' explorer and regular psilicobyn user. I admire the guy, but what is the likelihood this was environmentally induced by some substance (possibly by accident or contamination of false fungi genus. IE: Fly Agaric is harmless (in comparison to alcohol), but it is possible to consume other hallucinogenic mushrooms which look identical and are poisonous). I can't find anything about this but it makes you think? --213.106.102.178 21:56, 14 June 2006 (UTC)

Chloroquine
When you're stuck, try antimalarials. JFW | T@lk  23:53, 6 March 2006 (UTC)

Probably a stupid question, but...
What defines glioblastoma multiforme? I know that they're a very serious form of brain tumor with a poor survival rate etc. from the article but I'm still a little confused what makes a brain tumor glioblastoma multiforme. Since I've read that brain tumors do not often metastasize I'm not sure what factors influence the severity of a tumor. The article is obviously meant for someone with a little more background knowledge but if anyone knew a way to explain this I'd be extremely thankful if you could clear this up. Sorry for my ignorance and thank you for any help offered. Blademaster 02:35, 13 October 2006 (UTC)

A pathologist is the gold standard for diagnosing a glioblastoma. After the tumor is surgically removed it is sent to a pathologist who identifies it. The severity of a tumor is defined by how 'malignant' or 'aggressive' it is. Some tumors a surgeon can remove, give the pt some chemotherapy, and the tumor won't return. Other tumors (like the gliolblastoma), will consistently grow back no matter how many surgeries, radiation therapy, chemotherapy are done. —Preceding unsigned comment added by 96.18.18.2 (talk) 22:38, 21 June 2008 (UTC)

GBM is distinguished from lower grade astrocytoma by histological endothelial cell proliferation and/or necrosis.

Long-term survivors
Has anyone more information on the mentioned long term survivors and Dr. Ben Williams? To me this sounds a bit strange and like snake oil - but I would be glad to be proved wrong.

My mom has just been diagnosed with GBM IV and I need to know in layman terms please, what is the actual survival rate of this disease. We have been told less than a year without treatment and only one year with treatment. Is this accurate?66.233.34.208 (talk) 03:08, 18 July 2009 (UTC)diane thompson


 * It varies greatly. The median survival times should be a rough indicator meaning half the patients with the mentioned condition would die before that time and half after. You cannot really predict how long a patient will live and a few have managed to live more than 5 years.


 * My ex-husband was diagnosed with GBM IV in December or 2000...I am glad to report that he is still alive...and living a somewhat normal life. He is in an assisted living facility, however he got a part time job, plays golf, goes out with friends, etc.  Just 2 short years ago he was knocking on death's door.  In a nursing home, unable to feed himself, walk, talk, in diapers, etc.  He was diagnosed at age 39.—(Jap524 18:46, 13 June 2007 (UTC))

Temozolomide
It's my impression that temozolomide (Temodar) is now the chemical agent of choice for initial chemotherapy, and that the other chemical agents mentioned such as carboplatin are no longer considered desirable treatments for GBM. However I am strictly a layman. It would be good if someone with current expertise would review this part of the entry and update it if appropriate.—67.39.204.192 21:47, 15 September 2007 (UTC)

I was recently diagnosed with GBM and my understanding is that this is in fact correct. As shown in the National Cancer Institute article (http://www.cancer.gov/clinicaltrials/results/glioblastoma0604) the PCV regimen has been replaced by temozolomide (Temodar) as the current standard of care. The Temodar has been found to be effective in getting through the blood brain barrier and has significantly less side effects. The NCI article notes an increase in the 2 year survival rate for GBM of 10% (radiation alone) to 26%. (radiation + Temodar).

It would be much appreciated if this Wiki could be updated to the current "standard of care" for GBM

Craig Farnsworth cfarnsworth9@gmail.com 67.39.204.192 21:47, 15 September 2007 (UTC)


 * I have added some references to the "Treatment" section to address this. (However, that section is still poorly organized. It would probably be best to delete the statements that can't be specifically tied to a source, and then split the experimental treatments from the current standard of care under a separate heading.)--Arcadian 23:47, 15 September 2007 (UTC)

New treatment reported
I saw an article in Physics Today regarding this cancer, and an experimental treatment using low frequency electric fields. Take a look here (http://ptonline.aip.org/journals/doc/PHTOAD-ft/vol_60/iss_8/19_1.shtml) for details. Perhaps this should be referenced in a section in the article page, but I'm a WikiNewbie so I'll let someone more competent do that. MGF mgforbes@mindspring.com 12.24.60.12 05:27, 27 September 2007 (UTC) Also www.nytimes.com/2009/11/17/health/17tumor.html?ref=science

