An oligodendroglioma is a rare type of brain tumour.
This section should be read with our general information about brain tumours, which has more detailed information about tests, treatments and their side effects. We hope it answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having treatment.
The brain and spinal cord make up the central nervous system (CNS). The brain controls different functions of the body, how we think, feel, learn and move. The spinal cord is made up of nerves that run down the middle of the back (spine). Messages from the brain go back and forwards to organs in the body through the spinal cord.
Oligodendroglioma is a type of glioma. Gliomas start in glial cells, which support and protect nerve cells in the brain (neurons). Oligodendroglioma develops from a type of glial cell called an oligodendrocyte. These cells make up the fatty covering of nerve cells.
Grading of oligodendroglioma
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Oligodendrogliomas are divided into two types, depending on their grade. The grade is how the tumour cells look when they are examined under a microscope. There are only two grades:
Grade 2 is low grade which means the tumour grows slowly
Grade 3 is high-grade and the tumour cells grow more quickly.
Grade 2 gliomas are sometimes called low-grade gliomas.
Oligodendrogliomas are more likely to happen in people who are in their 40s and 50s. It is not a common type of brain tumour.
Causes of an oligodendroglioma
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As with most brain tumours, it’s not known what causes oligodendrogliomas, but research is going on to find out more. Some risk factors are having had previous radiation to the head or certain rare genetic (hereditary) conditions.
People with slow-growing oligodendrogliomas may have mild symptoms for several years before the tumour is discovered.
Seizures (fits) can be the first symptom. Other general symptoms can include headache and changes in behaviour and personality.
Oligodendrogliomas usually develop in the frontal or temporal lobes of the cerebrum (see diagram above). The symptoms may relate to the area of the brain that is affected:
frontal lobe may cause gradual changes in mood and personality, weakness or numbness of one side of the body
temporal lobe problems with coordination and speech, and it may affect memory.
Sometimes symptoms are caused by increased pressure within the brain (raised intracranial pressure). This may be caused by a blockage in the ventricles (fluid-filled spaces of the brain), which leads to a build-up of cerebrospinal fluid (CSF). CSF is the fluid that surrounds the brain and the spinal cord. This increased pressure may also be caused by swelling around the tumour itself.
Raised intracranial pressure can cause headaches, sickness (vomiting) and vision problems.
Your doctors need to find out as much as possible about the type, position and size of the tumour, so they can plan the best treatment for you. You will usually have a number of different tests.
The doctor will examine you and do checks on your nervous system. This includes checking your reflexes and the power and feeling in your arms and legs. They also shine a light at the back of your eye to check if the optic nerve is swollen, which can be a sign of raised pressure in the brain. Your doctor will ask some questions to check your reasoning and memory. You will also have blood tests taken to check your general health and to see how well your kidneys and liver are working.
You will have a CT scan or MRI scan to find out the exact position and size of the tumour.
CT (computerised tomography) scan
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes 10-30 minutes. CT scans use small amounts of radiation, which will be very unlikely to harm you or anyone you come into contact with.
You will be given an injection of a dye, which allows particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it’s important to let your doctor know beforehand.
Watch our video about having a CT scan at macmillan.org.uk/testsandscans
MRI (magnetic resonance imaging) scan
This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure it’s safe for you to have an MRI scan.
Before having the scan, you’ll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan show up more clearly. During the test you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones.
To diagnose oligodendroglioma, you usually need to have a small sample of tissue removed from the tumour (biopsy). You need an operation under general anaesthetic to have this done. A neurosurgeon (brain surgeon) makes a small hole in the skull and passes a fine needle into the tumour to remove a small sample from it. A CT scan is done at the same time to help guide the surgeon to the exact area.
The biopsy will also show if the cells are slow- or fast-growing (low grade or high grade). Your doctor will discuss whether a biopsy is necessary in your case, and what the operation involves.
Your treatment will depend on a number of factors. This includes whether the tumour is slow growing (low-grade) or fast growing (high-grade), its size and position, and your general health.
A team of different specialists will plan your treatment. This will usually include doctors who specialise in treating conditions of the brain (a neurologist or neurosurgeon), a cancer doctor who specialises in treating brain tumours (oncologist) and a specialist nurse.
Your doctor will explain the aims of your treatment, its benefits and disadvantages and the risks of treatment. You and your doctor can then decide on the treatments that are right for your situation.
