By taking the time to learn more about your condition and treatment options after an astrocytoma diagnosis, you are taking on an active role in your care. An astrocytoma is looked at on a scale ranging from low-grade astrocytoma to high-grade astrocytoma. Developing an understanding of the medical terms, treatment options and expected outcomes can help you feel more in control, reducing stress and helping give you peace of mind as you progress along your treatment path.
What is an Astrocytoma?
An astrocytoma is a tumor that arises from a specialized, star-shaped cell in the brain called an astrocyte. Astrocytes are part of a larger family of support cells in the brain called glial cells. This is why astrocytomas are considered a subgroup of a larger family of brain tumors called gliomas. An astrocytoma is considered a primary brain tumor, which means it develops from cells within the brain, as opposed to spreading from another site in the body (metastases).
Before discussing the different types of astrocytomas, it can be helpful to understand a concept related to tumors called grade. Grade is a classification based on how aggressive a tumor is. This includes how quickly it grows and whether or not it is invading surrounding tissues. The higher the grade, the more aggressive a tumor is and, as a result, the more aggressive treatment will need to be.
What are the Different Types of Astrocytoma?
An astrocytoma is generally identified as “low-grade” or “high-grade.” More specifically, they can be classified as Grade I, III, III or IV. Think of the scale as a gradient, and keep in mind that an astrocytoma has potential to transform into another grade. This is why it is extremely important to adhere to any follow-up schedule established by your doctor.
Grade I – Pilocytic or Juvenile Pilocytic Astrocytoma
Grade I astrocytomas typically occur in children or young adults. They tend to be small and slow growing, and many patients can be carefully monitored without treatment. However, larger, faster growing and symptomatic tumors may require intervention.
Grade II – Low-Grade Glioma
The slowest-growing type of astrocytoma in adult patients is a Grade II astrocytoma. These tumors can grow large and have the potential to damage adjacent structures and/or cause symptoms.
Grade III – Anaplastic Astrocytoma
The next grade of astrocytoma, Grade III, indicates a tumor is behaving more aggressively. Once an astrocytoma reaches Grade III, it is no longer a low-grade astrocytoma and is instead considered high-grade.
Grade IV – Glioblastoma Multiforme
The most aggressive form of astrocytoma is Grade IV, also known as glioblastoma multiforme (GBM). GBM is actually the most common form of primary brain tumor in adults. One way your doctor will classify your astrocytoma as Grade IV is by the presence of dead cells around the tumor, indicating quick growth and cell death – a sign the tumor is spreading aggressively.
What are the Astrocytoma Treatment Options?
Your doctor will recommend a treatment path based on your individual needs, and one main consideration is the grade of your astrocytoma. Generally speaking, the more aggressive your astrocytoma, the more aggressive your treatment will need to be. Other important factors include the size and exact location of your tumor, as it may be adjacent to or intertwined with delicate structures that make surgery difficult.
If you have been diagnosed with a low-grade astrocytoma that is small, not causing symptoms and/or in an area that cannot be operated on, your doctor may recommend a “watch and wait” approach. This means you will not be scheduled for treatment unless your tumor changes in the future, as detected by imaging or the development of new symptoms.
Another treatment option used in both low grade and high-grade astrocytoma is surgical resection, or removal, of all or part of your tumor. Sometimes an invasive astrocytoma cannot be removed completely or there are delicate neighboring structures. In this case, the neurosurgeon will remove as much of the tumor as he or she safely can and follow-up with adjunct therapy.
These adjunct therapies can include radiation therapy, such as Gamma Knife Radiosurgery or fractionated radiotherapy, or chemotherapy. The goal of adjunct therapy is to eradicate any remaining tumor cells, preventing further growth and spread of your tumor. The higher grade and more aggressive your astrocytoma, the greater the chance you will require radiation therapy and/or chemotherapy in addition to surgery.
Treating Your Personal Astrocytoma
Because astrocytomas can vary in aggressiveness, size and location, it is important that you work with an expert who can develop the most effective treatment plan for your specific condition. Generally speaking, a higher-grade astrocytoma will be treated with a more aggressive and urgent approach, and your doctors will use all the tools at their disposal, so to speak. If you have a low-grade astrocytoma, your doctor may simply recommend monitoring before proceeding with treatment. No two patients will be exactly alike, and being under the care of someone experienced in treating astrocytoma will ensure you receive personalized care specific to your needs.
