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A glioma is the most common brain tumour that starts in the brain itself. This page explains what gliomas are, their main types, and how they are graded and treated.
A glioma is a brain tumour that begins in the brain's glial cells — the support cells that surround, feed and protect the neurons. Gliomas are the most common type of primary brain tumour, meaning a tumour that starts in the brain itself rather than spreading there from another organ. They can grow anywhere glial cells are found: the brain, the brainstem and the spinal cord.
"Glioma" is really an umbrella term. It covers several different tumours that vary enormously in how fast they grow and how they are treated — from slow-growing tumours that can be controlled for many years, to fast-growing ones such as glioblastoma. This page sits within our wider brain cancer & tumour hub and explains, in plain language, what gliomas are, their main types, how they are graded, and how they are diagnosed and treated.
Gliomas are graded by the World Health Organization from Grade 1 to Grade 4 — they are not "staged" with the Stage I–IV (TNM) system used for most cancers, because gliomas almost never spread outside the brain and spinal cord. Since the 2021 WHO classification of brain tumours (reflected in NCCN and EANO guidance), the diagnosis also depends on molecular markers such as IDH status and 1p/19q co-deletion — so two tumours that look identical under the microscope can be classified, and treated, very differently.
Gliomas are grouped by the kind of glial cell they arise from. The type, together with the WHO grade and molecular markers, tells your team how the tumour is likely to behave — and shapes the whole treatment plan.
The broadest group of gliomas, arising from star-shaped support cells called astrocytes. Astrocytomas range from slow-growing Grade 1 and Grade 2 tumours through to Grade 4 glioblastoma. The grade and IDH status together drive the treatment plan. Read more about astrocytoma and its grades.
Arises from oligodendrocytes, the cells that make the brain's insulating myelin. Oligodendrogliomas are defined by an IDH mutation together with a 1p/19q co-deletion, and they tend to grow more slowly and respond particularly well to chemotherapy and radiation — so the molecular result genuinely changes the outlook.
A WHO Grade 4 astrocytic tumour and the most common malignant glioma in adults. It grows quickly and infiltrates surrounding brain, so it needs surgery, radiation and chemotherapy together. Our dedicated page explains what glioblastoma is in detail.
Arises from ependymal cells that line the brain's fluid-filled spaces (the ventricles) and the central canal of the spinal cord. Ependymomas are more common in children and young adults, and treatment centres on maximum safe surgery, often followed by radiation depending on grade and location.
Slow-growing gliomas — including pilocytic astrocytoma (Grade 1, often in children) and diffuse Grade 2 tumours. Many can be controlled for years, and some Grade 1 tumours are cured by surgery alone. Learn more on our low-grade glioma page.
Faster-growing gliomas that infiltrate the surrounding brain and need combined treatment. This group includes anaplastic (Grade 3) astrocytomas and oligodendrogliomas, and Grade 4 glioblastoma. Urgent, coordinated care matters most here.
Gliomas are not given the Stage I–IV number most people associate with cancer. Instead they are given a WHO grade from 1 to 4, based on how aggressive the tumour cells look under the microscope and — since the 2021 WHO classification — on their molecular markers. The grade, not a stage, tells your team how urgent treatment is and which combination of treatments is needed.
Because the modern diagnosis combines grade and molecular biology, an accurate tissue diagnosis is essential. A brain tumor specialist will use both to plan treatment. Speak to a CION neuro-oncologist to understand what your tumour type and grade mean.
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Whether you want to understand your MRI, confirm the exact glioma type and grade, or get a second opinion before treatment — CION's neuro-oncology team is here to help, with same-week appointments.
The symptoms of a glioma depend on where in the brain the tumour grows, because different areas control different functions. A low-grade glioma may cause symptoms that build slowly over months or years, while a high-grade glioma can cause symptoms over weeks. Importantly, none of these symptoms means a tumour on its own — most headaches, and many seizures, have other causes. What matters is a symptom that is new, persistent and progressive.
Red flag: a first adult seizure, or new one-sided weakness, speech loss or sudden vision change that is persistent and progressive, always warrants an urgent brain MRI. Speak to a CION neuro-oncologist if you or a loved one has these signs.
Diagnosing a glioma takes more than a single scan. The pathway confirms the tumour, identifies its exact type and grade, and — crucially — reads its molecular biology so the right treatment can be chosen.
An MRI with contrast is the gold standard for finding and characterising a glioma. It shows the tumour's location, size and its relationship to critical brain areas, and reveals features that suggest its grade. Specialised sequences add information about blood flow and the tumour's closeness to speech and movement areas. But imaging can only suggest a glioma — it cannot confirm the exact type.
Only a tissue sample confirms a glioma, its type and its grade. Tissue is obtained either during surgical removal of the tumour or, for deep or risky locations, via a stereotactic needle biopsy. Both the biopsy and any neurosurgery are coordinated with accredited neurosurgical partners; CION manages the diagnosis, molecular testing and the treatment that follows.
This is where glioma care has changed most. Three markers from the tumour tissue guide everything that follows. IDH status is the single most powerful prognostic marker in glioma — IDH-mutant tumours grow more slowly and have a better outlook than IDH wild-type tumours of the same grade. 1p/19q co-deletion identifies oligodendrogliomas, which respond particularly well to chemotherapy and radiation. MGMT promoter methylation predicts how well alkylating chemotherapy is likely to work. The 2021 WHO classification is built around these markers (per NCCN and EANO guidance), which is why grade alone no longer tells the full story. CION arranges IDH, 1p/19q and MGMT testing as standard on every malignant glioma sample. You can read more on our molecular testing for brain tumours page.
