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Radiation therapy remains a cornerstone treatment for gliomas, using precise, high‑energy beams to slow tumor growth and ease symptoms like headaches, seizures, and neurological changes.

“Radiation is a very effective treatment for glioma,” explains Dr. Nicolas Gonzalez Castro, a neuro‑oncologist at Dana‑Farber Cancer Institute. “But it’s also associated with neurotoxicity, affecting healthy brain cells that receive high doses of radiation.”

O’Shea has been open about her diagnosis since late 2025, when she revealed she had undergone a biopsy on her birthday and spent weeks waiting for clarity. “I want to live my life as normally as possible while I’m fighting this,” she told followers, promising honesty as she navigated treatment.

So far, she’s undergone brain surgery, chemotherapy, and now radiotherapy.

Gliomas can also extend into areas of the brain where complete removal is not possible without risking serious neurological side effects. Although surgery aims to remove as much tumor as possible, microscopic cells often persist. These remaining cells can later grow and cause the tumor to return.

To help reduce this risk, radiation therapy (and sometimes chemotherapy) is recommended

Dr. Jacob Young, a Neurosurgeon focused on glioma surgery at the University of California, San Francisco, explains to SurvivorNet what goes into brain surgery.

“Believe it or not, it’s very safe to do awake surgery. That doesn’t mean that the patient is wide awake the entire time. We are talking about many hours for these operations. We have to go slow to be safe, but what we do is we get patients very comfortable,” says Dr. Young.

WATCH: What to Expect From Glioma Surgery?

“We use a combination of intravenous medications and local medicine, just like you would get at the dentist. To numb the skin and the area around the incision. [This] allows us to awaken a patient when we need them, to participate in either language or cognitive testing.”

Dr. Young continues, “We can have patients awake and participating in tasks to help guide us. To let us know if they’re starting to develop any indications that we’re getting close to critical areas.”

Early symptoms—an uneven smile and persistent migraines—were what first pushed her to seek medical help. “I noticed my smile was a little uneven, and it felt harder to talk,” she recalled.

Despite the physical and emotional strain, O’Shea has held onto moments of joy. “My first day being disabled and in pain, and I couldn’t stay awake, but frick me—I laughed to tears four times,” she wrote. “I still did things I loved in between. I also had the world’s best nap.”

She credits her support system for helping her stay grounded. “Surround yourself with the right people and work to your limits,” she said.

How Radiation Treatment Is Delivered to Patients

Radiation therapy for gliomas is usually given five days a week for several weeks, with each session lasting typically 10–20 minutes, and it feels similar to getting an X‑ray.

Before treatment starts, glioma patients undergo a specialized CT scan to map out their care. A lightweight, custom‑fitted mask is created to keep the head still. It doesn’t block breathing or vision and helps ensure the radiation is delivered safely and precisely each day.

The radiation oncologist works with medical physicists and dosimetrists to design a highly detailed plan. Using advanced software, they outline the tumor, protect as much healthy brain tissue as possible, and determine the safest and most effective dose.

“No doubt that radiation is really the cornerstone of the management and treatment of gliomas,” Dr. Iyad Alnahhas, a neuro-oncologist at Thomas Jefferson University in Philadelphia, tells SurvivorNet. “It is the treatment that tends to work fastest, and it’s a really essential paradigm for the treatment of these diseases.”

Daily Treatments:
During radiation sessions, patients lie on the treatment table with their mask in place while the linear accelerator machine moves around them. The radiation doesn’t have any notable feeling—no heat, no pain, no burning. Most people are able to drive themselves to and from appointments.

Depending on the tumor’s type and grade, your doctor may use different radiation techniques:

• IMRT (Intensity‑Modulated Radiation Therapy): The most common, offering highly precise targeting
• Proton Therapy: May reduce exposure to healthy brain tissue for select patients
• Stereotactic Radiosurgery (SRS): Used less often for gliomas, but may be appropriate for small or recurrent areas

Radiation Side Effects

As O’Shea experienced, radiation comes with treatment side effects. Radiation is generally well tolerated, but side effects can vary based on the tumor’s location, the total dose, and individual sensitivity.

Short‑Term (During or Shortly After Treatment)

These are usually temporary:

• Fatigue (very common)
• Hair loss in the treatment area
• Scalp dryness or irritation
• Headaches or pressure
• Nausea, depending on the tumor’s location
• Temporary symptom flare‑ups from swelling

Your doctor may prescribe steroids or other medications to help manage swelling and discomfort.

Long‑Term (Months to Years Later)

These can appear well after treatment ends:

• Cognitive changes (memory, processing speed)
• Radiation necrosis, which can resemble tumor regrowth
• Hormonal changes if the pituitary gland is affected
• Stroke‑like symptoms or, rarely, very late secondary tumors

Your care team will monitor you closely for any long‑term effects and address them promptly if they arise.

WATCH: Radiation’s Key Role In Glioma Treatment

What type of glioma benefits most from radiotherapy?

• Grade I gliomas: Lower-grade gliomas are often managed successfully with surgery alone if the tumor is completely removed.
• Grade II gliomas: These may or may not require radiation after surgery. This decision depends on factors like patient age, symptoms, tumor genetics, and how much of the tumor was resected. Some grade II tumors with certain genetic markers (e.g., IDH mutations) may be treated with newly approved targeted therapies instead.
• Grade III gliomas: These typically require radiation therapy after surgery, followed by chemotherapy.
• Grade IV gliomas (glioblastoma): Advanced tumors are commonly treated with radiation plus chemotherapy immediately after surgery, followed by additional chemotherapy and possibly tumor-treating fields. This combination approach aims to control tumor growth and delay recurrence.