Using viruses to attack tumor
Some refs to a newly published research: A Viral Attack against Brain Tumors, Systemic Vesicular Stomatitis Virus Selectively Destroys Multifocal Glioma and Metastatic Carcinoma in Brain

I'm not an editor so wouldn't know how to properly update the article with this interesting new research. —Preceding unsigned comment added by 89.1.86.245 (talk) 22:10, 3 March 2008 (UTC)


 * 7 years later We should see if there has been any progress such as testing it in immune-competant animals or clinical trials. - Rod57 (talk) 12:22, 14 January 2016 (UTC)


 * There are several problems with this form of treatment. First of all, the immune system of the patient could attack the virus in an immunocompetent patient, rendering the treatment ineffective. Secondly, even if the virus was genetically modified to selectively target tumor cells, the virus could mutate into a pathogenic strain and wreak havoc in the patient's body like in the movie I Am Legend. In other words, life, uh, finds a way. ScamsAreHorrible172 (talk) 07:40, 21 March 2018 (UTC)

Clinical trials
I removed a large section on various phase I, phase II and phase III trials without prejudice. Most Wikipedia articles, even on rare and incurable conditions, do not discuss ongoing research in such detail because it is entirely unclear which modalities will eventually reach clinical practice. Phase III trials are sort of the absolute maximum we cover. Rather than citing individual studies/agents/modalities, something could be said for discussing various trends in experimental science. JFW | T@lk  13:37, 14 April 2008 (UTC)


 * I agree these shouldn't be in the main article but as some patients family members (as myself) wish to inspect all alternatives, perhaps adding references in the TALK part of here would be useful... —Preceding unsigned comment added by 89.139.162.214 (talk) 12:17, 15 June 2010 (UTC)


 * For some diseases such as GBM the standard of treatment ('clinical practice') is to get on a clinical trial, so mention of trials (of specific agents) is IMO justified. It should not be pushed onto the talk pages. Perhaps a separate page of GBM clinical trials linked from the main article ? - Rod57 (talk) 12:17, 14 January 2016 (UTC)

Approval of Avastin
Should the recent (May 12, 2009) news about avastin be added? Am Cancer Soc link Avastin Approved for Glioblastoma, Article date: 2009/05/12 By Rebecca Viksnins Snowden The FDA recently approved Avastin (bevacizumab), manufactured by Genentech, to treat glioblastoma multiforme (GBM), a type of brain cancer, that hasn't responded to other therapies. The approval is the latest for the drug, which is also used to treat certain types of breast, lung, colon, and rectum cancers. [...] AdderUser (talk) 16:13, 21 May 2009 (UTC)


 * yes, (that link is dead but FDA Approval for Bevacizumab. Dec 2014 works.) now bevacizumab is mentioned in the article but just for control of symptoms, due to a 2014 review. Probably deserves more discussion. —Rod57 (talk) 12:08, 14 January 2016 (UTC)

Summary from NYT
I inserted a paraphrase of the New York Times article, because it was a good summary and got to the important points that patients want to know -- what is the survival, and what is the treatment. We shouldn't force readers to go through the whole article until they get to the bottom to find out the survival statistics. Note that Lawrence Altman is an M.D., and is more reliable that most sources. --Nbauman (talk) 23:54, 27 August 2009 (UTC)

How we die
Having been with relatives dying of cancer and now a relative with glioblastoma - it would be helpful to know what to expect at the end. Generally medical articles shy away from these explanations. For anyone seeking information a short description of the final process allows a certain amount of mental preparation. I have been told that the patient will go in to a coma and that possibly morphine will be used to alleviate any pain. Is this true? How much pain is associated with this type of tumour? How long is the coma likely to last? A257 (talk) 23:48, 18 February 2010 (UTC)

Wikipedia is absolutely not for medical advice, and any information read in any Wikipedia articles should never be used as medical advice of any kind. See WP:Medical disclaimer. Immunize (talk) 23:46, 31 March 2010 (UTC)


 * I have read that the worse the tumour gets the more time the patient will sleep, until eventually they will spend most of the time asleep. Finally, they will fall into a coma and pass away. From what I understand there won't be too much suffering compared to other forms of cancer. I too have GBM and have done a little research into this. —Preceding unsigned comment added by 212.159.87.26 (talk) 08:18, 3 April 2010 (UTC)


