Unraveling the Link: Exploring the Relationship between Glioblastoma and Epilepsy
This blog post is in collaboration with the Epilepsy Foundation.
Many brain cancer patients, particularly those diagnosed with Glioblastoma brain cancer, develop epilepsy as their illness progresses. Understanding the link between the two is vital to both the patients, as well as those conducting research. The Glioblastoma Research Organization (GBMRO) is thrilled to dive deeper into understanding the complex relationship between Glioblastoma and epilepsy with the help of our partners at the Epilepsy Foundation. Through this blog and during Brain Cancer Awareness Month, our organizations are teaming up to provide readers with helpful content and resources.
Are you looking for more interactive content? Join the Epilepsy Foundation for a free Seizure Recognition & First Aid Certification Training on Tuesday, May 23 at 2 P.M. EST featuring our very own GBMRO medical advisory board member, Dr. Michael E. Ivan, alongside the foundation’s Professional Advisory Board member and instructor, Dr. Lorraine Newborn-Palmer.
Click here to reserve your spot.
Glioblastoma and Epilepsy
Glioblastoma (GBM), an aggressive brain cancer, accounts for nearly half of brain tumors in adults. As the brain is the human control center, many bodily symptoms can erupt, a common symptom being epilepsy. Epilepsy, a common neurological disorder, causes surges of electrical activity in the brain that promote recurring seizures.
As the tumor grows, normal brain tissue can be both invaded and damaged, leading the way for a disruption of normal electrical activity in the brain. This disruption causes seizures or, in some patients, the development of epilepsy. This connection between GBM and epilepsy is of great importance as there has been much research on common genetic pathways, current problems in treatment, and the impact of certain therapies.
What is Glioblastoma Brain Cancer?
Glioblastoma Multiforme is one of the most difficult-to-treat malignant tumors. The risk factors for this cancer can include, but are not limited to, genetic predisposition and exposure to toxic agents. There is no substantial research regarding the causes of this specific cancer, but these are commonly agreed upon.
GBMs develop most commonly in the spinal cord and brain. In the brain, these tumors can present in cerebral hemispheres such as the frontal and temporal lobes. As previously mentioned, it is very aggressive, with a 6.6-month average survival rate without treatment. To learn more about Glioblastoma and our research-funding mission, click here.
Symptoms of this cancer are related to the tumor’s location, size, and pressure on brain areas. The most typical symptoms individuals can experience are headaches, confusion, memory loss, motor weakness, seizures, nausea, personality changes, difficulties concentrating, hemiparesis and aphasia.
While this cancer has been previously coined “treatment resistant,” diagnosis at an early stage allows patients access to new and improved treatment methods and research in the field. Current treatment options can include the removal of the cancer through surgery or other methods to break up the cancerous matter. Broad treatment options are limited due to the rarity of the cancer and the patient-specific diagnosis.
What is Epilepsy?
Epilepsy is a common brain disorder that causes recurring seizures. It is important to note that not everyone who has a seizure has epilepsy. A seizure on its own can be a symptom of another medical ailment, while epilepsy is a neurological disease. These unprovoked seizures are caused by irregular electrical activity in the brain that can change aspects of one’s personality. While not all seizures result from triggers, some can be provoked by stress, alcohol, drugs, flashing lights and nutritional factors.
During a seizure, an individual can experience convulsions, the lack or absence of awareness and other involuntary bodily functions. There are different types of seizures, the three significant groups being focal onset, generalized onset and unknown onset. These classifications are based on the beginning of a seizure, the individual’s level of awareness and the body movements during the event.
Glioblastoma-Related Epilepsy
In 30 to 62% of patients with Glioblastoma, seizures and the development of epilepsy are experienced. Because the development of GBM inhibits the development of healthy brain tissue and changes the course of normal brain electrical activity, the risk for epilepsy and seizures is higher than in individuals without this cancer.
The presence of epilepsy in a broad range of brain tumors can indicate an early warning sign, leading toward a good prognostic factor for survival. With Glioblastoma specifically, epilepsy can be indicative of edema or neuroinflammation. GBM with epilepsy is complex. While anticonvulsant drugs could lessen the frequency of seizures and improve the survival rate, the seizure could lead to other complications in these patients. These challenges can change the course of treatment and prognosis.
Diagnosis and Treatment of Glioblastoma Brain Cancer and Epilepsy
The traditional treatment for epilepsy is antiepileptic medications (AEDs), dietary changes, and in some cases, surgery. For the treatment of epilepsy in patients with gliomas, treatment can include AED Levetiracetam and recording electrical activity in the brain during tumor resection surgery—this is known as intraoperative electrocorticography. For patients with Glioblastoma, a stage 4 glioma, similar treatment follows. The side effects of the medication include cognitive impairment, bone marrow suppression, liver distress, and skin issues.
For both Glioblastoma brain cancer and epilepsy, a multidisciplinary approach to treatment is of great importance. As each Glioblastoma and brain is structured differently, treatment may differ from case to case.
