What is Glioblastoma?

Glioblastoma (GBM) is the most common aggressive primary brain tumour in adults. It develops from the supporting cells of the brain (glial cells) and grows by infiltrating the surrounding brain tissue, making it impossible to remove every tumour cell surgically.

Although glioblastoma is an aggressive tumour, effective treatments are available. Modern management combines surgery, radiotherapy and chemotherapy with the aim of prolonging survival, preserving neurological function and maintaining quality of life.

Most glioblastomas develop spontaneously without an identifiable cause. They are not inherited, are not contagious and are not caused by anything a patient has done or failed to do.

Patients commonly present with headaches, seizures or progressive neurological symptoms caused by the growing tumour and the swelling it produces within the brain. Symptoms may also include weakness, speech or language difficulties, memory or personality changes, visual disturbance and problems with balance or coordination.

For many patients and their families, the diagnosis comes unexpectedly following an emergency admission or investigation of new neurological symptoms.

How is Glioblastoma Diagnosed?

Glioblastoma is usually suspected following an MRI scan of the brain.

Although MRI can strongly suggest the diagnosis, confirmation requires tissue obtained during surgery or biopsy. The tumour is then examined by a neuropathologist and undergoes detailed molecular testing.

Important molecular markers include:

• IDH mutation status
• MGMT promoter methylation
• Other tumour-specific genetic alterations

These molecular features provide important information regarding tumour biology, expected response to treatment, prognosis and, in some cases, eligibility for clinical trials.

Does Everyone Need Surgery?

For most patients, surgery is the first and most important step in treatment.

Surgery is performed to:

• confirm the diagnosis
• obtain tissue for molecular and genetic testing
• relieve pressure within the brain
• improve neurological symptoms
• remove as much tumour as can be achieved safely
• optimise the effectiveness of subsequent radiotherapy and chemotherapy.

Because glioblastoma infiltrates normal brain tissue microscopically, complete removal is rarely possible. The aim of surgery is therefore maximum safe tumour resection—removing as much tumour as possible while preserving neurological function, independence and quality of life.

Extensive clinical research has consistently shown that patients who undergo greater degrees of safe tumour removal generally experience improved survival and better functional outcomes.

What Are the Treatment Options?

Successful treatment almost always requires a multidisciplinary approach involving neurosurgeons, neuro-oncologists, radiation oncologists, neuroradiologists, neuropathologists and specialist nursing staff.

Surgery

Maximum safe surgical resection remains the cornerstone of treatment whenever feasible.

The objective is to remove as much tumour as safely possible while preserving important neurological functions such as speech, movement, vision and memory.

Radiotherapy

Following recovery from surgery, most patients receive external beam radiotherapy.

Radiotherapy treats microscopic tumour cells that remain within the surrounding brain and has been shown to improve both tumour control and overall survival.

Chemotherapy

Temozolomide is the standard chemotherapy used for glioblastoma.

It is administered concurrently with radiotherapy and usually continued afterwards as maintenance treatment. The benefit of chemotherapy varies according to the tumour’s molecular profile, particularly MGMT promoter methylation status.

Clinical Trials

Clinical trials continue to investigate new therapies including targeted treatments, immunotherapy, tumour vaccines and novel drug combinations.

For selected patients, participation in a clinical trial may provide access to promising new therapies alongside current standard treatment.

Which Treatment is Best?

TThere is no single treatment that is appropriate for every patient with glioblastoma.

Treatment recommendations depend on many factors, including:

• patient age
• neurological function
• tumour location
• extent of tumour removal
• molecular profile
• overall health
• individual goals and preferences.

The objective is not simply to treat the tumour, but to recommend the approach that offers the greatest overall benefit while preserving neurological function, independence and quality of life.

What Happens After Surgery?

Following surgery, the tumour undergoes detailed pathological and molecular analysis to establish the definitive diagnosis.

Patients are then reviewed by a multidisciplinary neuro-oncology team, where imaging, pathology and treatment options are discussed before an individualised treatment plan is developed.

Most patients commence radiotherapy and chemotherapy approximately three to six weeks after surgery, allowing adequate time for recovery and wound healing.

Regular MRI scans are performed throughout treatment to monitor the response and identify tumour recurrence as early as possible.

What is the Prognosis?

