Mixed gliomas

Mixed gliomas are a type of tumour that develops from the main supporting cells (glial cells) in the brain or spinal cord.

Symptoms may include:

  • headaches
  • feeling or being sick
  • seizures (fits)
  • problems with coordination, speech or sight
  • weakness in an arm or a leg.

To find out more about the tumour you have different tests. These can include an MRI scan or CT scan, and a biopsy.

There are four grades of mixed gliomas. The grade describes how the tumour cells look when they are examined under a microscope. Low-grade (grade 1 or 2) tumours grow slowly, while high-grade (grade 3 or 4) tumours grow more quickly.

Treatment depends on the tumour’s grade, its size, its position and your health. Your doctor will talk to you about the best treatment for you and explain the benefits and disadvantages. The main treatments are surgery, radiotherapy and sometimes chemotherapy. You may have other treatments to improve any symptoms.

Treatment can cause side effects. Your doctor will explain what to expect and how side effects can be managed.

What are mixed gliomas?

Mixed gliomas are a rare type of tumour that usually starts in the brain or sometimes the spinal cord.

It’s best to read this along with our general information about brain tumours and spinal cord tumours. This has more detail about tests and treatments. We also have information about brain tumours that’s written just for teens and young adults.

This information is about gliomas in adults. If you need information about gliomas in children, you can contact the Children’s Cancer and Leukaemia Group at www.cclg.org.uk.

Gliomas are tumours that develop from the main supporting cells (glial cells) in the brain or spinal cord. Different types of gliomas are named after the different types of glial cells:

We have information about these different types of gliomas.

However, sometimes a glioma develops from a mixture of these different types of glial cell. This is called a mixed glioma. Mixed gliomas usually start in the brain or sometimes the spinal cord. They can sometimes spread from where they started to other parts of the brain or spinal cord. They don’t spread to other parts of the body.

Grading mixed glioma

Gliomas can be slow-growing or fast-growing. Your doctor may talk about the ‘grade’ of the tumour. The grade describes how the tumour cells look when they are examined under a microscope. Gliomas can be graded from 1 to 4. Low-grade tumours (grades 1 and 2) are slow growing. High-grade tumours (grades 3 and 4) grow faster.

The grade and position of a glioma gives your doctors an idea of how the tumour may develop. This can help them plan your treatment.

Causes of mixed glioma

As with most brain tumours, the cause of mixed glioma is not known, but research is going on to find out more. We have more information about risk factors for brain tumours.

Symptoms of mixed glioma

Symptoms may include:

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

The symptoms may develop slowly or quickly depending on how fast the tumour grows and where it is in the brain. Seizures (fits) are often the first symptom. The tumour may cause other symptoms depending on which part of the brain is affected.

Sometimes, symptoms are caused by increased pressure on the brain (called raised intracranial pressure). This can be caused by swelling around the tumour, by the tumour itself or by a build-up of the fluid that surrounds and protects the brain and spinal cord (cerebrospinal fluid). Symptoms include:

  • headaches
  • feeling or being sick
  • problems with balance and with sight
  • being confused.

Tests for mixed glioma

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 on 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 an MRI (magnetic resonance imaging) scan or CT (computerised tomography) scan to find the exact position and size of the tumour. You may also have a biopsy.

MRI scan

This scan uses magnetism to build up a detailed picture of areas of your body. You may be given an injection of dye, into a vein, to improve the images from the scan. This test is painless and will take about 30 minutes. We have more detailed information about having an MRI scan.

CT scan

A CT (computerised tomography) scan uses x-rays to build a three-dimensional (3D) picture of the inside of the body. You may be given either a drink or injection of dye. This is to make certain areas of the body show up more clearly. This scan takes about 30 minutes and is painless. We have more detailed information about having a CT scan.


Sometimes, a sample of cells from the tumour (biopsy) is taken and looked at under a microscope before you have any treatment. This test involves an operation. Your doctor will explain if you need a biopsy and exactly what the operation involves. Sometimes the biopsy and surgery to remove the tumour are done at the same time.

If you have a biopsy, this can be done under a general or local anaesthetic. The neuro (brain) surgeon makes a small hole in the skull and passes a fine needle through into the tumour. They remove a small sample of tissue, which is looked at to find out the type and grade of cells in the tumour.

Treatment for mixed glioma

The main treatments for mixed glioma are surgery and radiotherapy. Sometimes chemotherapy is also used. You may have a combination of treatments.

Your treatment will depend on a number of factors. These include whether the tumour is slow-growing (low-grade) or fast-growing (high-grade), its size and position, and your general health.

If the tumour is low-grade, your doctor may suggest monitoring (watch and wait) for a time until treatment is needed.

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 will have time to talk this through with them before you make any treatment decisions. You may be given a choice of treatment options. Let your specialist know if you need more information or time.

