The History of Glioblastoma

Glioblastoma is a malignant type of very fast growing brain tumor which attacks the glia, or supportive tissues of the brain that provide nourishment to the brain as well as assisting neurons with transmitting signals through the nervous system. According to the Central Brain Tumor Registry of the United States (CBTRUS), over 32 percent of all tumors diagnosed are glioblastomas. A prognosis of the tumor is quite poor with survival rate extending to only about one year without treatment. Diagnostically, the tumors are separated into two groups: primary and secondary, which affect genders and ages differently.

Ancient History

• From ancient Egypt to South America, brain surgery has been documented going back as far as 7,000 B.C., and is actually the only type of ancient surgery for which we have more than anecdotal evidence. In the Neolithic Age (late Stone Age), it was common for the tribe's shaman to perform rituals to cast out the spirits that were infecting the sick person. When that didn't work, trepanation, in which a hole is drilled into the skull to let out the evil spirits, was born. Considering the times, where there was no anesthesia, no metal surgical tools and no sterile operating room, it is amazing that ancient skulls have been discovered that had bone growth around the trepanation site, which indicates that at least some of the patients survived.

Brain Surgery in Ancient Greece

• Hippocrates, an ancient Greek physician, lived around 400 B.C., and has been referred to as "the father of medicine." It is thanks to him that we have our moral and ethical structure in medicine, the oath known as the Hippocratic Oath, which all doctors take wherein they promise, "First, do no harm." He was influential in taking medicine out of the realm of spirituality, religion and philosophy and making it a hard science. He wrote many texts on brain surgery methods, how to recognize seizures and, perhaps most famously, an entire treatise called "On Injuries of the Head," which detailed instructions on how trepaning was done.

Medieval Brain Surgery

• The work that Hippocrates began continued into medieval times. As tools became more sophisticated, so did the art of neurosurgery. Barber-surgeons took their act on the road and traveled from town to town, claiming that they could remove the "stone of madness" and free the mentally ill from their torment.

The Modern Age

• Fast forward to two hundred years ago, and we see that historical efforts to develop a system by which brain tumors could be classified dates to the 1830s. Glioma were first named by a German pathologist named Rudolph Virchow in 1860. Known as "the father of pathology," Virchow contributed a great deal to the fields of science and classification and was one of the first to study brain tumors at the microscopic level. Credited with inventing one of the two methods of autopsy still in use today, Virchow's reputation still suffered in his refusal to believe that bacteria caused infection.

The 20th Century

• Percival Bailey, an American surgeon, along with his colleague Harvey Williams Cushing, who was also a neurosurgeon, created the first major system of classification for brain tumors in 1926. Cushing has often been called "the father of neurosurgery." Hans Joachim Scherer, a neuropathologist who studied medicine in Munich in the 1920s, was the first to delineate glioblastomas into its two groups. After moving to Berlin in 1931 to continue his research, he was arrested and questioned by the Gestapo. Upon gaining his freedom, he quickly relocated to Antwerp, Belgium (by way of Paris and several other stops) and began his work again with the Bunge Institute. After the Germans invaded Belgium in 1941, Scherer was ordered by the German military back to Breslau, and there Scherer became one of three doctors who carried out autopsies and central nervous system dissections on over 300 Polish and German children who had been euthanized in a mental hospital. He was killed in 1945 by an Allied forces bomb.

The 21st Century and Beyond

• To date, the standard treatment for glioblastoma was either surgery or radiation, or both. There are, however, many clinical trials and biomedical studies being conducted that may give us insight into how this malignant killer can be cured. According to Medical News Today, in November 2008 Drs. Johan Skog of the Netherlands and Xandra Breakefield of Massachusetts General Hospital made a groundbreaking discovery. Due to the advent of genome and DNA analysis, they have discovered unique markers which illustrate a biological process that tumors go through in order to change their environment to support their growth. What this means is rather than utilizing brain scans or biopsies, these genetic markers will allow oncologists to discern the presence of a glioblastoma using only a blood test and to possibly cure them with gene therapy. When researchers analyzed the RNA markers in the blood of a glioma patient, they were able to get a molecular "snapshot" of sorts of the tumor. In the future, we may be able to tell if we're even prone to brain tumors, just through a finger prick.