 * I strongly doubt that GBM patients all die in a similar way as tumors in different parts of the brain affect patients differently. —Preceding unsigned comment added by 89.139.162.214 (talk) 12:16, 15 June 2010 (UTC)


 * I strongly doubt you are qualified to make such a statement. Look at the following link from www.cancerhelp.org.uk. It says:
 * "There is a set of symptoms that is common to most growing brain tumours. Once a brain tumour reaches a critical size, and cannot be slowed down with treatment, the increased pressure inside the head begins :::to cause headaches, sickness and drowsiness.


 * At first, it will be possible to control these symptoms by increasing your steroid dose. But eventually, the steroids will not be able to reduce the swelling any further. You can have painkillers and :::medication to control sickness. But you may find you become increasingly drowsy. This often comes on slowly. You or your relatives may notice you are sleeping a bit more than usual. This can carry on for :::quite a time. At this stage, many people can carry on with a relatively normal life, even though they may be drowsy at times and need more sleep than they used to.


 * As time goes on, you may find that you are sleeping more and more. Gradually, it may become more and more difficult to wake you. Eventually most people slip into unconsciousness. You may be unconscious for :::days or weeks before you die. During this time, you will need nursing care to keep you comfortable. There is information about what happens in the last few days of life in the dying with cancer section of :::CancerHelp UK." —Preceding unsigned comment added by 212.159.87.26 (talk) 13:57, 20 July 2010 (UTC)

Rarely a spinal tumor?
I know of someone who had a glioblastoma multiforme tumor in the spinal column and it apparently didn't spread there from the brain as the spinal fluid was clear. Doctors say that is exceedingly rare.

If someone who knows about this subject could add to the article, I think that might be appropriate. I'm not bold enough. 108.120.212.149 (talk) 16:20, 12 May 2010 (UTC) (thought I was logged in!) JordanHenderson (talk) 16:22, 12 May 2010 (UTC)

Current clinical trials and old clinical trial results
Results of phase I and phase II clinical trials shouldn't be in the main article but I believe that adding them here would be helpful to at least some of the people that are unable to throughly research the Internet to find all in existence. As prognosis for GBM is bleak, we all get to a stage where we'll try many other alternatives, even if only passed phase I trials. Wikipedia is here to supply information, not to withhold it. 89.139.162.214 (talk) —Preceding undated comment added 12:23, 15 June 2010 (UTC).


 * This talk page is not the best place for it (eg they get archived). If people wont accept this in a section on Experimental treatments perhaps we should link to a new article GBM - Experimental treatments or GBM - clinical trials/results ?

Help needed...
My mother in law, age 83, was diagnosed in April this year with a has a stage 4 GBM which causes speech problems and she has remained very independent. She has completed 30 radiation treatments and the MRI shows that the tumor has gone from 2 to 3 centimenters during that time. SHe has had one dose of chemo ( 4 capsules of something every 6 weeks) which means she has only had one dose and a new MRI later this minth. The doctors stated that she needs help in her home but she says she does not need any help. We are at a point where we don't know what to do and the doctors have told us that they can nnot tell us what to expect next. Has anyone got suggestions or what is effected after her speech and eye sight?? —Preceding unsigned comment added by 71.72.240.169 (talk) 21:12, 6 September 2010 (UTC)

Translation into Chinese Wikipedia
The 16:15, 20 November 2010 24.199.120.101 version of this article is translated into zh:胶质母细胞瘤 to expand a stub.--Wing (talk) 20:52, 23 November 2010 (UTC)

RPA class
Hello, the prognosis table includes "RPA class" but this term is not defined anywhere. I'm not familiar enough with the data to explain RPA myself. Hopefully someone can elaborate on this.

Thanks! — Preceding unsigned comment added by Cogorno (talk • contribs) 22:23, 30 November 2011 (UTC)

Incidence
The lede states that "GBMs occur in only 2–3 cases per 100,000 people in Europe and North America". It doesn't identify a source for that, but after looking at some other sites, I suspect that should be "only 2-3 cases ANNUALLY per 100,000 people". Without a qualifier it implies lifetime incidence, which seems too low. --GenericBob (talk) 05:25, 10 January 2012 (UTC)

Removal of laundry list of Causes
I'm tempted just to remove the laundry list at the top of the "Causes" section, but I don't know if there are any applicable Wikipedia standards that are relevant.

