A glioma is a tumour that grows from the supporting (glial) cells within the brain itself. Treatment usually starts with surgery to remove as much of the tumour as can be safely removed, or a biopsy if removal is not safe, followed in many cases by radiotherapy and chemotherapy. For families in Lahore facing this diagnosis, understanding the type and grade of glioma is the key to knowing what treatment and outlook to expect.
Gliomas range from slow-growing tumours that people live with for many years to fast-growing tumours such as glioblastoma. This page aims to explain the options honestly and in plain language.
Unlike a meningioma, which presses on the brain from outside, a glioma grows within the brain tissue and its edges blend into normal brain. This is why it usually cannot be "cured" by surgery alone, and why treatment is planned as a team.
Today, gliomas are also classified by molecular markers in the tumour tissue, such as IDH mutation, 1p/19q codeletion and MGMT methylation. These results help predict how the tumour will behave and how well it may respond to treatment, so they are as important as the grade.
Go to an emergency department for a first seizure, a prolonged seizure, increasing drowsiness, severe headache with vomiting, or rapidly worsening weakness.
In almost all cases there is no identifiable cause, and nothing the patient or family did caused it. Previous radiation to the head and a few rare inherited syndromes increase the risk. Gliomas are not contagious.
MRI with contrast is the main test. Additional MRI sequences such as perfusion, spectroscopy, diffusion tensor imaging (to show the main nerve pathways) and functional MRI (to map speech and movement areas) may help with planning. The final diagnosis, grade and molecular profile come only from examining tumour tissue obtained at biopsy or surgery.
Where it is safe, the aim is maximal safe resection: removing as much tumour as possible without causing new disability. Evidence suggests that more complete removal is linked with longer survival in many gliomas, but protecting function always comes first. When a tumour lies deep, in both sides of the brain, or in critical areas where removal would cause serious harm, a biopsy is taken instead to confirm the diagnosis and guide further treatment.
Neuronavigation links the MRI to the instruments in theatre, helping to plan a safe path and judge the tumour edges. When a glioma lies in or near areas controlling speech or movement (eloquent areas), awake brain surgery may be advised. The patient is comfortable and pain-free, and is woken during the key part of the operation to talk or move while the brain is mapped, so that important areas can be protected.
After surgery, most high-grade gliomas and many low-grade ones are treated with radiotherapy, often combined with chemotherapy such as temozolomide, under the care of an oncologist. Some low-grade gliomas that have been well removed may be monitored with MRI before further treatment. The plan is decided jointly by the neurosurgeon, oncologist and pathologist once the full tissue results are back.
Steroids reduce brain swelling, anti-seizure medicines control fits, and physiotherapy and rehabilitation help recovery. Support for the family is part of good care.
Most patients with a suspected glioma will need either a resection or a biopsy, because tissue is needed for diagnosis. The choice depends on the tumour's size and location, the patient's age and general health, and their wishes. Some very small, possibly low-grade lesions in elderly or unwell patients may be watched initially after discussion.
After a craniotomy, many patients stay in hospital for about three to seven days, longer if there is weakness needing rehabilitation. Tiredness is common for several weeks. Radiotherapy, if needed, usually begins a few weeks after surgery once the wound has healed. Return to work and driving depend on the tumour type, seizures and local regulations, and are discussed individually. Regular MRI scans continue long term.
Risks include bleeding, infection, brain swelling, seizures, blood clots, and new or worsened weakness, speech or memory problems. Some new deficits are temporary and improve over weeks; occasionally they are permanent. Awake mapping and navigation are used to reduce these risks, not remove them entirely.
Outlook varies widely. Many people with low-grade or IDH-mutant gliomas live for many years with good quality of life. Glioblastoma, sadly, cannot usually be cured, and treatment aims to control it for as long as possible while keeping the patient well. Dr. Khawar Anwar discusses the outlook openly and compassionately with each patient and family, at a pace that suits them. More on the wider range of tumours is on our brain tumour surgery page and the neurosurgery overview.
Because gliomas grow into the surrounding brain, microscopic tumour cells usually remain even after a visibly complete removal. That is why radiotherapy, chemotherapy and regular scans are often needed after surgery.
If a tumour is deep or in a critical area, trying to remove it could cause serious harm. A biopsy safely obtains tissue to confirm the type, grade and molecular markers, which guides the oncology treatment.
Only if the tumour is close to speech or movement areas and awake mapping is felt to be safer. Most glioma operations are done under general anaesthesia.
Markers like IDH and 1p/19q help define the tumour type and predict behaviour, and MGMT status helps predict response to chemotherapy. Your team will explain your results once available.
A new glioma on MRI should be assessed promptly. Bring all scans and reports, and book an appointment online or by phone.
Dr. Khawar Anwar is a Consultant Neurosurgeon & Spine Surgeon at PINS / Lahore General Hospital, Lahore, with over 10 years of experience in brain and spine surgery. He sees patients in Lahore and Gujranwala and focuses on minimally invasive and endoscopic techniques where they are suitable for the patient.
See the full list on the certifications page or read more about Dr. Khawar Anwar.
See all clinics, maps and timings on the locations page.
To book, call or WhatsApp 0333-7574732 and tell us which clinic and day suits you. Please bring your MRI or CT scan (films and CD), reports and a list of your current medicines to the consultation. For sudden weakness, loss of bladder or bowel control, a sudden severe headache or a head or spine injury, go to the nearest emergency department first.