Where possible, surgery is the main treatment for an oligodendroglioma. The aim is to remove as much of the tumour as possible without damaging the surrounding brain tissue. Depending on the size and position of the tumour, it may not be possible to remove it completely. You may need further treatment, usually with radiotherapy, after surgery.
Sometimes an operation may not be possible. This may be because the position of the tumour makes it too difficult to reach and surgery would not be safe. Radiotherapy can be used when surgery is not possible.
Some people who have raised pressure in the brain due to fluid building up may need a small operation to drain away the extra fluid. The surgeon places a long thin tube (a shunt) into the brain to drain the extra fluid away to another part of the body.
Radiotherapy treatment uses high energy rays to destroy cancer cells and is often used after surgery. The aim of the radiotherapy is to destroy any remaining brain tumour cells. If surgery is not possible you may have radiotherapy on its own.
Side effects of radiotherapy
Your doctor and specialist nurse will talk to you about the likely side effects. Radiotherapy makes you feel very tired and this can carry on for weeks or longer after it finishes. Try to get plenty rest. The skin on your scalp may become itchy and red or darker and you will lose the hair on the area being treated. This usually grows back after 2- 3 months. Your nurse will give you advice on looking after the skin on your scalp and coping with hair loss.
Radiotherapy to the whole brain may cause a long term risk of some changes to your memory or thinking. Your cancer doctor and nurse will talk this over with you.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be given alone to treat oligodendroglioma, or after surgery and/or radiotherapy. It can be used if the tumour comes back.
A nurse usually gives you the treatment into a vein (intravenously). You may also have chemotherapy as tablets.
Watch our video about having chemotherapy intravenously at macmillan.org.uk/chemotherapyintoavein
Side effects of chemotherapy
Your doctor or specialist nurse will tell you what to expect. They can prescribe drugs to reduce some side effects and give you advice on what you can do to manage side effects. One of the main side effects is risk of infection. Chemotherapy temporarily reduces the number of white blood cells which help fight infection. Other side effects can include; feeling sick, sore mouth, or possible hair loss. Always let them know about any side effects you have.
Steroids are drugs that are used to reduce swelling around the tumour. They improve symptoms and help you to feel better. If you have raised pressure in the brain you will be treated with steroids straightaway.
You usually have steroids as tablets. Some of the side effects include; indigestion, weight gain, restlessness, agitation and sleep disturbance. Let your doctor or nurse know if these are causing problems or you notice any other side effects. Taking steroids with food can help reduce indigestion. Your doctor may also prescribe medication to prevent indegestion. It is very important to take steroids exactly as they have been prescribed.
Medicines and seizures
If you experience a seizure you may be given a medicine called an anticonvulsant to help prevent them.
Some people may need support to help them to recover from their symptoms or after treatment. This may be from a physiotherapist to help improve your balance, walking or strength. Occupational therapists can provide equipment and help you be more independent. Other services such as speech therapy or psychological support services are also available.
You will be monitored very closely after treatment with regular scans and check-ups at clinic.
Being diagnosed with a brain tumour may feel very frightening at times. You may have many different feelings, including anxiety, anger, fear or feeling low or depressed. Many people go through these in coping with their illness. It’s important to get the support you need.
You may find it helpful to talk things over with family and close friends and with your doctor or nurse. You can also talk to one of our support service nurses. Sometimes people need more help to cope with difficult feelings of anxiety or depression. Your doctor can refer you to a counsellor or psychologist for more support.
You may not be allowed to drive for a period of time depending on the treatment you have had and if you have had any fits (seizures). Although this can be upsetting it’s important to follow the advice you are given.Your doctor will ask you to contact the Drivers and Vehicle Licensing Association (DVLA). It is your responsibility to contact the DVLA. Your doctor or nurse will explain what you need to do.
You can contact the DVLA by phone on 0300 790 6806 or at dvla.gov.uk
This information has been compiled using information from a number of reliable sources, including:
Guidelines on management of low-grade gliomas: report of an EFNS–EANO* Task Force. European Journal of Neurology 2010, 17: 1124–1133
High-grade malignant glioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2010
Packer and Schiff. Neuro-oncology. 1st edition. 2012. Wiley-Blackwell.
Thanks to Dr Catherine McBain, Consultant Clinical Oncologist, who reviewed this edition.
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