My initial concern was the statement that aspartame usage parallels the rise in occurrences of glioblastomas, which is misleading to the point of being useless. However, the entire section is almost entirely full of "links", which most people will assume refers to some kind of causative link, which is generally not supportable. Many of the citations don't even appear to be specific to glioblastoma, but brain cancer in general, making the suggestions even more tenuous.

I would suggest, at the very least, replacing it with something more general (such as stating that the causes are unknown but some potential causes have been or are being investigated, although only *some subset* have been demonstrated to be causative.) In the event that it is deemed the section should be left in, sufficient disclaimers should be added so that a layperson is not mislead. For example, even the portion about CMV states "Although CMV is suspected of having a causative role, this has not yet been definitively established," while there is no such disclaimer at all for the aspartame comment, which is significantly more tenuous. — Preceding unsigned comment added by Mstrofbass (talk • contribs) 20:23, 2 December 2013 (UTC)

Why does "spongioblastoma" redirect here?
Not used or explained in article. 86.159.197.174 (talk) 05:18, 26 August 2014 (UTC)


 * The same is true of "pseudopalisade". Equinox ◑ 15:57, 11 June 2016 (UTC)

Glioblastoma vs GBM
Searching for glioblastoma redirects to GBM. The articles states that GBM has two forms: giant cell glioblastoma representing up to 5% of all glioblastomas, and gliosarcoma, estimated at approximately 2.1% of all glioblastomas. What are the other 93%? (Lower grade astrocytomas? WHO claims grades I, II, and II represent only 30% of astrocytomas, grade IV being GBM.  The numbers seem very inconsistent.  Is this a terminology problem, or a numbers problem, or are we missing an article on non-multiform glioblastomas?

Thanks for your attention. — Preceding unsigned comment added by 98.64.247.112 (talk) 19:41, 6 February 2015 (UTC)

External links modified
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Prevent or treat
Intro says "There is no clear way to prevent the disease. " which seems unhelpful padding as it could be said about most cancers. I think it should be deleted or changed to something like "There is no known cure." or "It has a poor prognosis even with treatment" - Rod57 (talk) 11:18, 14 January 2016 (UTC)

Primary vs secondary
This is mentioned in the article but only defined further down in Diagnosis. The one line definition could be repeated in the lead ? - Rod57 (talk) 11:18, 14 January 2016 (UTC)

Cellphone radiation
Does this article understate the potential risk factor of chronic exposure to EMF? For example, 3x in cases of exposure > 25 years: http://dx.doi.org/10.1016/j.pathophys.2014.10.001 — Preceding unsigned comment added by 2404:130:0:1000:4DF1:8C40:C153:21B7 (talk) 01:47, 15 March 2016 (UTC)


 * It isn't likely that cell phones have any effect. They operate at such a high frequency that there is very little penetration of electromagnetic radiation due to a well-understood phenomenon called "skin effect".  In this context, skin effect does not refer to human skin.  One would expect electronics engineers and technicians who work with radio equipment to be at highest risk, but there is no evidence that they suffer from glioblastomas any more than the general population. — Quicksilver (Hydrargyrum)T @ 16:00, 20 July 2017 (UTC)

The International Journal of Radiation Oncology chart
Does anyone have any evidence that anything has changed with that? Certainly in 14 years some things have changed.Bjoh249 (talk) 23:58, 12 September 2017 (UTC)

External links modified
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Non-risks
The section entitled Non-Risks should be edited to remove Cell Phones as a non-risk. This section currently states that:  "No links have been found with... electromagnetic fields, such as from cell phones and electrical wiring within homes." This claim cannot be found in the (outdated) citations given for the claim. Further, several reputable medical journals and institutions have publicly stated that there is no conclusive decision yet, either way. In fact there are several "Significant Ongoing Studies", according to the FDA.

Glioblastoma is a brain tumor, obviously, and ongoing studies on cell phones as a possible carcinogen for brain cancer should not be ignored. There have been no conclusions made in a published medical journal to support putting cellphone and EMF under the heading of "Non-risks".

Further support for revising this section comes by way of the antiquated citations used (that don't even support the claim). There are 3 citations for this claim (19,20,12). Citation #19 is from 2007 and the conclusion was that "The potential elevated risk of brain tumors after long-term cellular phone use awaits confirmation by future studies.". Citation #20 is from 2009 and the conclusion was "In summary our review yielded a consistent pattern of an increased risk for acoustic neuroma and glioma after >10 years mobile phone latency." (Glioma is a Glioblastoma). Citation #12 is the only recent citation, from 2015 and there seems to be no conclusion that supports this non-risk claim.

