Astrocytomas brain cancer

What is astrocytoma brain cancer?

A tumor that originates in small, star-shaped cells called astrocytes in the brain or spinal cord.

Brain tumors may emerge primarily from brain cells such as astrocytes or neurons or spread to the brain from other parts of the body (known as primary brain tumors) or metastatic brain tumors). The most common type of brain cell is glia, and astrocytes are a class of glial cells. Tumors resulting from glial cells are known as gliomas; categorizing the tumor based on the particular form of glial cells would be a more detailed definition. Therefore, for tumors originating from astrocytes, the term astrocytoma is used.

The most prevalent glial tumor is astrocytoma and can occur throughout the brain and spinal cord.

The signs and symptoms of astrocytoma depend on your tumor’s location. Seizures, headaches and nausea may be caused by astrocytomas that arise in the brain. In the area affected by the rising tumor, astrocytomas that develop in the spinal cord may cause weakness and impairment.

Astrocytoma may be a slow-growing tumor or can be a rapidly growing, aggressive cancer. Your prognosis and treatment choices are dictated by the aggressiveness(grade) of your astrocytoma.

Subdivisions of Astrocytoma

• grade I astrocytoma
• grade II astrocytoma
• grade III astrocytoma
• grade IV astrocytoma

There are several types of astrocytoma:

• It is unusual to have anaplastic astrocytoma. They are tumors of grade III that develop fast and spread to surrounding tissue. Owing to their tentacle-like digits, which expand into surrounding brain tissue, they are difficult to extract completely.
• Grade IV astrocytomas are also called glioblastomas. Glioblastomas represent over 50 per cent of astrocytomas. They develop very rapidly and are difficult to treat because they are always a combination of multiple types of cancer cells.
• Astrocytomas that are diffuse may develop into nearby tissue, but they grow slowly. They are considered low-grade (grade II), but can grow into tumors of a higher grade.
• Astrocytic pineal tumours may be of any grade. Around the pineal gland, they develop. Melatonin, which helps regulate sleep and waking, is released by this small organ in the cerebrum.
• In adults, brain stem gliomas are rare. It doesn’t happen often, but in the brain stem, the portion that connects to the spinal cord, gliomas may often develop.
• Pilocytic astrocytomas and giant subependymal cell astrocytomas are more prevalent and considered to be Grade I in infants.

Symptoms of astrocytoma

The symptoms of an anaplastic astrocytoma can differ depending on the exact location of the tumor, but they typically include:

• headaches
• lethargy or drowsiness
• nausea or vomiting
• behavioral changes
• seizures
• memory loss
• vision problems
• coordination and balance problems

Diagnosis of astrocytoma

Tests and procedures used to diagnose astrocytoma include:

• Neurological examination : Your doctor will ask you about your signs and symptoms during a neurological exam. Your vision, hearing, balance, agility, strength and reflexes can be tested by him or her. Problems will offer clues about the portion of your brain that could be affected by a brain tumor in one or more of these regions.
• Imaging tests : Imaging tests will assist your doctor in assessing your brain tumor’s position and scale. MRI is also used to diagnose brain tumors and can be used with functional MRI, perfusion MRI, and magnetic resonance spectroscopy, along with advanced MRI imaging.

Other imaging tests may include CT and positron emission tomography (PET).

• Removing a sample of tissue for testing (biopsy) : Depending on your specific case and the position of your tumor, a biopsy may be performed with a needle prior to surgery or during surgery to remove your astrocytoma. In a laboratory, a sample of suspicious tissue is analyzed to assess the cell types and their level of aggressiveness.

Specialized tumor cell tests will tell your doctor the types of mutations that have been developed by the cells. This provides hints to your doctor about your prognosis and may guide your choices for treatment.

Treatment of astrocytoma

Surgery in astrocytoma

It will work to extract as much of the astrocytoma as possible from the brain surgeon (neursurgeon). The aim is to eliminate all the cancer, but the astrocytoma is also found near delicate brain tissue, which makes it too dangerous. Your signs and symptoms can be minimized also by eliminating some of the cancer.

For certain individuals, the only care required could be surgery. Additional therapies may be prescribed for others to kill any cancer cells that may linger and decrease the chance of the cancer coming back.

Astrocytoma reduction surgery. It will work to extract as much of the astrocytoma as possible from the brain surgeon (neursurgeon). The aim is to eliminate all the cancer, but the astrocytoma is also found near delicate brain tissue, which makes it too dangerous. Your signs and symptoms can be minimized also by eliminating some of the cancer.

