Astrocytoma is a kind of brain tumor that starts in special brain cells called astrocytes.
What is astrocytoma?
An astrocytoma is a type of brain tumor that originates in the brain or spinal cord. It develops from astrocytes, which are star-shaped glial cells that support nerve cells. Astrocytomas are one of the most common types of gliomas. A glioma is a broad category of brain tumors that originate from glial cells. Glial cells are the supportive cells in the brain and spinal cord that surround neurons and provide them with support, nourishment, and protection.
There are several main types of glial cells, and the type is named after the type of glial cell they arise from including:
- Astrocytes: These form astrocytomas, a type of brain tumor that originates in astrocytes, which are star-shaped glial cells that support nerve cells in the brain and spinal cord. These tumors can vary greatly in their aggressiveness, from slow-growing and benign to highly malignant and fast-growing.
- Oligodendrocytes: These form oligodendrogliomas. They produce myelin, which insulates nerve fibers.
In rare cases, an oligoastrocytoma containing both astrocytes and oligodendrocytes may occur.
The American Association of Neurological Surgeons notes notes that there are around 15,000 new astrocytomas diagnosed each year. Astrocytomas are among the most common primary brain tumors. They represent a significant portion of all glial tumors. Low-grade astrocytomas (grades 1 and 2 are less aggressive and more common in younger individuals, including children and young adults. Pilocytic astrocytomas (grade 1) are particularly notable in pediatric populations.
AHN Neuro-Oncology Center of Excellence
Our experts in the AHN Neuro-Oncology Center of Excellence offer some of the newest, most innovative care for patients with benign and malignant brain tumors. We use the latest tools and procedures to make the diagnosis process as minimally invasive as possible. You can get numerous tests done on the same day and in one location, to reduce your wait and travel time. We know this is a difficult and stressful time. Our understanding staff is by your side, guiding you and answering your questions. We also offer robust support services to treat the whole person.
Why choose AHN for your brain cancer treatment?
Our highly experienced team of neuro-oncologists (brain cancer specialists) and neurosurgeons (brain surgeons) performs treatments that are only available at the very best hospitals in the country. By choosing AHN for your care, you will find:
- Improved survival rates: We use aggressive treatments while making sure you are feeling as well as you can. Helping you live a longer, more comfortable life is our priority.
- Advanced technology: Sophisticated tools, such as ChemoID®* and genome analysis, allow us to understand how the tumor will respond to different treatments before we suggest them. This level of analysis helps us build a treatment plan that will be specific to your health needs.
- Minimally invasive treatments: Many of our treatment options are outpatient procedures that involve a short recovery time. Instead of spending all your time in a hospital, you can live your life and enjoy your family and friends.
- A collaborative approach: We discuss all our patients in a weekly meeting with our brain cancer experts. You benefit from the combined experience of a team that includes neuro-oncologists, radiation oncologists, neurosurgeons, medical oncologists, and neuroradiologists. Because we are always up to date on your progress, we are able to give you the best possible care.
- Robust support: We invite all patients with brain cancer to join our weekly support group to share feelings, discuss symptoms, and help one another cope. It may help you feel better during treatment and experience an improved state of mind.
- A convenient, after-hours cancer clinic: If you experience side effects from treatment, call your physician’s office first, then visit our After Hours Oncology Clinic, conveniently located at West Penn Hospital. We treat you quickly, without exposing your compromised immune system to the germs you may encounter at a traditional emergency room. Plus, our clinic is more affordable than a visit to the ER. And since our oncology specialists have access to your records, they may even be able to advise you over the phone and save you from making a trip.
- Clinical trials: If you meet the eligibility requirements, you may be able to participate in an experimental clinical trial. You could gain access to a groundbreaking treatment before it is widely available. Learn more about our clinical trial program.
Astrocytoma symptoms and signs
The signs and symptoms of astrocytomas can be quite varied, largely depending on the size, location, and growth rate of the tumor within the brain or spinal cord. They generally arise from two main reasons:
- Increased intracranial pressure (ICP): As the tumor grows, it takes up space within the rigid skull, increasing pressure on the brain.
- Disruption of brain function: The tumor can directly damage brain tissue, interfere with nerve signals, or disrupt blood flow to certain areas.
These issues can cause the following symptoms and signs:
- Headaches: This is one of the most common symptoms and headaches caused by astrocytomas can often feel different than previous headaches. They may be more severe in the morning when you wake up and can become more frequent or persistent Sometimes they are accompanied by nausea and/or vomiting.
- Vision problems: Due to pressure on the nerves that control eye movement, vision problems can occur including burred or double vision. Sometimes patients lose their peripheral vision or have swelling of the optic nerve.
- Seizures: These can be generalized and affect the whole body or they can affect a specific part of the body. If you are experiencing new-onset seizures, you should see a doctor immediately.