Please consider removing cell phones from the Non-Risks section until concrete evidence is corroborated.

-- — Preceding unsigned comment added by Wbeaton (talk • contribs) 20:35, 13 April 2018 (UTC)
 * does this work for you? What do others think? Jytdog (talk) 18:09, 19 April 2018 (UTC)

Jytdog, I think that the changes you've made are a vast improvement. This gives the risk assessment more of a neutral position, cognizant of ongoing research. Hopefully, others will agree. --Wbeaton (talk) 18:21, 19 April 2018 (UTC)

Prevention
What wording are you wanting for "Methods of prevention are unclear. " Doc James  (talk · contribs · email) 10:35, 17 November 2019 (UTC)

Newcastle disease
My edit about this was reverted here. I'm not sure the statement (which was essentially "this could eventually lead to a new kind of treatment, but right now we're not sure") really needs to be backed by a better source. In turn I do think its inclusion makes the article better, not worse - and anyway I doubt you can find a meta-analysis that covers something as experimental as this (I certainly can't even if one exists). Do feel free to convince me otherwise on any of the preceding points, though.

In any case, the fact that the Newcastle disease article continues to provide far more detailed information about the same thing seems sort of inconsistent to me. (No, I'm not advocating purging that too. Instead, I would put my edit back in, at worst with some kind of tag that highlights the need for other sources. But rather than go to an edit war over something I'm not at all an expert in, I'll leave this to other interested editors.) KissL 11:37, 10 November 2020 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 2 September 2021 and 14 December 2021. Further details are available on the course page. Student editor(s): Kolpinge1191, Mames29. Peer reviewers: 0703jiveyjane.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:26, 16 January 2022 (UTC)

Proposing rolling page back to November 24th
I am proposing that this page be reverted to the version on, prior to the edit by. Kolpinge1191 was editing as part of a class and doesn't seem to be active anymore (although your input is welcome if you are). I've already reverted edits from one of his classmates on Multiple Sclerosis. I think that their definition of epidemiology might be a bit broader than what the epidemiology section of medicine articles covers per Manual of Style/Medicine-related articles. Kolpinge1191 put information about general risk factors, as well as prognostic information, into the epidemiology section of the glioblastoma article. Additionally, there are multiple grammatical errors, including run-on sentences.

If I get no responses, eventually I'll proceed with reversion.

Lukelahood (talk) 16:46, 13 January 2022 (UTC)

I reverted it. Lukelahood (talk) 00:16, 20 January 2022 (UTC)

Brigham and Women's research
"Scientists Develop a Cancer Vaccine to Simultaneously Kill and Prevent Brain Cancer" (Jan 4 2023); cited: "Bifunctional cancer cell–based vaccine concomitantly drives direct tumor killing and antitumor immunity" Mapsax (talk) 01:42, 7 January 2023 (UTC)

5 year survival rate discrepancy
Hello, don't know the remedy or even if any is needed, so instead of editing I'm posting here.

There are contradictory statements regarding 5 year survival rates in the introductory statement and the prognosis section (5-10℅ and 1-3℅ respectively.) Since they have different references, it's probably due to them being different studies, but since thye are very different, it may be confusing for some readers and difficult to reconcile.

A discussion of the years of the studies, sample size, methodology, limitations, pros and cons, and academic consensus would be ideal – as was done in the treatment section for radiotherapy, chemotherapy, and electrotherapy (and is something I am not qualified for and cannot do justice.)

Perhaps a quick fix would be to amend the prognosis section with something like: "While some studies have indicated a 5 year survival rate of 5-10℅, others have shown results as low as 1-3℅" (obviously not ideal) 222.152.169.41 (talk) 14:22, 18 February 2024 (UTC)

CAR-T-cell experimental therapy
Has anyone heard of something called CAR-T-cell experimental therapy? It seems to have produced quite good results thus far in at least one of the three persons that the news release discussed. (March 2024) 76.16.47.132 (talk) 00:50, 18 March 2024 (UTC)

Wiki Education assignment: The Impact of Cancer
— Assignment last updated by 22ilovecats22 (talk) 21:41, 18 April 2024 (UTC)