Behind the Tumor: Astrocytoma

Types

Noncancerous astrocytomas

Grade 1 astrocytomas, which are noncancerous, include:

• • Pilocytic astrocytoma: This is a slow-growing tumor that doesn’t tend to spread. It’s the most common grade 1 astrocytoma. It’s benign and doesn’t require chemotherapy or radiation therapy after it’s surgically removed. Pilocytic astrocytomas most often develop in your cerebellum.
  • Pleomorphic xanthoastrocytoma: This tumor usually grows slowly and most often develops in your temporal lobe. It often causes seizures. Surgery usually cures this type of brain tumor.
  • Subependymal giant cell astrocytoma (SEGA): This tumor mainly develops in children who have tuberous sclerosis, a genetic condition. It grows inside ventricles, which are fluid-filled spaces deep in your brain. Surgery usually cures it.

Cancerous astrocytomas

Cancerous astrocytomas include:

• • Grade 2 astrocytomas: These astrocytomas tend to spread to nearby brain tissue. Because of this, surgery alone might not be enough to treat them.
  • Grade 3 astrocytomas: These astrocytomas are more aggressive than grade 2 astrocytomas and often present as a progression from grade 2 astrocytomas. Surgery alone never cures these tumors. They require radiation and almost always require chemotherapy.
  • Glioblastomas: These are grade 4 astrocytomas. They’re the most common form of astrocytoma and the most aggressive — they grow and spread rapidly. They can either present as a cancerous progression from a previously existing lower-grade astrocytoma (10% of cases) or begin as a grade 4 tumor (90% of cases).

Location

Diffuse astrocytoma can appear in various parts of the brain and nervous system, including the cerebellum, cerebrum, brainstem, spinal cord, and central areas of the brain. They most commonly develop in the frontal or temporal lobes.

Population

Astrocytomas can affect anyone, but different grades tend to affect people at different ages:

• Grade 1 astrocytomas most often affect children and teens.
• Astrocytomas, grade 2 most often affect adults between 20 and 60.
• Astrocytomas, grade 3 most often affect adults between 30 and 60.
• Glioblastoma (grade 4 astrocytoma) most often affects adults between 50 and 80.

Grade 3 and 4 astrocytomas are more likely to affect adults assigned male at birth than adults assigned female at birth.

Symptoms

Astrocytoma symptoms vary based on the tumor’s location. An astrocytoma in the brain can cause personality changes, seizures, headaches and nausea. An astrocytoma in the spinal cord can cause weakness and disability in the area affected by the growing tumor.

Diffuse astrocytoma can appear in various parts of the brain and nervous system, including the cerebellum, cerebrum, brainstem, spinal cord, and central areas of the brain. They most commonly develop in the frontal or temporal lobes.

Treatment

Astrocytoma treatments include:

• Surgery to remove the astrocytoma. A brain surgeon, also called a neurosurgeon, works to remove as much of the astrocytoma as possible. The goal is to remove all of the tumor. Sometimes the tumor is in a spot that is hard to reach. It may be too risky to remove it all. Even so, removing some of the astrocytoma may lower your symptoms. For some people, surgery may be the only treatment needed. For others, more treatments may be recommended to kill any remaining tumor cells and lower the risk of the tumor coming back.

• Radiation therapy. Radiation therapy uses powerful energy beams to kill tumor cells. The energy can come from X-rays, protons and other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine sends beams to exact points in your brain. The treatment only takes a few minutes. Radiation therapy might be used after surgery. It can be used if the cancer wasn’t removed completely or if there’s a higher risk the cancer will return. Radiation may be used with chemotherapy for cancers that grow quickly. For people who can’t have surgery, radiation therapy and chemotherapy may be used as the main treatment.

• Chemotherapy. Chemotherapy uses strong medicines to kill tumor cells. Chemotherapy medicines can be taken in pill form or injected into a vein. Sometimes, a circular wafer of chemotherapy medicine can be put in your brain after surgery. There, it slowly dissolves and releases the medicine. Chemotherapy is often used after surgery to kill any tumor cells that might remain. It can be used with radiation therapy for tumors that grow quickly.

• Clinical trials. Clinical trials are studies of new treatments. These studies offer a chance to try the latest treatment options. The risk of side effects may not be known. Ask a member of your health care team whether you can participate in a clinical trials.

• Supportive care. Supportive care, also called palliative care, focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other health care team members to provide extra support. Palliative care can be used at the same time as other treatments, such as surgery, chemotherapy or radiation therapy. Often, palliative care begins as you start your astrocytoma treatments. You may not need to wait for complications to happen in order to receive palliative care

Questions To Ask Your Doctor

It may be helpful to ask your healthcare team the following questions:

• Why did I get astrocytoma?
• What kind of astrocytoma do I have?
• What’s the best treatment for me?
• What clinical trials am I eligible for?
• What are the treatment risks and side effects?
• What type of follow-up care do I need after treatment?
• What are the chances that the cancer will come back or spread after treatment?
• What signs of tumor growth should I look for?
• What signs of treatment complications should I look for?
• Are my family members at risk of developing astrocytoma?

Additional Common Questions

• What is the difference between astrocytoma and glioblastoma?

Glioblastoma is a type of astrocytoma — a grade 4 astrocytoma, specifically. Glioblastoma is an aggressive cancerous tumor that grows and spreads quickly. It’s the most common cancerous primary brain tumor.

• Is astrocytoma malignant or benign?

There are several types of astrocytoma tumors — some are benign and some are malignant. Grade 1 astrocytomas are benign (noncancerous). Grades 2 through 4 are malignant (cancerous).