Glioblastoma remains one of the most challenging brain tumours to treat. However, outcGlioblastoma remains one of the most challenging brain tumours to treat. However, outcomes continue to improve as advances in surgery, molecular diagnosis, radiotherapy, chemotherapy and clinical trials allow treatment to become increasingly individualised.

Survival varies considerably between patients and depends on many factors, including:

• age
• overall health
• neurological function
• tumour location
• extent of surgical resection
• molecular characteristics
• response to treatment.

Published survival statistics are helpful when studying large groups of patients, but they cannot predict what will happen to any individual person.

Many patients live significantly longer than expected, particularly when treatment is tailored to their tumour biology and coordinated through an experienced multidisciplinary neuro-oncology team.

​Why Seek a Second Opinion?

Many patients and families seek a second opinion following a diagnosis of glioblastoma.

A specialist review can help confirm the diagnosis, review imaging, discuss the extent of tumour removal, explain molecular findings and ensure every appropriate treatment option—including surgery, radiotherapy, chemotherapy and clinical trials—has been carefully considered.

For recurrent glioblastoma, a second opinion may also help determine whether further surgery, additional therapies or clinical trial participation are appropriate.

Why Choose Professor Lai?

A diagnosis of glioblastoma affects not only the patient, but their entire family. Successful treatment requires more than expert surgery. It requires thoughtful clinical judgement, careful surgical planning, close collaboration with neuro-oncologists and radiation oncologists, and ongoing support throughout every stage of treatment.

Professor Lai has extensive experience in the microsurgical management of glioblastoma and other complex brain tumours. His surgical philosophy is to achieve maximum safe tumour resection—removing as much tumour as possible while preserving neurological function—recognising that maintaining quality of life is just as important as prolonging survival.

Working within a dedicated multidisciplinary neuro-oncology team, Professor Lai develops individualised treatment strategies integrating surgery, molecular diagnosis, radiotherapy, chemotherapy and clinical trials where appropriate.

Patients are referred from across Melbourne, regional Victoria, throughout Australia and overseas for primary treatment, recurrent glioblastoma and complex second opinions. Every recommendation is guided by sound clinical judgement, the best available evidence and compassionate, patient-centred care.

Frequently Asked Questions

Is glioblastoma a brain cancer?

Yes. Glioblastoma is a malignant primary brain tumour. Unlike many other cancers, it rarely spreads outside the brain, but it can grow rapidly within the brain and requires prompt specialist treatment.

Can glioblastoma be cured?

At present, glioblastoma cannot usually be cured because microscopic tumour cells extend beyond what can be safely removed. Modern treatment aims to prolong survival, preserve neurological function and maintain quality of life.

Is surgery always necessary?

For most patients, surgery is recommended to establish the diagnosis, relieve pressure within the brain and remove as much tumour as safely possible. In selected situations, a biopsy rather than tumour removal may be the safest option.

Why can’t the whole tumour be removed?

Glioblastoma infiltrates normal brain tissue microscopically. Although the visible tumour can often be removed, microscopic tumour cells remain beyond the margins of surgery. This is why radiotherapy and chemotherapy remain essential components of treatment.

Will I need chemotherapy and radiotherapy?

Most patients receive both radiotherapy and temozolomide chemotherapy following surgery. Your treatment plan depends on your overall health, tumour characteristics and molecular test results.

Can glioblastoma come back?

Unfortunately, recurrence is common despite successful initial treatment. However, further surgery, chemotherapy, radiotherapy or clinical trials may be appropriate for selected patients.

Can I continue working or driving?

This depends on your symptoms, neurological recovery, whether you have experienced seizures and the treatment being undertaken. Many patients are able to return to selected daily activities following treatment, although temporary or permanent driving restrictions may apply. Individual advice should always be discussed with your treating specialist.

Should my family members be screened?

In almost all patients, glioblastoma occurs sporadically and is not inherited. Routine brain imaging for family members is therefore not recommended unless there is a recognised inherited cancer syndrome, which is uncommon.

Should I get a second opinion?

Yes. A second opinion can help confirm the diagnosis, review treatment options and ensure every appropriate therapy has been carefully considered. Many patients find this provides reassurance and confidence before making important treatment decisions.

A diagnosis of glioblastoma is life-changing, but it is not a journey that should be faced alone. Careful surgery, coordinated multidisciplinary care and ongoing support help ensure that every treatment decision is focused on maximising both survival and quality of life.

Video