Astrocytoma is among the most common types of brain tumors. These tumors are not always curable. With recent breakthroughs in research, however, full remission is becoming achievable for an increasing number of patients with astrocytoma of the brain. Centers for Neurosurgery, Spine & Orthopedics (CNSO) is New Jersey’s most comprehensive brain and spine center. Learn more about astrocytoma treatment options.
Quick Facts About Astrocytoma
- Astrocytoma is a type of brain tumor that forms from astrocytes, or star-shaped glial cells that support the neurons (brain cells) in the brain and spinal cord.
- There are four grades of astrocytoma with varying degrees of aggression. Grade 4 astrocytoma is a glioblastoma multiforme, a highly invasive brain cancer.
- Astrocytoma is not always curable. With breakthrough research leading to improved treatment options, however, more patients are achieving remission.
- Ongoing clinical trials are investigating multiple ways to improve astrocytoma care.
What Is an Astrocytoma?
An astrocytoma is a type of glioma, or a brain tumor that forms from glial cells. These are cells that form the glue-like support structure of the brain. They surround neurons, holding them in place and helping them function effectively. Specifically, astrocytoma tumors form from astrocytes, star-shaped glial cells that make up the majority of cells in the central nervous system.
Types and Grades of Astrocytoma
Scientists have identified four primary types or grades of astrocytomas, categorized by their rate of spread and how unusual their cells look under a microscope. Generally, the more abnormal the tumor cells appear, the faster the tumor is likely to grow. The types of astrocytomas include:
Grade 1 (Juvenile Pilocytic Astrocytoma)
Grade 1 astrocytomas are most common in children and teens and are benign brain tumors that can be cured. They grow slowly and have well-defined borders. Surgery is the standard treatment and is curative if all of the tumor can be safely removed. Radiation therapy may also be used if the tumor cannot be fully removed. Chemotherapy is sometimes recommended as an alternative to radiation therapy for very small children.
Grade 2 (Low-Grade Astrocytoma)
Grade 2 astrocytoma tumors are most common in adults. They grow slowly and often have “diffuse” borders, meaning that it can be difficult to tell where the tumor ends. This makes surgical treatment challenging. First-line treatment is surgical resection, and if the tumor can be removed completely, it provides the best overall prognosis and is, at times, curative. If the tumor cannot be completely removed safely, then either the residual mass is conservatively monitored and removed if further growth is noted, or treated with radiation or chemotherapy, depending on the genetics of the mass.
Grade 3 (Anaplastic Astrocytoma)
Grade 3 astrocytoma tumors are most common in adults. They grow faster than low-grade tumors and are more likely to invade neighboring tissue. Treatment depends on how far the tumor has spread. Surgery and radiation therapy are the standard, followed by chemotherapy to prevent further spread. Clinical trials are also available for anaplastic astrocytoma.
Grade 4 (Glioblastoma Multiforme)
Glioblastoma multiforme is the most common and invasive type of malignant brain tumor. Lower-grade astrocytoma tumors can sometimes evolve into glioblastomas. These tumors grow extremely rapidly and invade nearby tissue aggressively, making them difficult to treat. Complete surgical resection is impossible, meaning that radiation or chemotherapy is almost always recommended and required.
Is Astrocytoma Curable?
The definition of a “cure” is complicated in brain cancer treatment. For most diseases, a cure refers to complete eradication: the disease is no longer present in the patient. For brain cancer, however, this is often impossible. While low-grade astrocytoma tumors may be fully eliminated, anaplastic astrocytoma and glioblastoma are extremely difficult to eradicate completely.
Instead of eradication, neuro-oncologists often aim for long-term remission. When cancer is in remission, there is a significant reduction in symptoms. Though undetectable, the disease is not completely gone. Small amounts of cancer cells still exist inside the patient’s body.
Complete remission is not the same as a cure. Because some cancer cells may remain, there is still a risk of the cancer recurring. However, this does not mean that treatment was unsuccessful. Many patients live long, fulfilling lives after remission. If the cancer recurs, routine monitoring increases the likelihood that it is detected early enough for a successful second treatment.