For certain individuals, the only care required could be surgery. Additional therapies may be prescribed for others to kill any cancer cells that may linger and decrease the chance of the cancer returning.

Sometimes, surgery to remove a glioma is guided by computer software that combines tumor MRI and CT scans. This technology helps surgeons recognize and remove tumors with great accuracy while preventing brain damage, including sensitive regions that regulate movement, voice, hearing, touch, vision, smell and taste.

Radiation therapy in astrocytoma

In order to destroy cancer cells, radiation therapy uses high-energy beams, such as X-rays or protons. You lie on a table during radiation therapy as a machine works around you, directing beams to accurate points in your brain.

After surgery, radiation therapy may be recommended if your cancer has not been completely removed or if there is an elevated likelihood that your cancer will return. For aggressive tumors, radiation is also paired with chemotherapy. As a primary treatment, radiation therapy and chemotherapy can be used by patients who do not undergo surgery.

Any cancer cells or sections of a tumor that remain after surgery can also be killed using this method. Radiation treatment typically starts in order to remove a glioma or astrocytoma two to four weeks after surgery.

For the treatment of glioma or astrocytoma, physicians use external beam radiation therapy in which radiation is delivered from outside the body. The tumor is given external beam radiation therapy by a system called a linear accelerator. During therapy, it rotates around you.

Radiation therapy is successful in killing the cells of the tumor, especially when it is given in fractions. Normal treatments are given five days a week for a duration of six weeks. Using machine algorithms, the dose and delivery of radiation is carefully contoured and optimized to optimize the efficacy of killing tumor cells and mitigate damage to the surrounding brain. Treatments with directed beam radiation (stereotactic radiosurgery) are not recommended.

Chemotherapy in astrocytoma

To kill cancer cells, chemotherapy uses medications. It is possible to take chemotherapy drugs in pill form or via a vein in your arm. In certain cases, following treatment, a circular wafer of chemotherapy medicine may be inserted in the brain where it dissolves and releases the drug slowly.

After surgery, chemotherapy is also used to destroy any cancer cells that may remain. Radiation treatment for aggressive cancers should be paired with this.

If surgery may not be performed, chemotherapy can be given after surgery or as the main therapy. Temozolomide, the most popular chemotherapy drug used is (Temodal). PCV, which is procarbazine (Matulane), lomustine (CeeNU, CCNU) and vincristine, is the most popular chemotherapy medication combination used (Oncovin). For radiation therapy, PCV is typically administered.

If required, our physicians can administer IV chemotherapy every three to six weeks for several hours, with time between treatments to allow the body to recover. During a period of three to six months, this cycle may be repeated several times.

Low blood cell levels, hair lack, loss of appetite, and nausea and vomiting may be side effects of chemotherapy.

Immunotherapy in astrocytoma

Immunotherapy provides promising brain cancer treatment options, typically treated with chemotherapy, radiation therapy, and surgery.

In 2005, the chemotherapy temozolomide (Temodar®) was approved to treat newly diagnosed glioblastoma (GBM) patients based on a randomized phase III clinical study that showed that it added 2.5 months to the median survival of patients. However, over 50% of GBM tumors generate a DNA repair protein called MGMT (methylguanine methyltransferase) that effectively neutralizes temozolomide chemotherapy. These patients derive negligible therapeutic benefit from the addition of temozolomide to their treatment.

Immunotherapy is a form of treatment that helps destroy cancer cells by taking advantage of a person’s own immune system. For brain and nervous system cancers, there are currently two FDA approved immunotherapy options.

Targeted Antibodies

• Bevacizumab (Avastin®): a monoclonal antibody that targets the VEGF/VEGFR pathway and inhibits tumor blood vessel growth; approved for advanced glioblastoma
• Dinutuximab (Unituxin®): a monoclonal antibody that targets the GD2 pathway; approved for first-line treatment of high-risk pediatric neuroblastoma

Several other immunotherapies are being used to treat different types of brain cancers in clinical trials.

Clinical trials in astrocytoma

The tests on potential drugs are clinical trials. These trials offer you an opportunity to try the new treatment options, but there might be no established chance of side effects. Ask your doctor if you may be qualified for a clinical trial.

Palliative care in astrocytoma

Palliative care is advanced medical care that focuses on offering pain relief and other extreme disease symptoms. To offer an additional layer of support that complements your ongoing treatment, palliative care physicians work with you, your family and your other doctors. When undertaking more aggressive therapies, such as surgery, chemotherapy or radiation therapy, palliative care may be used.

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• September 2nd, 2020