- Nausea and vomiting: Especially in the morning, without an obvious cause like illness.
- Personality and behavioral changes: Irritability, apathy, impulsivity, poor judgment, social inappropriateness.
- Neurological issues: This may include weakness or paralysis on one side of the body and problems with balance and coordination.
- Speech problems: These can include problems where the person is having slurred or delayed speech or difficulty forming words.
It’s important to know that the symptoms can develop slowly over weeks or months and sometimes come and go, which make them easy to dismiss. If you are experiencing new health issues or a worsening of health issues, it’s important to see your doctor.
Causes and risk factors
There are certain risk factors that can make a person more susceptible to developing astrocytomas. It is important to know that having these risk factors doesn’t mean you will develop the disease, but it is important to understand the various ways your health can be affected. The following can be causes and risk factors associated with astrocytomas:
- Genetic syndromes: Certain inherited genetic conditions significantly increase the risk of developing astrocytomas. These include:
- Neurofibromatosis type 1 (NF1): Individuals with NF1 are at a higher risk of developing low-grade astrocytomas, particularly optic pathway gliomas.
- Tuberous sclerosis complex (TSC): This condition can lead to the development of subependymal giant cell astrocytomas (SEGAs).
- Li-Fraumeni syndrome: This rare inherited disorder increases the risk of various cancers, including brain tumors.
- Von Hippel-Lindau disease (VHL): While more commonly associated with hemangioblastomas, VHL can also increase the risk of certain glial tumors.
- Previous radiation therapy: Exposure to radiation, particularly to the head, for the treatment of other cancers (e.g., leukemia in childhood) is a known risk factor for developing secondary brain tumors, including astrocytomas, years later.
- Age: While astrocytomas can occur at any age, certain types are more common in specific age groups. For instance, low-grade astrocytomas are more prevalent in children and young adults, while high-grade astrocytomas (like glioblastoma) are more common in older adults.
Astrocytoma screening and diagnosis
There isn’t a standard screening screening for astrocytomas, but there are certain tools that can be used if there have been persistent symptoms and signs to look for the presence of tumors. The diagnosis of an astrocytoma typically begins when a person experiences symptoms that suggest a problem with their brain. These symptoms can be varied and depend on the tumor's size, location, and rate of growth.
AHN uses a multidisciplinary approach to diagnosis using different tools that can give your care team the information necessary to determine the appropriate and tailored treatment plan.
Types and stages of astrocytoma
Unlike many other cancers that are staged based on tumor size, lymph node involvement, and metastasis, brain tumors, including astrocytomas, are primarily categorized by their grade according to the World Health Organization (WHO) Classification of Tumors of the Central Nervous System. This grading system reflects the tumor's aggressiveness and biological behavior. The WHO classification assigns a grade from 1 to 4, with Grade 1 being the least aggressive and Grade 4 being the most aggressive.
Astrocytoma treatment
Treatment for astrocytomas at AHN is focused on each individual patient getting the personalized treatment they need to achieve the best health outcomes possible. We are committed to exceptional care that prioritizes minimally invasive procedures that target brain tumors like astrocytomas. Using state-of-the-art technology, we can work to deliver a treatment plan focused on your needs.
Surgery
Traditional surgery aims to physically remove as much of the astrocytoma as possible, relieving pressure and aiding diagnosis. When traditional surgery isn't feasible or can't remove the entire tumor, GammaKnife** offers a noninvasive, highly precise radiation treatment option to target the tumor cells that remain or are in sensitive areas, minimizing damage to healthy brain tissue.
GammaKnife is a noninvasive form of stereotactic radiosurgery (SRS). It's a machine that delivers highly focused beams of radiation to a precise target in the brain. After traditional surgery, if some tumor cells couldn't be safely removed, GammaKnife can be used to treat these remaining tumor cells. The key advantage of GammaKnife is its extreme precision. It delivers a high dose of radiation to the tumor while largely sparing the surrounding healthy brain tissue. This significantly reduces the risk of side effects compared to whole-brain radiation.
Radiation therapy
Radiation therapy uses high-energy rays, like X-rays or protons, to damage and kill cancer cells. For astrocytomas, it works by targeting the tumor cells and disrupting their DNA, preventing them from growing and dividing. After surgery, it's common for some microscopic tumor cells to remain. Radiation therapy is often used to kill these remaining cells, reducing the chance of the tumor growing back. For tumors that cannot be completely removed surgically, or for those in critical areas, radiation can help shrink the tumor and alleviate symptoms caused by its pressure on the brain. Even if a tumor can't be eliminated, radiation can help slow down its growth, extending life and improving quality of life. In some cases, radiation is used proactively to prevent the tumor from returning in its original location.