Current Treatment Options for Astrocytoma
Treatment options for astrocytomas depend on the tumor’s size, grade, and location, as well as how far it has spread. Over the last several years, there have been considerable advances in understanding the genetics of brain tumors. This allows the neuro-oncologist to better tailor treatment, knowing that tumors with specific genetic mutations or changes respond best to a specific chemotherapy. The patient’s age and overall health are also factors to consider. The neuro-oncologist, in collaboration with the neurosurgeon, will help the patient understand what to expect from treatments, such as:
- Surgery: Brain tumor surgery is the first-line treatment approach for almost all types of brain tumors, including astrocytomas. Complete resection is only possible when the tumor’s borders are clear, typically only in the case of Grade I and II astrocytomas, for instance, a pilocytic astrocytoma. Otherwise, neurosurgeons remove all the tumors that are visible on the imaging and during surgery, knowing that with high-grade, grades III and IV astrocytomas, cells that have crossed the border between the tumor and the brain may have invaded into normal brain tissue.
- Radiation therapy: This treatment kills tumor cells with a concentrated beam of radiation. It is the preferred choice for tumors that are surgically inaccessible due to their location. It is also used to eliminate tumor cells that remain after brain tumor surgery.
- Chemotherapy: This treatment uses strong drugs to kill cancer cells. It is often used during or after radiation therapy to stop cancer from spreading after treatment. It may also be used as an alternative to radiation therapy to prevent brain damage in young patients.
- Targeted therapy: An emerging treatment, this approach uses molecular science to precisely attack tumor cells without damaging healthy tissue. It is often effective when other treatments fail, but not all astrocytoma tumors have a corresponding targeted therapy.
Neurosurgeons and neuro-oncologists may also apply multiple treatments to the same tumor. This comprehensive approach helps to eliminate more of the cancer, making it more effective for high-grade astrocytoma.
Survival Rates
Astrocytoma survival rates vary widely between patients. Every case is unique, and treatment effectiveness hinges on multiple factors, including tumor size, location, and molecular and genetic features, and complete vs. partial resection, as well as the patient’s overall health. The estimated five-year survival rates for each grade of astrocytoma are as follows:
- Grade 1: nearly 100%
- Grade 2: 80%
- Grade 3: 45%
- Grade 4: 5% to 10%
It is important to keep in mind that survival rates are estimates based on large numbers of people. They do not necessarily predict the outcome for any individual patient’s case.
Looking Ahead with Cancer Research
Though brain tumor treatment is challenging, new discoveries are transforming the future of cancer care. Ongoing research is currently investigating multiple pathways for improving astrocytoma outcomes. Some of these include:
- Surgery: Advances in neuroimaging are helping surgeons differentiate tumor cells from healthy tissue, making surgical resection more effective. Improvements in neuro navigation and the use of virtual and augmented reality help surgeons more precisely locate and define the borders of brain tumors during surgery. Intraoperative use of fluorescence, a way of marking tumor cells, making them more easily seen and recognized through the microscope, is helping to guide tumor resections and improve safety and efficacy.
- Immunotherapy: Clinical trials are investigating immunotherapies that empower the patient’s immune system to combat cancer.
- Personalized medicine: Genetic analysis of brain tumors informs targeted treatments that attack specific cell mutations for more precise treatment.
- Other innovations: Nanomedicine, viral therapies, and novel drug combinations all represent promising avenues for further investigation.
Patients can get involved with these endeavors by enrolling in clinical trials. These are supervised tests to determine the effectiveness of new treatments in development. Participants can receive cutting-edge therapies while also supporting cancer research, meaning that everybody wins.
Find Expert Astrocytoma Treatment Near You in New Jersey
The diagnosis of a brain tumor, especially an astrocytoma, is always frightening and life-altering. Advances in surgical treatment and adjunctive treatment of focused radiation and chemotherapy maximize prognosis and have improved the quality and quantity of life. In addition, clinical trials are exploring advanced therapies that lead to improved survival rates for all grades of astrocytoma. Centers for Neurosurgery, Spine & Orthopedics is pleased to offer cutting-edge therapies for astrocytomas and other brain tumors at locations near you in New Jersey. Contact CNSO today to learn more or to schedule a consultation.
Frequently Asked Questions About Astrocytoma
Can low-grade astrocytoma tumors be cured?
Grade I and many grade II astrocytomas can be cured with complete surgical resection.
Are clinical trials for astrocytoma worth considering?
Clinical trials provide patients with access to advanced therapies that are still in development, potentially leading to an improved treatment outcome.
Who is a good candidate for astrocytoma clinical trials?
Candidacy for clinical trials depends on the patient’s unique case and what trials are currently accepting applicants. Patients can speak with their oncologist to find out about clinical trial opportunities.