How Genetic Testing Can Make a Difference In Your Glioma Treatment Journey

Gliomas are a type of tumor that starts in the brain. They can range from slow-growing (low-grade) to more aggressive forms.

“Nowadays, with not only brain cancers, but cancers in general, there has been a lot that’s been discovered about how different mutations in the tumor actually affect the behavior. Also, there are a number of mutations for which we have drugs that can target those mutations,” Dr. David Peereboom, an oncologist at the Cleveland Clinic Cancer Center in Ohio, tells SurvivorNet.

Biomarkers are essentially a tumor’s “fingerprints.” By studying these fingerprints, doctors can predict what treatments may be most effective and least toxic for you.

“The way to discover that [biomarker] is to do testing,” Dr. Peereboom explains. “The most helpful testing is called Next Generation Sequencing. What that does is it looks at all the DNA in the tumor, and the DNA is analyzed, and there are parts of DNA that may be abnormal or mutated.”

This testing might be performed using tissue obtained during a biopsy, surgery, or a blood test.

“There are a handful of those mutations that are called driver mutations,” Dr. Peereboom adds. “Driver mutations, as the name implies, are mutations that actually drive the behavior of the cancer. And for a handful of those, they’re actually, nowadays, there are some drugs that will target those mutations.”

How is Molecular Testing Done?

Molecular testing is typically performed on a sample of tumor tissue. This tissue is obtained from either surgery or a biopsy. Pathologists conduct the testing; these doctors are specially trained to study the characteristics of tumor tissues.

Molecular testing is widely available throughout the country, making it accessible to most patients diagnosed with gliomas.

What Types of Molecular Testing Are There?

Several molecular testing techniques are used on tissue samples. One method is antibody staining, where pathologists “stain the tumor with an antibody to look for the presence of the IDH mutant protein,” Dr. Alexandra Miller, Director of the Neuro-Oncology Division at NYU Langone Health, explains. Tumors without the mutation will not be visible with the stain. However, tumors that have the IDH mutation will stain or show a color that pathologists can recognize. This is a very common technique pathologists use for many tumor types.

WATCH: Understanding Molecular Testing for Glioma

Another method is molecular sequencing, which Dr. Miller explains is a process where doctors examine the DNA of the tumor cells to find specific changes or mutations in the genes. Both techniques can confirm whether the IDH mutation is present in the tumor cells.

Dr. Miller tells SurvivorNet that molecular testing “should be performed on every glioma.”

By determining whether a tumor carries the IDH mutation, doctors can offer FDA-approved targeted therapies like Vorasidenib, which Dr. Miller calls a “huge breakthrough” that slows the progression of the disease. This personalized approach marks an exciting advancement in the fight against gliomas, giving patients new hope and better treatment options.

WATCH: Who Benefits From Vorasidenib?

The FDA-approved drug Vorasidenib marks a major advance for patients with IDH-mutant gliomas—especially grade 2 tumors. In the INDIGO trial, a Phase 3 clinical trial, it reduced the risk of disease progression or death by 61% and extended progression-free survival (period with stable disease) from 11.1 to 27.7 months. For many patients, that represents a life-changing difference.

Better Understanding Brain Tumors

Brain tumors can impact a person’s cognitive function and overall well-being, depending largely on the tumor’s size, type, and specific location within the brain. When large enough, tumors may interfere with the central nervous system, pressing on nearby nerves, blood vessels, or tissues. This disruption may result in difficulties with coordination, balance, or mobility.

According to the American Society of Clinical Oncology (ASCO), brain tumors make up 85–90% of all primary central nervous system (CNS) tumors. They can be benign or malignant, with treatment and symptoms varying based on tumor type and location.

“The goal is to remove as much of the tumor as we can while keeping the patient well neurologically,” Dr. Reid Thompson, Chair of Neurosurgery at Vanderbilt University Medical Center, tells SurvivorNet. In other words, to remove as much of the tumor as possible without causing harm to the patient.

Even though surgery can remove a large part of the tumor, any remaining cancer cells can continue to grow over time, leading to the tumor’s return. For this reason, surgery is often followed by other treatments, like radiation or chemotherapy, to try to eliminate any remaining cells.

WATCH: Hope for Glioblastoma Research

While some brain tumors cause noticeable symptoms, others can go unnoticed for long periods. When symptoms do occur, they might include:

• Persistent headaches
• Difficulty speaking or processing thoughts
• Muscle weakness
• Behavioral or personality changes
• Vision disturbances
• Seizures
• Hearing loss
• Confusion
• Memory issues

Treatment Options for Brain Tumors

Treatment strategies for brain cancer depend on several variables, including the tumor’s size, type, grade, and location. Doctors may recommend:

• Surgery
• Radiation therapy
• Chemotherapy

Your medical team will help guide you based on your individual diagnosis. The prognosis—or outlook—depends on:

• Tumor type and growth rate
• Tumor location in the brain
• Presence of genetic mutations or abnormalities
• Whether the entire tumor can be removed
• The patient’s overall health

Questions to Ask Your Doctor

If you or a loved one has been diagnosed with a glioma, be sure to discuss molecular testing with your treating team. Here are some questions to ask:

• Do you need both the tissue sample and blood samples for molecular testing?
• What specific mutations will you be testing for in my tumor?
• Do I have any genetic mutation that would change the course of my treatment?
• Am I eligible to receive targeted therapy? What about immunotherapy?
• Is there a clinical trial that would be relevant for me?