Facing a glioblastoma diagnosis means making big decisions quickly. This guide breaks down what it is, how it’s treated, and how to get help along the way.
A primary brain tumor is a tumor that starts in the brain rather than spreading there from somewhere else in the body (called metastasis). Glioblastoma begins in glial cells, the supporting cells of the brain, and it is the highest and most aggressive grade of glial tumor, known as grade 4. It grows quickly, and recurrence is nearly universal.
One thing that sets glioblastoma apart is how it grows. Rather than staying in one clearly defined area, glioblastoma cells can extend into the surrounding brain tissue in thin, root-like patterns. These cells may reach beyond what a scan can fully show or what a surgeon can safely remove, which means some tumor cells often remain even after surgery. This is one of the major reasons glioblastoma tends to return, even after treatment appears successful at first. The tumor can also vary from one area to another, which is part of what the term “glioblastoma multiforme” refers to and part of what makes it difficult to treat. Unlike many other cancers, glioblastoma rarely spreads beyond the brain and spinal cord.
In the United States in 2026, an estimated 24,740 people will be diagnosed with a malignant brain or other nervous system tumor, and about 18,350 people will die from one. Glioblastoma is the most common malignant type in this group, accounting for roughly half of malignant brain and central nervous system tumors.
Glioblastoma is diagnosed about 1.6 times as often in men as in women, and it is most often found around age 65. The risk rises with age. These patterns do not tell the whole story however. Brain and central nervous system cancer is among the ten leading causes of cancer death in the United States, and among women aged 20 to 39 it is the fourth leading cause of cancer death.
Glioblastoma itself is uncommon in children. Brain tumors as a whole are the leading cause of cancer death in people under 20, but the high-grade gliomas that occur in children are usually classified as different, pediatric-type tumors, not as glioblastoma.
Because glioblastoma grows quickly, symptoms can appear suddenly and worsen over a short period. The specific symptoms depend on where the tumor sits in the brain. Managing seizures, headaches, and other neurological effects is part of treatment from the start.
This combination is known as the Stupp protocol, and it has been the standard of care since 2005. After surgery, patients receive radiation with concurrent temozolomide, followed by maintenance temozolomide. Treatment may look different for older adults or for people whose overall health makes intensive therapy harder to tolerate. A wearable device called Tumor Treating Fields (“Optune”), added to maintenance temozolomide, improved survival in a large clinical trial, though its use varies because of the device burden, adherence needs, access, and cost. Throughout treatment, managing symptoms and supporting the mental health of patients and caregivers are part of good care.
A clinical trial tests a new approach to treating a brain tumor under careful rules meant to keep participants safe. Many treatments used today were first studied in clinical trials, and a trial can offer access to therapies that are otherwise not available to the general public.
Timing matters. Trials can open at different points: at diagnosis or before surgery, in the short window after surgery but before radiation and chemotherapy, after initial treatment is complete, and again if the tumor returns. Because some options are only available early, it helps to ask about trials as soon as possible rather than waiting. Some treatments can also affect future eligibility. Certain medicines, such as bevacizumab (Avastin), and devices such as Tumor Treating Fields (Optune), may change which studies you can join later, which is one more reason to ask early.
Biomarkers can open more doors, too. Some trials are designed for tumors with specific molecular features, so biomarker testing can reveal options you would not find otherwise. This is one more reason to know your results and share them with your care team.
Joining a trial is always a shared decision with your doctor. BTN’s nurse navigators run personalized, nationwide trial searches that go beyond ClinicalTrials.gov, check eligibility against your diagnosis and biomarkers, and give you a short, vetted list to review with your care team.
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IDH, short for isocitrate dehydrogenase, is a gene involved in how cells produce energy. A mutation in IDH marks a distinct, generally slower-growing kind of glioma. Glioblastoma is defined as an IDH-wildtype tumor, so IDH testing mainly confirms the diagnosis. It also reflects biology: IDH-wildtype tumors like glioblastoma tend to be more aggressive than IDH-mutant gliomas, which is part of why standard treatment is intensive.
MGMT is more directly tied to treatment. It is a gene that helps cells repair a specific kind of DNA damage. Temozolomide, the chemotherapy used in standard treatment, works by damaging the tumor’s DNA. When the MGMT gene is switched off, a change called promoter methylation, the tumor is less able to repair that damage, so temozolomide tends to work better. Glioblastomas with a methylated MGMT promoter generally respond better to standard chemoradiation than those without.
Together, these markers help your care team understand the tumor and plan treatment. Your results, along with your age and how much of the tumor was removed, shape that plan. Ask your care team what your specific results mean for you.
Survival varies from person to person based on age, biomarkers, and how much tumor can be removed during surgery. These figures are averages across many patients and are not a prediction for any single person. A care team can give context specific to an individual diagnosis.
After recurrence, median survival is around six months, though this varies widely. There is no single standard for recurrent glioblastoma. Options may include clinical trials, repeat surgery, another course of radiation, chemotherapy, or bevacizumab (Avastin) in certain settings. Managing symptoms and protecting quality of life become central at this stage. Many patients and families look into clinical trials and palliative care when standard treatments have been exhausted.
Studies are looking at cancer vaccines, immune checkpoint inhibitors, cell therapies such as CAR T-cell and NK-cell treatments, oncolytic virus therapy, targeted drugs, new drug-delivery methods, and device-based approaches like laser interstitial thermal therapy and focused ultrasound. Results so far are mixed, and some large trials have not improved survival. Most of these are available only through a clinical trial rather than as routine care. Ongoing research and trial enrollment remain important to improving outcomes for glioblastoma.

Meet Dr. Roxana Dronca, the newest member of Brain Tumor Network’s Board of Directors and a nationally recognized oncology leader.