You may have other treatments to help any symptoms caused by the tumour. You may be given steroids to reduce swelling around the tumour or other drugs to control seizures (fits). If you have raised pressure on the brain due to a build-up of CSF, you may have surgery to drain off the extra fluid.

Monitoring (watch and wait)

This may be an option for some people. It means choosing to wait and see if the tumour grows and causes symptoms, or if your symptoms get worse, before you have treatment. Your specialist doctor will explain the benefits and risks of monitoring.

Some people may have monitoring after surgery if not all of the tumour has been removed. It means you may be able to delay having further surgery or radiotherapy if you don’t have symptoms that are causing problems.

During monitoring, you will see your specialist doctor regularly at a clinic. You will have regular scans to check for changes in the size of the tumour. Your doctor will tell you about possible symptoms to look out for. They will ask you to tell them straight away if you have any new symptoms, or changes in your symptoms.


If possible, surgery is the main treatment for mixed glioma. The aim is to remove as much of the tumour as possible without damaging nearby areas of the brain or spine. Your surgeon will explain what your operation will involve. They will talk to you about the possible complications and risks.

Depending on the size and position of the tumour, it may not be possible to remove all of it. You may need further treatment, usually radiotherapy, to treat the remaining tumour cells.

Sometimes, it’s not safe to do an operation because the position of the tumour makes it hard to reach. In this case, radiotherapy is often used.

If the tumour has caused a build up of cerebrospinal fluid (CSF), you may need a small operation to drain away the extra fluid. The surgeon places a long, thin tube (shunt) into the brain to drain the extra fluid away to another part of the body.

Some people may need extra support to help with their recovery after surgery. This may be from a physiotherapist who can help you to improve your balance, walking or strength. Occupational therapists can provide equipment and help you become more independent.

It can take a while to recover, so it’s important to take good care of yourself. Get plenty of rest, try to eat well and follow the advice given by your surgeon and specialist nurse.

We have more information about surgery to the brain or spine.


Radiotherapy uses high-energy rays to destroy cancer cells. It is often used after surgery or as the main treatment if surgery is not possible.

Your cancer doctor (oncologist) will tell you how long your treatment will last and the type of radiotherapy you will have.

Radiotherapy makes you feel very tired and this can carry on for weeks or longer after it finishes. Get plenty of rest but try to balance this with some gentle activity, such as short walks. This can help you to feel less tired.

The skin in the treated areas may become itchy and red or darker. You will lose the hair in the area being treated. This usually grows back again after 2 to 3 months. We have more information about coping with hair loss.

Your cancer doctor and specialist nurse will talk to you about the side effects of radiotherapy and how they are managed. They will also explain the risk of late side effects. These are side effects that sometimes start months or years after radiotherapy.


Chemotherapy  is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be given alone to treat mixed gliomas or with surgery and/or radiotherapy.

You may have chemotherapy given into a vein (intravenously) by a nurse in a chemotherapy day unit. Or you may have chemotherapy as tablets.

Side effects include:

  • being more at risk of infection
  • tiredness
  • hair loss
  • feeling sick
  • a sore mouth.

Your cancer doctor or nurse will talk to you about the immediate side effects and ways of managing them. They will also discuss any possible long-term effects.


Steroids are drugs that reduce the swelling around the tumour. You may be given them before or after surgery or during radiotherapy. They can improve your symptoms and help you feel better. If you have raised pressure on the brain, you will be treated with steroids straight away.

You usually have steroids as tablets. Some of the side effects include:

  • indigestion
  • weight gain
  • restlessness
  • agitation
  • sleep disturbance.

Tell your doctor or nurse if these are causing problems or you notice any other side effects. Taking steroids with food can help reduce indigestion.

It is important to take them exactly as your doctor has prescribed them.


If you have seizures (fits), you may be given drugs called anticonvulsants to help prevent them. We have more information about anticonvulsants.


You may not be allowed to drive for a period of time. Although this can be upsetting, it’s important to follow the advice you are given.

You will need to contact the Drivers and Vehicle Licensing Association (DVLA) if you live in England, Scotland or Wales. If you live in Northern Ireland you will need to contact the Driver and Vehicle Agency (DVA). They will advise you of any restrictions on your right to drive:

  • The Drivers and Vehicle Licensing Agency (DVLA) has information about driving with a medical condition if you live in England, Scotland or Wales. Visit GOV.UK or call 0300 790 6806.
  • The Driver and Vehicle Agency (DVA) has information about driving with a medical condition if you live in Northern Ireland. Visit nidirect or call 0845 4024 000.

If you’re not sure what you should do, check with your cancer doctor or specialist nurse. They will explain things to you.


After your treatment has finished, you’ll have regular check-ups, tests and scans. These appointments are a good opportunity to talk to your doctor about any worries or problems you have.

Many people find they get very anxious before appointments. This is natural. It can help to get support from family, friends, your specialist nurse or one of the organisations listed on our database. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.