Chemotherapy
Chemotherapy uses drugs to kill cancer cells throughout the body. These drugs typically work by targeting rapidly dividing cells, which cancer cells tend to be. For astrocytomas, chemotherapy drugs can be given orally (pills) or intravenously (through a vein). For certain types of astrocytomas, chemotherapy can slow down tumor growth and progression, particularly for higher-grade tumors. Some chemotherapy drugs are given concurrently with radiation therapy (chemoradiation) because they can make the tumor cells more sensitive to the effects of radiation, increasing its effectiveness. If an astrocytoma returns after initial treatment, chemotherapy may be a primary option to manage the recurrence.
Targeted therapy
Targeted therapy is a newer type of cancer treatment that focuses on specific molecular characteristics or pathways within cancer cells that promote their growth and survival. Unlike traditional chemotherapy, which affects all rapidly dividing cells, targeted therapy aims to be more specific to cancer cells, often resulting in fewer side effects. Many astrocytomas have specific genetic mutations or overactive proteins that drive their growth. Targeted therapies are designed to block these specific pathways or proteins, thereby stopping or slowing tumor progression.
Astrocytoma FAQs
A brain tumor of any type can bring questions and concerns. AHN is here to help you understand your options and feel confident in your care plan. Your AHN care team is your go-to resource for specific answers, guidance, and a tailored treatment plan. We’ve also included answers to some of our patients’ most frequently asked questions, which can help you get a base understanding of this condition.
What is the survival rate for astrocytomas?
The survival rate for astrocytomas varies widely depending on several critical factors, primarily the grade of the tumor, the patient's age, the extent of surgical removal, and the tumor's molecular characteristics. Astrocytomas are graded from one to four, with Grade 1 being the least aggressive and Grade Four (glioblastoma) being the most aggressive.
- Grade 1 (pilocytic astrocytoma): These are typically slow-growing and often curable with surgery alone. The five-year survival rate can be over 90%.
- Grade 2 (diffuse astrocytoma): These are also slow growing but tend to infiltrate surrounding tissue, making complete removal difficult. The 5-year survival rate can range from 40% – 70%, but can vary greatly with molecular features.
- Grade 3 (anaplastic astrocytoma): These are more aggressive than Grade Two. The five-year survival rate is generally between 20% – 40%.
- Grade 4 (glioblastoma, GBM): This is the most common and most aggressive type of primary brain tumor. The median survival time is typically around 12 to 18 months, with a five-year survival rate of less than 10%.
How rare is astrocytoma?
Astrocytomas are relatively uncommon but are the most common type of primary brain tumor (tumors that originate in the brain rather than spreading from elsewhere). Overall, primary brain and central nervous system tumors are rare, affecting about 7 to 8 people per 100,000 per year in the United States. Of these, astrocytomas make up a significant proportion, with glioblastoma (grade 4 astrocytoma) being the most common malignant brain tumor in adults. While not "rare" in the context of brain tumors, they are rare compared to more common cancers like breast, lung, or prostate cancer.
What is the best treatment for astrocytoma?
There is no single best treatment for astrocytoma; instead, treatment is highly individualized and depends on numerous factors, including:
- Tumor grade: Lower-grade tumors (1 and 2) might be managed differently than higher-grade ones (three and four).
- Location of the tumor: Whether it's in a surgically accessible area or a critical brain region.
- Patient's age and overall health: These influence tolerance to aggressive treatments.
- Extent of tumor removal: How much of the tumor can be safely removed surgically.
- Molecular markers: Specific genetic mutations or alterations within the tumor cells (e.g., IDH mutation status, MGMT promoter methylation, 1p/19q co-deletion status) play a crucial role in guiding treatment decisions and predicting response.
Typically, a multidisciplinary approach is used, combining several treatments:
- Surgery: Often the first step, aiming for maximal safe resection to remove as much of the tumor as possible.
- Radiation therapy: Used after surgery to kill residual tumor cells or as a primary treatment if surgery isn't possible.
- Chemotherapy: Often used alongside or after radiation, especially for higher-grade tumors.
- Targeted therapy: May be used if the tumor has specific molecular characteristics that can be targeted by particular drugs.
- Clinical trials: Participation in clinical trials offers access to cutting-edge treatments and is often considered for aggressive tumors.
How rare is astrocytoma with oligodendroglioma?
The term astrocytoma with oligodendroglioma refers to a historical classification for a tumor known as an oligoastrocytoma. However, this diagnosis is now considered obsolete under the current World Health Organization (WHO) Classification of Central Nervous System Tumors (most recently updated in 2021). Previously, oligoastrocytomas were diagnosed when a tumor displayed features of both astrocytic and oligodendroglial cells. With advancements in molecular diagnostics, it's now understood that most tumors previously classified as oligoastrocytomas actually have a predominant molecular profile that aligns with either a pure astrocytoma or a pure oligodendroglioma.
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ChemoID is a registered trademark of Edwards Comprehensive Cancer Center.
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Gamma Knife® is a registered trademark of Elekta Instruments, Inc.