According to the 2021 WHO classification (reflected in NCCN and EANO guidance), an IDH mutation is now part of the diagnosis of a glioma — not just an add-on. IDH-mutant gliomas behave differently from IDH wild-type tumours and tend to have a better outlook at the same grade, which is why two tumours that look identical under the microscope can be classified, and treated, differently. This is exactly why molecular testing should be part of the standard work-up for every malignant glioma — if it has not been arranged, ask for it before treatment begins.
There is no single treatment for "a glioma" — the plan depends entirely on the type, grade and molecular markers. What stays the same is that CION reviews every case at a multidisciplinary tumour board before any plan is finalised, and coordinates each step as one continuous journey.
What CION delivers directly: radiation therapy (IMRT/IGRT), systemic drug therapy, imaging and diagnosis, molecular testing, steroid and seizure management, and supportive and rehabilitation care. Specialist radiosurgery and neurosurgery are arranged through coordinated, accredited partners. For the full picture, see our brain tumor treatment in Hyderabad page.
A glioma diagnosis raises a lot of questions, and it is normal to feel overwhelmed. You deserve time to understand what is happening and to feel confident in the plan. At CION, every case is reviewed by a tumour board — surgery, radiation and medical oncology deciding together — and we make decisions for healing, not billing, with transparent costs explained up front.
A second opinion is particularly worthwhile in three situations:
To go deeper, read about astrocytoma and its grades, low-grade glioma, and glioblastoma (GBM). You can also explore our broader brain tumor treatment in Hyderabad page.
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Start Your Story. Book Free Consultation.A glioma is a brain tumour that begins in the brain's glial cells — the support cells that surround and protect the neurons. Gliomas are the most common type of primary brain tumour (a tumour that starts in the brain itself, rather than spreading there from elsewhere). The word "glioma" is an umbrella term: it covers several different tumours that vary enormously in how fast they grow and how they are treated. Some gliomas are slow-growing and can be controlled for many years; others, such as glioblastoma, are fast-growing. The exact type is confirmed by a biopsy and molecular testing, not by imaging alone.
Gliomas are grouped by the glial cell they arise from. The main types are astrocytomas (from star-shaped astrocyte cells — the broadest group, ranging from low-grade tumours to glioblastoma), oligodendrogliomas (which carry a characteristic 1p/19q co-deletion and tend to respond well to treatment), and ependymomas (which arise from the cells lining the brain's fluid spaces). Glioblastoma is a WHO Grade 4 astrocytic tumour and is the most common malignant glioma in adults. You can read more about astrocytoma and its grades and low-grade glioma on our dedicated pages.
Not all gliomas behave the same way, but most gliomas are considered malignant or have the potential to behave aggressively over time. They are graded by the World Health Organization on a scale of Grade 1 to Grade 4 rather than staged like other cancers. Grade 1 gliomas (such as pilocytic astrocytoma, more common in children) grow very slowly and can often be cured with surgery alone. Higher-grade gliomas — Grade 3 and Grade 4 — grow faster and need a combination of treatments. The grade, together with molecular markers, tells your team how the tumour is likely to behave, which is why an accurate tissue diagnosis matters so much.
Gliomas are not given a Stage I–IV number the way most cancers are. Instead they are given a WHO grade from 1 to 4, based on how the tumour cells look under the microscope and — since the 2021 WHO classification — on their molecular markers. Lower-grade gliomas (Grade 1–2) grow slowly; higher-grade gliomas (Grade 3–4) grow faster and infiltrate surrounding brain. Markers such as IDH mutation, 1p/19q co-deletion and MGMT methylation are now part of the diagnosis itself, because two tumours that look identical under the microscope can behave very differently depending on their biology.
Diagnosis usually starts with an MRI of the brain with contrast, which shows the tumour's location, size and features that suggest its grade. However, imaging can only suggest a glioma — a tissue sample (biopsy) is needed to confirm the exact type, grade and molecular profile. The sample is obtained either during surgery or, for deep or risky locations, with a stereotactic needle biopsy. At CION, biopsy and neurosurgery are coordinated with accredited neurosurgical partners, while we manage the imaging, molecular testing (IDH, 1p/19q, MGMT), radiation and systemic therapy directly. Accurate diagnosis is what allows the treatment plan to fit your exact tumour.
Treatment depends entirely on the type and grade. A slow-growing low-grade glioma may be managed with maximum safe surgery followed by watch-and-wait or radiation, while a high-grade glioma such as glioblastoma needs surgery, radiation and chemotherapy together. CION delivers radiation therapy (IMRT/IGRT), systemic drug therapy, imaging, molecular testing, and steroid and seizure management directly, and coordinates surgery and specialist radiosurgery with accredited neurosurgical partners. Every glioma case is reviewed by a multidisciplinary tumour board before a plan is finalised. For a full overview, see our brain tumor treatment in Hyderabad page.
Since the 2021 WHO classification (reflected in NCCN and EANO guidance), molecular testing is part of the glioma diagnosis itself — not an optional extra. Three markers matter most. IDH status is the single most powerful prognostic marker in glioma: IDH-mutant tumours grow more slowly and have a better outlook than IDH wild-type tumours of the same grade. 1p/19q co-deletion identifies oligodendrogliomas, which respond particularly well to chemotherapy and radiation. MGMT methylation predicts how well alkylating chemotherapy will work. CION arranges these tests as standard on every malignant glioma sample, so your treatment is matched to your tumour's biology.
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