Oligodendroglioma: Let's learn about this type of brain tumor in simple terms

Do you often get headaches for no reason? Or have you suddenly had a seizure for the first time in your life? Sometimes the most serious reason behind these things is a brain tumor. Even hearing these words makes us very scared, right? But today we are going to talk about a type of brain tumor that is a little rare, but responds very well to treatment. That is oligodendroglioma.

Simply put, what is oligodendroglioma?

Oligodendroglioma is a tumor that develops in the brain. Very rarely, it can also develop in the spinal cord. These tumors develop from a special type of cell in our nervous system called glial cells. To be precise, from cells called 'oligodendrocytes' among those glial cells.

Now you might be wondering what these glial cells, oligodendrocytes, are. Imagine that our nervous system is a big company. The main work in it is done by employees called neurons. They are the ones who carry messages from the brain to the body and from the body to the brain. So there is a group of helpers who help these neurons, protect them, and give them the nutrition they need. Those are the glial cells .

So what are these oligodendrocytes?

This name sounds a bit strange, doesn't it? It's made up of several Greek words.

• Oligo (Oligo-): small
• Dendro (-dendro-): like a tree
• Cytes (-cytes): cells

Simply put, it means "small cells with branches like a tree." The work of these cells is very important. Our neurons have a long arm called an axon. This is where electrical signals travel. Just like an electrical wire. So there is a protective sheath around this axon. It is called the myelin sheath. This ensures that signals travel quickly and without leakage. That myelin sheath is made of these cells called oligodendrocytes . One oligodendrocyte cell can make a myelin sheath around the axon of about 30-40 neurons at the top and bottom. That is why it is said to have branches like a tree.

So, oligodendroglioma is a tumor that develops from the uncontrolled division of oligodendrocyte cells, which perform that valuable function.

Are there varieties of these nuts?

Yes. The World Health Organization (WHO) has divided these tumors into stages (grades) based on their severity. Accordingly, there are two main types of oligodendroglioma. Let's look at this in an easy way to understand it.

What are the symptoms of oligodendroglioma?

Most often, symptoms of brain tumors appear when the tumor grows large enough to start pressing on the surrounding brain tissue. The two most common symptoms of oligodendroglioma are headaches and seizures . In fact, about 80% of people with this disease experience seizures.

This is because this type of tumor most often develops in the cerebral cortex, the outermost, wrinkled part of our brain. This area contains the centers responsible for our daily functions, such as vision, speech, and muscle control. When a tumor stimulates these areas, seizures can occur.

In addition to seizures, "focal symptoms" may also occur, indicating a problem in a specific area of ​​the brain. These include:

• Muscle weakness or paralysis on one side of the body or one side of the face .
• Hearing loss.
• Difficulty speaking or understanding what others say (aphasia).
• Weak vision, double vision, blurred vision.
• Memory problems.
• Difficulty thinking and concentrating.

What is the reason for this situation?

This is a very important point. To be diagnosed with oligodendroglioma, two genetic changes must be present.

Imagine that there is a big recipe book that gives instructions to the cells in our body. We call it DNA. The things that this DNA is coiled up into are called chromosomes. When cells divide, this recipe book is copied. Sometimes mistakes can happen during that copying. Well, two such mistakes are the reason for this.

1. 1p/19q co-deletion: Two small parts of our chromosomes number 1 and number 19 are deleted. This is the main genetic marker in these tumors.

2. IDH1 or IDH2 mutation: A change occurs in a gene that makes an enzyme that helps with metabolism in our body.

So far, no other risk factors have been identified for this condition.

What complications can this cause?

The complications of a brain tumor depend on its location and size. Some of the main ones to watch out for are:

• Malignant transformation: Sometimes, a low-grade (Grade 2) tumor can change over time and become a high-grade (Grade 3) cancer.
• Stroke-like conditions: As the tumor grows, pressure inside the brain increases, causing blood vessels to bulge, leading to stroke-like conditions.
• Changes in the bones of the skull: These tumors can become hard due to calcium deposits. A slow-growing tumor can also affect the bones of the skull.

How to diagnose this disease?

When you go to see your doctor when you have symptoms, he will follow a few steps.

1. Physical and nervous system examination: The doctor will check your balance, muscle strength, vision, and reflexes.

2. Diagnostic imaging: Scans are performed to look inside the head.

• CT scan (Computed Tomography): This is usually the first thing done when something like a seizure occurs. These tumors can be seen well on a CT scan because they contain calcium.
• MRI scan (Magnetic Resonance Imaging): This can provide a more detailed look at the brain tissue, size, and location of the tumor.

3. Brain Biopsy: This is the test that confirms the disease 100% . Scans alone cannot say for sure that it is oligodendroglioma. In a biopsy, a neurosurgeon surgically removes a very small piece of the tumor and sends it to the laboratory. There, the cells are examined under a microscope. They also check for the presence of the genetic changes we talked about earlier, the 1p/19q co-deletion and the IDH mutation . If both of those are present, it is definitely oligodendroglioma.

What are the treatments? Is it possible to cure it completely?

The good news is that, compared to other types of brain tumors, oligodendroglioma is one of the most treatable and curable tumors. It is usually treated with a combination of treatments.

Surgery

The first and most important goal is to remove as much of the tumor as possible through surgery. Sometimes the tumor can be completely removed. This depends on many factors, including the size of the tumor, its location, and the experience of your doctor.

Chemotherapy

Chemotherapy is given to kill any cells that may be left after surgery. There are many effective drugs for oligodendroglioma.

• PCV treatment regimen: This is a combination of three drugs: procarbazine, lomustine, and vincristine.
• Temozolomide: This drug is sometimes used instead of PCV because it has relatively few side effects and is very similar in effectiveness to PCV.

Radiation Therapy

This involves targeting high-energy rays (similar to X-rays) to the tumor site, destroying any remaining cancer cells while minimizing damage to surrounding healthy tissue.

Your doctor and medical team will decide together what treatment is right for you, how long it will last, and whether you need chemotherapy or radiation treatment after surgery.

What will life be like with this disease? (Outlook)

It's understandable for anyone to be scared and shocked when they hear about a brain tumor. But oligodendroglioma is not a condition to lose hope in.

The five-year survival rate - the percentage of people alive 5 years after diagnosis - is between 69% and 90% for low-grade tumors. Even for high-grade tumors, it is between 45% and 76%. These are just statistics, your situation could be much better.

Also, research is now underway on new drugs that target these tumors with the IDH mutation, so we can have good hope for the future.

Things you can do and questions to ask your doctor

If you have this disease, it is important to follow the instructions given by your medical team. It is essential to go to treatment on time and take your medication correctly. Treatment can have side effects. Don't be afraid to talk to your doctor about them and learn about what can be done about them.

Don't hesitate to ask your doctor these questions:

• What stage (grade) is my tumor?
• Where in the brain is this located? What abilities might it affect?
• What treatment options do I have?
• Can this tumor be completely removed with surgery?
• What are the side effects or complications of the treatment?
• Do I need chemotherapy, radiation therapy, or both?
• What is the treatment schedule like?
• What symptoms should I seek medical attention for during or after treatment? (e.g., severe headache, recurrent seizures).

Oligodendroglioma, brain tumor, seizures, headache, brain cancer