Coping with Glioblastoma Brain Cancer and Epilepsy
The union of these diagnoses, as well as each disease on its own, can be daunting and challenging to accept. At the Glioblastoma Research Organization, it is understood that this journey is medical, emotional and can cause financial distress. Many resources and projects within our organization can connect you with individuals fighting a similar battle and ongoing research to find a cure. To view these resources, visit here.
For those with epilepsy, the same follows. On the Epilepsy Foundation’s page, there are numerous videos and resources to help one prepare for a seizure, as well as prepare their support system. Throughout either journey, you are not alone. One way an individual can prepare is by recording the events and symptoms that follow. There are different tools and apps to track your seizures, for a list of options visit the Epilepsy Foundation’s website, click here.
Current Research and Future Directions
For both the Glioblastoma Research Organization and the Epilepsy Foundation, there is a large commitment to bettering lives and potentially saving them.
In a new study published on February 8, 2023, by Yale University, a new treatment option for Glioblastomas seems hopeful. The study mentions using two available therapies to inhibit the tumor from growing.
While the treatment of epilepsy in Glioblastoma patients can be different than in patients without cancer, much research still needs to be done. In another study by Yale University, a neurostimulation device is said to alleviate symptoms in patients. This personalized approach claims to help predict the events.
Looking to the Future
Glioblastoma-related epilepsy can impair normal functioning and add stress to an already difficult situation. Both the GBMRO and the Epilepsy Foundation understand these difficulties and hope to raise awareness as best as possible.
In the event of any seizure, seeking medical attention and advice is paramount. Not all Glioblastoma-related seizures can indicate the development of epilepsy, but each case is different. All seizures signify a serious matter and should be handled in a specific way.
Innovative research is being conducted in the field, and new online resources are available for caregivers. Provided on the Epilepsy Foundations page are tools to help manage seizures, resources to find a community and tips for parents and caregivers.
Join us for more epilepsy-related content on Tuesday, May 23. Reserve your spot for a free Seizure Recognition & First Aid Certification Training at 2 P.M. EST hosted by the Epilepsy Foundation and led by the Foundation’s Professional Advisory Board member and instructor Dr. Lorraine Newborn-Palmer.
Click here to reserve your spot.
On our page, there is much to learn about Glioblastoma brain cancer. To check out more content, visit our blog. You can read a Q&A by Dr. Ricardo Komotar on Epilepsy here and browse more informative articles as well as caregiver stories.
Please note that the information provided by the Glioblastoma Research Organization is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem without consulting a qualified health-care provider.
References
Armstrong, T. S., Grant, R., Gilbert, M. R., Lee, J. W., & Norden, A. D. (2016). Epilepsy in Glioma patients: mechanisms, management, and impact of anticonvulsant therapy. Neuro-oncology, 18(6), 779–789. https://doi.org/10.1093/neuonc/nov269
Epilepsy Foundation. (2023, May 13). https://www.epilepsy.com/
Fernandes C, Costa A, Osório L, et al. Current Standards of Care in Glioblastoma Therapy. In: De Vleeschouwer S, editor. Glioblastoma [Internet]. Brisbane (AU): Codon Publications; 2017 Sep 27. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK469987/ doi: 10.15586/codon.glioblastoma.2017.ch11
Fonkem, E., Bricker, P., Mungall, D., Aceves, J., Ebwe, E., Tang, W., & Kirmani, B. (2013). The role of levetiracetam in treatment of seizures in brain tumor patients. Frontiers in neurology, 4, 153. https://doi.org/10.3389/fneur.2013.00153
Glioblastoma Research Organization. (n.d.). https://www.gbmresearch.org/
Kanderi T, Gupta V. Glioblastoma Multiforme. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558954/
Nelson, J. S., Burchfiel, C. M., Fekedulegn, D.; Andrew, M. E. (2012, September). Potential risk factors for incident Glioblastoma Multiforme: The Honolulu heart program and Honolulu-Asia Aging Study. Journal of neuro-oncology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4693293/
Prakash, O., Lukiw, W. J., Peruzzi, F., Reiss, K., & Musto, A. E. (2012). Gliomas and seizures. Medical hypotheses, 79(5), 622–626. https://doi.org/10.1016/j.mehy.2012.07.037
van der Meer, P. B., Taphoorn, M. J. B., & Koekkoek, J. A. F. (2022). Management of epilepsy in brain tumor patients. Current opinion in oncology, 34(6), 685–690. https://doi.org/10.1097/CCO.0000000000000876
Weir, W. (2023, May 1). New treatment merges two technologies to fight brain cancer. YaleNews. https://news.yale.edu/2023/02/08/new-treatment-merges-two-technologies-fight-brain-cancer#:~:text=A%20new%20treatment%20developed%20by,(green%20with%20blue%20nuclei).
Yale Medicine. (2021, March 24). A new hope for patients with epilepsy. https://www.yalemedicine.org/news/epilepsy-deep-brain-stimulation
