Glioma brain tumours

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Find out more about gliomas or a type of primary brain tumours 

Glioma brain tumours - Dr Alex Koefman, Neurosurgeon Brisbane

Neurosurgeon Brisbane

Dr Alex Koefman about gliomas

Glioma brain tumours key points

  • Gliomas are primary brain tumours, meaning they originate in the brain and have not spread from another body part
  • There are 4 grades of gliomas
  • Symptoms are headaches, stroke-like symptoms and seizures
  • Brain surgery is one of the treatment options

Gliomas | Brain tumour surgery Brisbane

What is it?

Gliomas are primary brain tumours. These are very different from metastatic (also called secondary) brain tumours. 

Primary brain tumours originate in the brain itself. Secondary brain tumours originate outside the body, like in the lung, breast or bowel, and then spread to a secondary site in the brain.

There are only two types of cells in the brain. The first is called the neuron which transmits electricity and is responsible for all the brain activity including movement, thinking, speaking, seeing etc.

The other is the glial cells. Glial cells are like little scaffolding, or the bubble wrap that keeps all the neurons in place and physically supported.

Tumours of the neurons are very rare. Tumours of the glial cells on the other hand are much more common. They are collectively called gliomas. In fact gliomas make up 2 of the top 4 most common brain tumours in adults. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Neurosurgeon Brisbane

There is one other thing to know about gliomas, and that’s the grade. There are 4 grades: 1, 2, 3 and 4. 

  • Grade 1 only occurs in children and is completely unrelated to the other 3 grades.
  • Grade 2 is most commonly seen in young adults. Another name for a grade 2 glioma is “low grade glioma.”
  • Grade 3 and 4 are called “high grade glioma” and are more commonly seen in people over the age of 50.

In recent times, research has shown that the genetics of brain tumours is the most important information dictating prognosis, response to treatment, and overall quality of life.

Glioma tumour symptoms

What are the symptoms?

There are only 3 symptoms that can occur

  1. Headaches due to pressure on the brain from the tumour pushing on the brain and causing swelling in the brain. This pressure can also make you feel vague and somewhat confused.
  2. Stroke-like symptoms. For example if the tumour is pressing on the speech centre of the brain then you might have problems speaking. If it is pushing on the movement part of your brain then you may have weakness in your face, arms or legs. Similarly, if it is in the vision part of your brain then you may have blind spots in your vision, and keep running into things.
  3. Seizures. Grade 2 gliomas very commonly cause seizures.

Glioma brain tumour surgery Brisbane

How is it treated?

The three types of treatment for gliomas are:

  • Surgery
  • Chemotherapy or immunotherapy (drug treatment)
  • Radiotherapy (x-ray treatment).

Depending on the type of cancer it will be a different combination of these.

Do I need surgery when I have a glioma?

There are 3 reasons that surgery is required.

  1. To get a diagnosis.
    It is as good as impossible to know 100% what type of cancer something is just by looking at the scans. Sometimes it is necessary to do brain surgery to get samples of abnormal tissue. We then send these samples to the lab where they can do a series of tests to get the answer once and for all.
  2. To relieve symptoms of pressure.
    By reducing the size of the tumour it is possible to significantly improve your symptoms like headache. If the tumour is causing stroke-like symptoms then it may also be possible to improve this by removing as much of the tumour as it is safe to do so. So this is all about improving your quality of life.
  3. Oncological.
    This means we try to improve the overall length of life. Sometimes, by removing most or all of the tumour your overall prognosis gets a little bit better. Furthermore, by removing it it will make the effects of chemotherapy or radiotherapy more positive.

You will notice I’ve said “remove most of the tumour.” You may wonder why the whole tumour isn’t always removed? Well, in the brain it’s not always possible to do that. In the lung, the bowel or the skin for example, this can be done. But in the brain you can’t because it may risk vital parts of the brain that are next to, or surrounding the tumour. 

Dr Alex Koefman | Brain and Spinal Surgeon Brisbane
Dr Alex Koefman

Neurosurgeon Brisbane


We have very good evidence now that if you have a stroke during the surgery as a result of trying to remove every last bit of the tumour then your overall prognosis actually gets worse, not better. 

When I assess you I will be able to accurately determine if surgery is best for you and how much I will be able to safely remove and what this means for you overall.

It is horrifying news to find out you have a brain tumour, so it is vital that you feel in control of as much as possible, and that includes knowing everything you can going into treatment. I will take you through this.

Does the treatment work?

Fortunately with modern neurosurgery, chemotherapy, immunotherapy, and radiosurgery the situation for patients has been improved. However, despite the recent biotech revolution, no cure has ever been found. 

Glioma risk

Is this treatment safe?

It is vital that you are in control of as much as possible, and that includes knowing everything you can going into treatment. I will take you through this and all the risks and benefits of treatment. 

There are risks to treatment but fortunately in the last decade technology and equipment have evolved. This means the risks of this surgery are significantly less than what they used to be.

Here are the main risks of surgery for brain tumours:

  • Risk of stroke
  • Risk of epilepsy
  • Bleeding needing a second operation to remove the blood clot
  • Infection requiring antibiotics or a second operation to washout the infection
  • Risk that the tumour cannot be removed completely. Sometimes tumours are deliberately left behind so that you are not put at risk of stroke.

Neurosurgery has come a long way in modern times. Now surgery can be done quite routinely and with relatively quick recovery. Remember, most of the time we are trying to improve your quality of life by removing the tumour so performing an operation that makes you no better, or even worse is not appropriate. Performing big surgery to remove everything at all costs (to you) is certainly not a modern way of thinking. I will take you through everything when I see you and explain how I will get you through this as good as possible.

Brain surgeon Brisbane

What should I do now?

News of a brain tumour for you or family or friends is devastating. It’s usually news that comes like a freight train out of nowhere, and there will be a million questions. 

Your GP will refer you to a specialist. If you would like me to review your case then please contact my team immediately.

Ready to make an appointment?

Alex consults at Queensland Neurosurgery & Spine Surgery (QNS).
Dr Alex Koefman

Ramsay Specialist Centre
Suite 325
Newdegate St
Greenslopes QLD 4120


(07) 3397 4185

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