Oligodendroglioma

As a tumour grows, it can press on or grow into nearby areas of the brain. This can cause symptoms because it stops that part of the brain from working normally. Symptoms can also happen because the tumour causes a build-up of pressure inside the skull. This is called raised intracranial pressure.

Symptoms can depend on where the tumour is in the brain and how slowly or quickly it grows. They may develop suddenly or slowly over months or even years.

Possible symptoms include:

• seizures (fits)
• headaches
• feeling or being sick
• difficulty speaking
• weakness in an arm or a leg
• problems with movement and balance
• problems with sight.

Seizures are often the first symptom. People with a slow growing oligodendroglioma may have mild symptoms for several years before the tumour is found.

We have more information about possible symptoms of a brain tumour.

Your doctors need to find out as much as possible about the type, position and size of the tumour so they can plan your treatment.

You will have a brain MRI scan or brain CT scan to find out the exact position and size of the tumour.

You may also have a biopsy to take a small sample of the tumour to test. Brain tumour biopsies are usually done at the same time as surgery to remove the tumour.

Your doctor may also:

• check your reflexes and the power and feeling in your arms and legs
• shine a light at the back of your eye to check if there is swelling
• ask you some questions to check your reasoning and memory
• arrange for you to have blood tests to check your general health and to see how well your kidneys and liver are working.

Biomarker (or molecular marker) tests are extra tests that are done on samples removed from the tumour during surgery. The samples are tested for signs of gene changes.

This may give doctors information about:

• which treatment is likely to be the most effective
• how the tumour may develop.

For gliomas, biomarker tests look for changes in genes called IDH, 1p/19q and ATRX. Doctors may also test the sample to check the levels of a protein called MGMT in glioma tumour cells.

You may have to wait some time for the results of these tests. Your doctor can tell you if biomarker tests might be helpful in your situation.

Being diagnosed with a brain tumour can make you feel shocked, frightened, angry or upset. There is no right or wrong way to feel. It may help to get support from family, friends or a support organisation.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00
• Chat to our specialists online
• Visit our brain cancer forum to talk with people who have been affected by brain tumours, share your experience, and ask an expert your questions.

You may also want to get support from a brain tumour charity, such as:

• Brain Tumour Action
• The Brain Tumour Charity
• Brainstrust.

Most people diagnosed with a brain tumour will not be allowed to drive for a time after their diagnosis. Your doctor, surgeon or specialist nurse will tell you if this applies to you. 

If you have a driving licence, you must tell the licensing agency you have been diagnosed with a brain tumour.

You could be fined if you do not tell them. You could also be prosecuted if you have an accident.

The main treatments for oligodendrogliomas are surgery, radiotherapy and chemotherapy. You may have a combination of treatments. Your treatment depends on:

• the size and position of the tumour
• the grade of the tumour
• the biomarker results
• the symptoms you have.

A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and disadvantages of different treatment types. They will also explain the risks and side effects.

You may be given a choice of treatment options. You will have time to talk about this with your hospital team before you make any treatment decisions.

You will need to give permission (consent) for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist if you need more information or more time to decide on a treatment.

If the tumour is not causing you problems, your doctor may suggest active monitoring. Treatment can cause side effects and some of these may be permanent. Active monitoring means regularly checking the tumour to find out if it is growing. Your doctor will also monitor your symptoms carefully. Instead of starting treatment, you may see your specialist doctor regularly to have scans. This can help your doctor know if and when to recommend treatment.

If you need treatment, you may have surgery to remove some of the tumour. Depending on the size and position of the tumour, it may not be possible to remove all of it. Your surgeon will discuss this with you.

After surgery, your specialist doctor will discuss whether you might need further treatment. This will depend on:

• how much of the tumour it was possible to remove
• the biomarkers
• your symptoms
• your general health.

The aim of further treatment is to reduce the risk of the oligodendroglioma coming back after surgery. It also aims to reduce the risk of it developing into a higher-grade tumour.

You may have radiotherapy, with or without chemotherapy. Radiotherapy uses high-energy rays to destroy the tumour cells. Chemotherapy uses anti-cancer drugs to destroy the tumour cells. If you have chemotherapy, a combination of drugs may be used. These are procarbazine, lomustine (CCNU) and vincristine – this combination is called PCV.

Your doctor will talk to you about the benefits and possible side effects of having further treatment after surgery.

If you have a low-grade oligodendroglioma, you may be offered active monitoring after surgery, instead of further treatment. This means it may be possible to delay having further treatment until it is needed.

If surgery is not possible, the main treatment is usually radiotherapy. This could be with or without chemotherapy. You may have chemotherapy alone as your main treatment.

High-grade tumours grow more quickly and often need to be treated straight away. If surgery is possible, the surgeon will remove as much of the tumour as they can. After surgery, you will usually have radiotherapy or chemotherapy, or both. A combination of chemotherapy drugs may be used. These are called procarbazine, lomustine (CCNU) and vincristine – this combination is called PCV.

When surgery is not possible, the main treatment is usually radiotherapy. This could be with or without chemotherapy. You may have chemotherapy alone as your main treatment.

Your specialist doctor or nurse will explain your treatment and possible side effects. Most side effects are short term and will improve gradually when the treatment is over. Some treatments can cause side effects that do not get better. These are called long-term effects. You may also get side effects that start months or years later. These are called late effects.

We have more information about coping:

• before and after surgery
• with side effects of radiotherapy
• with side effects of chemotherapy

You may need treatment for the symptoms of an oligodendroglioma before you have any treatment for the tumour. You may also need your symptoms managed during your main treatment or for a while after it has finished.

You may have:

• drugs called anti-convulsants to prevent seizures
• steroids to reduce swelling around the tumour
• surgery to drain off excess fluid, to reduce pressure inside the skull.

Sometimes a brain tumour cannot be removed or controlled anymore. If this happens, you can still have treatment for any symptoms. You will have supportive care (sometimes called palliative care) from a specialist doctor or nurse who is an expert at managing symptoms.

We have more information about coping with advanced cancer.

Clinical trials are medical research trials involving people. Doctors may use clinical trials to test new treatments, find new drugs, or improve the way treatments are given.

Because these tumours are rare, there may not always be a relevant clinical trial happening. If there is, your doctor or nurse may ask you to think about taking part.

They will give you information about the clinical trial so that you understand what it means to take part. If you decide not to take part in a trial, your specialist doctor and nurse will respect your decision. You do not have to give a reason for not taking part. Your decision will not change your care. Your doctor will give you the standard treatment for the type of tumour you have.

We have more information about clinical trials.