Surgery for Glioblastoma
What is Surgery for Glioblastoma?
Surgery for glioblastoma is a neurosurgical procedure performed to remove as much of a glioblastoma (a fast-growing and aggressive brain tumour) as safely possible while preserving important brain functions. Surgery is usually the first step in treatment. It helps reduce tumour size, relieve symptoms, obtain tissue for diagnosis, and improve the effectiveness of additional treatments such as radiation therapy and chemotherapy.
When is Surgery for Glioblastoma Recommended?
Surgery for glioblastoma is typically recommended when imaging studies show a tumour that can be safely accessed and removed. It is often performed to confirm the diagnosis, reduce tumour burden, relieve symptoms such as headaches, seizures, or neurological deficits caused by pressure on the brain, and improve the effectiveness of subsequent treatments like radiation therapy and chemotherapy. The decision depends on the tumour's size, location, and the patient's overall health.
How Should I Prepare for Surgery for Glioblastoma?
Before glioblastoma surgery:
- Discuss the procedure, risks, benefits, and expected outcomes with your surgical team.
- Sign consent form.
- Attend all preoperative appointments and imaging studies.
- Inform your doctor about medications, allergies, and medical conditions.
- Stop certain medications, such as blood thinners, supplements, and fish oil.
- Follow fasting instructions carefully.
- Arrange transportation and support for recovery.
What Happens During Surgery for Glioblastoma?
During surgery, the surgeon makes an opening in the skull (craniotomy) to access the tumour. Advanced techniques such as neuronavigation, intraoperative MRI, fluorescence-guided surgery, or brain mapping may be used to help identify and remove tumour tissue safely. After the tumour is removed, the skull bone is replaced and secured, and the incision is closed. The removed tissue is then examined in a laboratory to confirm the diagnosis and guide further treatment.
What Happens After Surgery for Glioblastoma?
After glioblastoma surgery, the patient is closely monitored in the intensive care unit for neurological function, pain control, and potential complications. Brain imaging is often performed the next day to assess the extent of tumour removal and exclude complications. Most patients stay in the hospital for a few days and may require rehabilitation to improve strength, speech, or mobility. Once recovery begins, further treatment such as radiation therapy and chemotherapy is typically planned to target any remaining tumour cells and reduce recurrence risk.
What are the Risks and Benefits of Surgery for Glioblastoma?
Benefits:
- Removes as much of the tumour as safely possible.
- Relieves symptoms such as headaches, seizures, and neurological deficits.
- Reduces pressure within the brain.
- Provides tissue for accurate diagnosis and treatment planning.
- May improve survival and enhance the effectiveness of radiation and chemotherapy.
Risks:
- Post operative blood clot causing pressure.
- Swelling of the brain.
- Seizures.
- Neurological problems such as weakness, speech difficulties, or vision changes.
- Hydrocephalus (accumulation of brain fluid)
- Reactions to anaesthesia.
- Incomplete tumour removal due to tumour location or spread into surrounding brain tissue.
- Infection (brain, wound, urine, chest)
- Complications related to other medical conditions (heart, lungs, kidney)
- Clots in legs (Deep venous thrombosis) and clots in lungs (pulmonary embolus)
Note: Your surgeon will advise you on how likely the above complications are.
What can I expect when I am discharged from hospital
- You may experience pain (including headache), inflammation, and discomfort in the operated area. Pain and anti-inflammatory medications are provided as needed.
- Keep the surgical site clean. Instructions on surgical site care and bathing will be provided.
- Refrain from smoking and alcohol until your first follow up visit as it can negatively affect the healing process.
- Refrain from lifting anything heavier than 5 Kg and other strenuous activities until the first follow-up visit. These activities may include housework, yard work, gardening, mowing, etc.
- Gentle exercise and regular walking are recommended to improve strength and endurance from 2 weeks after surgery.
- Refrain from driving until you are fully fit and receive your surgeon’s clearance.
- Most patients can return to their normal daily routines in 4-6 weeks after surgery.
