By Dr. Mangesh B. Patil, Associate Director Radiation Oncology at HCG Cancer Centre Nagpur
The very mention of brain tumour tends to stop you in your tracks. And of all brain tumours, there is one that is especially daunting—glioblastoma. Known for its aggressive nature and resistance to conventional treatments, glioblastoma has often been considered one of the most difficult cancers to treat.
But even in the face of such a formidable prognosis, the landscape is changing. Slowly but surely, science is beginning to shift the narrative—offering new avenues of treatment, deeper understanding, and above all, a sense of hope, where once there was only despair.
Glioblastoma affects the brain’s supportive glial cells and tends to grow rapidly, infiltrating surrounding tissues. This makes surgical removal challenging, and recurrence common. Traditionally, treatment has involved a combination of surgery, radiation, and chemotherapy—but despite this aggressive approach, the results have historically been sobering.
What makes glioblastoma unique is that it cannot be approached like other cancers. It’s not simply about removing a lump or shrinking a tumour. It’s about navigating one of the most complex organs in the human body—the brain—without disrupting the very functions that make us who we are.
This complexity is part of what has made glioblastoma so challenging to treat. But this same daunting complexity is also what has driven some of the most fascinating and forward-thinking innovations in neuroscience and oncology.
The Rise of Personalised Treatment
One of the biggest breakthroughs in recent years has been the shift toward individualised or personalised treatment plans. No two glioblastoma cases are the same—and researchers are now treating it more like a fingerprint phenomenon, rather than a formula.
Today, we have the capability to analyse a tumour’s molecular profile and understand its genetic makeup. This allows specialists to tailor treatment strategies, choosing the most effective medications or therapy combinations, based on a patient’s unique tumour biology.
It’s a move away from the one-size-fits-all approach and toward more targeted, thoughtful medicine—a change that holds immense promise for patients.
Beyond the Scalpel: Modern Neurosurgery
While surgery still plays a central role in managing glioblastoma, the way it’s performed has undergone a quiet revolution.
Techniques such as Intraoperative MRI, Neuro-navigation, and Awake Brain Surgery allow surgeons to map critical brain areas and avoid damage to functions, such as speech, vision, and movement. This has drastically improved the quality of life after surgery and in some cases, allowed for more extensive tumour removal than was once thought possible.
Modern Radiation Therapy: Integral part of treatment
Unlike other parts of the body where surgical excision of tumor with margins is a norm, in brain surgery complete resection is challenging and therefore radiotherapy is an integral part of treatment. Radiation therapy takes care of the residual tumor left behind. Even in those cases of glioblastoma where complete removal of tumor is done adjuvant radiation therapy is essential to take care of the microscopic tumor cells in postoperative tumour bed and the surrounding part. Radiotherapy consists of use of ionizing radiations to damage the DNA of tumor cells causing death of cancer cells. Glioblastoma has a tendency to relapse within few months of surgery. Radiation therapy effectively delays the recurrence of tumor and improves the quality of life of a patient. Modern radiation therapy includes use of magnetic resonance MR imaging to accurately define and delineate the target to deposit the radiation dose accurately and spare the remaining brain effectively reducing the side effects. IGRT image guided radiotherapy is a modern radiotherapy technique in which on board Image guidance like CT computed tomography and MRI helps in precise delivery of radiation. Temozolomide is an oral chemotherapy drug used along with radiation for its radio sensitizing properties making tumor cells more sensitive to radiotherapy.
Immunotherapy: Teaching the Body to Fight Back
Immunotherapy—the science of using the body’s own immune system to attack cancer—has made headlines globally. And while its application in glioblastoma is still being explored, the signs are encouraging.
The concept is simple, yet powerful: train the immune system to recognize the tumour as a threat and launch a targeted attack. Experimental vaccines, T-cell therapies, and checkpoint inhibitors are all being studied for their potential role in treating glioblastoma.
Though not yet mainstream, these treatments represent a radical shift—from attacking the tumour externally, to awakening the body’s internal defence system.
The Promise of Precision and AI
Artificial intelligence (AI) and Machine Learning are now part of the glioblastoma conversation. From predicting patient response, to mapping tumour progression, these tools are helping doctors make more informed, faster decisions.
Even in India, top institutions are now integrating AI into radiology and diagnostics, making it easier to detect subtle changes, assess treatment response, and personalise care pathways. This means fewer invasive procedures and more proactive care—especially valuable in a condition as delicate as this.
Hope in Uncertainty
Glioblastoma may still be one of the toughest cancers, but it is no longer the mystery it once was, as evidenced by longer survivals, better recoveries, and more empowered patients. The science is advancing. The tools are improving and significantly, the approach is evolving—from one of fear, to one of fight.
Every day, in labs, hospitals, and consultation rooms around the country, devoted doctors and researchers are working toward a future in which glioblastoma is no longer a dead end, but rather, a battle that we are learning to win.
In India, awareness of brain malignancies is still growing, and we must begin talking freely about these. To the patients reading this, know that you are not alone. To the families, remember that every step you take counts. And to the caretakers and doctors, know that your perseverance is helping to mould the future.
