Pseudo-progression: A Key Focus Area of the Glioblastoma Foundation
Pseudoprogression vs. Progressive Disease
Pseudoprogression is the phenomenon of an appearance of tumor growth on brain scans post chemotherapy and radiation when there is no tumor growth. Pseudoprogression imitates tumor enlargement and is usually confused with an actual progression of the disease for many patients with glioblastoma who are visiting their doctors for follow-up exams.
The reason pseudoprogression happens is because post-treatment, brain tissue surrounding the removed tumor is often inflamed or there is a visible reaction to the combination of radiation and chemotherapy which can appear on an MRI. The creation and expansion of this tissue acts in a way similar to the growth of a tumor, but unlike a tumor, will disappear on its own in time.
Since it is so difficult to differentiate between pseudoprogression and actual progressive disease many patients are forced to wait post-treatment to determine whether they must continue treatment for an enlarging tumor or if it is simply the disease stabilizing. Determining the difference between pseudoprogression and actual progression can be very difficult for doctors, and being unable to do so can potentially have detrimental effects on the patients who are indeed suffering from a recurrence of the disease. Conversely, some patients run the risk of being treated for progressive disease when it is only pseudoprogression they are experiencing which can result in a premature conclusion of therapy or even needless surgery.
Are there currently any methods to differentiate?
There are several methods and criteria followed by medical professionals when deciding whether there is pseudoprogression or progressive disease but all with varying degrees of success. An example of one such criteria being the Response Assessment in Neuro-Oncology (RANO) criteria. This criteria states that any clinical deterioration is not strong enough evidence to suggest progressive disease in the initial 12 weeks (about 3 months) post chemotherapy. Other criteria have varying time requirements or percentage changes in tumor growth but as of now there is no universally agreed upon set of guidelines.
How is the Glioblastoma Foundation working to solve this problem?
Pseudoprogression is a main focus area of research funding at the Glioblastoma Foundation. The challenge of differentiating between pseudopression which actually has a positive impact of survival versus tumor progression, is a very important area of research funding at the Glioblastoma Foundation. From research into new MRI techniques through the Neil Peart Neurosurgery Research Award, which was most recently given to Dr. Rowland Han, a neurosurgery resident at Washington University in St. Louis, to early detection tests to determine Pseudoprogression, the Glioblastoma Foundation continues to seek out new studies and research endeavors that can help solve this issue.
Donations to the Glioblastoma Foundation go directly to fund research for a cure for Glioblastoma. We’re committed to funding new, more effective therapies to extend survival for patients diagnosed with glioblastoma and improve the standard of care for glioblastoma.
Tips for Patients
Patients of glioblastoma and their families who are now awaiting a verdict on whether they are experiencing pseudoprogression or progressive disease may have lots of anxiety and uneasiness as they wait. One way to ease this is to connect with others going through the same process either informally or through a support group. The Glioblastoma Foundation offers patient and caregiver support resources to help patients get the individualized support they need.
Pseudoprogression is an issue that affects many glioblastoma patients and takes away valuable time that could be used to treat a recurring instance of the disease. Psuedopression is a key focus area of the Glioblastoma Foundation, and you can help by supporting research to solve this important problem.
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