Astrocytoma

Astrocytoma is a growth of cells that starts in the brain or spinal cord. The growth, called a tumor, starts in cells called astrocytes. Astrocytes support and connect nerve cells in the brain and spinal cord.

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.

Some astrocytomas grow slowly. They aren't considered to be cancerous. These noncancerous tumors are sometimes called benign astrocytomas. Most astrocytomas grow quickly and are considered to be brain cancers. These are sometimes called malignant astrocytomas. Whether your tumor is benign or malignant is one factor your healthcare team considers when creating a treatment plan.

Astrocytoma signs and symptoms may vary based on where the tumor starts. This tumor can happen in the brain or in the spinal cord.

Symptoms of astrocytomas in the brain include:

• Seizures, which might cause loss of consciousness or changes in behavior, such as staring off into space.
• Headaches.
• Nausea and vomiting.
• Personality changes.
• Problems speaking.
• Feeling very tired or weak.

Symptoms of astrocytomas in the spinal cord include:

• Pain in the affected area.
• Pain that worsens at night.
• Weakness in the arms or legs that gets worse over time.
• Trouble walking.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have ongoing symptoms that worry you.

The cause of astrocytoma often isn't known. This tumor starts as a growth of cells in the brain or spinal cord. It forms in cells called astrocytes. Astrocytes support and connect nerve cells in the brain and spinal cord.

Astrocytoma happens when astrocytes develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In tumor cells, the DNA changes give different instructions. The changes tell the tumor cells to grow and multiply quickly. Tumor cells can keep living when healthy cells would die. This causes too many cells.

The tumor cells form a growth that may press on nearby parts of the brain or spinal cord as it gets bigger. Sometimes the DNA changes turn the tumor cells into cancer cells. Cancer cells can invade and destroy healthy body tissue.

Risk factors for astrocytoma include:

• History of radiation therapy. If you had radiation treatments for another cancer type, especially radiation near your head or neck, you may be more at risk.
• Middle age. Astrocytoma can happen at any age. It's most common in adults between ages 30 and 55.
• Hereditary syndromes. People with some disorders that run in families may be more likely to have astrocytoma. Examples include neurofibromatosis type 1, Lynch syndrome and Li-Fraumeni syndrome.

There is no way to prevent astrocytoma.

Tests and procedures used to diagnose astrocytoma include:

• Neurological exam. During a neurological exam, a member of your healthcare team will ask about your symptoms. Your vision, hearing, balance, coordination, strength and reflexes will be checked. Problems in one or more of these areas may help show the part of your brain affected by a brain tumor.

• Imaging tests. Imaging tests can help figure out the location and size of the brain tumor. MRI is often used to diagnose brain tumors. It may be used along with specialized MRI imaging, such as functional MRI, perfusion MRI and magnetic resonance spectroscopy.

  Other imaging tests may include CT and positron emission tomography scans, also called PET scans.

• Removing a sample of tissue for testing. A biopsy is a procedure to remove a sample of tissue from the tumor for testing. Often the sample is taken during surgery to remove the astrocytoma. If the astrocytoma is in a spot that's hard to reach with surgical tools, a needle might be used to get the sample. Which method is used depends on your situation. The tissue goes to a laboratory for review. Tests can determine the types of cells and how quickly they grow.

  Special tests can show detailed information about the tumor cells. Tests might look for changes in the genetic material of the tumor cells, called DNA. The results tell your healthcare team about your prognosis. Your team uses this information to create a treatment plan.

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 lessen 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 healthcare team whether you can participate in a clinical trial.
• 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 healthcare 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.

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If your health professional thinks that you might have astrocytoma, you'll likely be referred to a specialist. This specialist might be a cancer doctor, called an oncologist. You also may see a surgeon who specializes in operating on the brain, called a neurosurgeon.

Appointments can be short and being prepared can help. Here's some information that may help you get ready.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medications, vitamins or other supplements you take, including the doses.
• Questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember the information you're given.

For astrocytoma, some basic questions to ask your healthcare professional include:

• Do I have cancer?
• If the tumor isn't cancerous, do I still need to have it removed?
• Do I need more tests?
• What are my treatment options?
• What are the potential risks for these treatment options?
• Do any of the treatments cure my cancer?
• Can I have a copy of my pathology report?
• How much time can I take to consider my treatment options?
• Are there brochures or other printed materials that I can take with me? What websites do recommend?
• What would happen if I choose not to have treatment?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions, such as:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?