Astrocytoma Surgery in New Jersey

P
atients require support and compassion while dealing with an astrocytoma diagnosis. The medical team they choose should provide these resources to help make recovery easier.

At Centers for Neurosurgery, Spine & Orthopedics (CNSO), the team of neurosurgeons, brain care physicians, rehabilitation specialists, interventional pain management physicians, and certified physical therapists can assist patients throughout northern New Jersey with astrocytoma and other conditions.

What Is Astrocytoma?

An astrocytoma is a type of brain tumor that develops in astrocytes. Astrocytes are star-shaped glial cells that make up most of the central nervous system. An astrocytoma is typically slow-growing and can potentially disrupt surrounding brain tissues in patients of any age.

Types and Grading an Astrocytoma

Patients become diagnosed with a type and grade of astrocytoma, based on the severity of the tumor growth. If a patient has a low-grade tumor, this means the growth is in its early stages, and neurosurgeons consider it a Grade 2. Low-grade tumors typically do not spread to other brain areas and grow slowly over time. High-grade tumors are called glioblastoma multiforme (GBM), and neurosurgeons categorize them as Grade 4 tumors. GBMs can stem from low-grade astrocytomas or oligodendrogliomas.

The type and grade of astrocytoma a patient is diagnosed with can affect which treatment they receive. For example, neurosurgeons may choose to wait to remove a low-grade tumor, such as a melanoma, if it is not of a malignant type and is not causing or expected to cause any symptoms. In other cases, they must surgically remove the tumor to provide the patient with a better prognosis. High-grade tumors most commonly need to be removed as soon as possible. This means patients must seek the advice of a neurosurgeon as soon as possible.

Diagnostic Procedures for an Astrocytoma

A brain tumor may be discovered as an incidental finding or during a workup for unexplained signs and symptoms. Testing in which a brain tumor would become visualized is imaging exams of the head, such as magnetic resonance imaging (MRI), computed tomography (CT) scans, and positron emission tomography (PET) scans. After a patient has been diagnosed with a brain tumor, they will need to meet with a neurosurgeon who can identify the type of brain tumor and the subsequent treatment. Often by reviewing an MRI, the neurosurgeon can determine whether the tumor is an astrocytoma or a meningioma. Patients who consult with CNSO neurosurgeons will experience compassionate care during this diagnostic period and throughout the treatment.

In many cases, neurosurgeons cannot accurately determine the grade or type of astrocytoma without accessing the tumor directly. This means neurosurgeons must perform a minor minimally invasive brain surgery to take a small sample, called a biopsy of the tumor. If the tumor is small enough, the CNSO neurosurgeon may remove it during the biopsy. In either event, the specimen is sent to the pathology laboratory for testing to determine the type and stage of the tumor.

Multidisciplinary Approach

CNSO takes a comprehensive, conservative approach to care. Collaboration with the patient and several specialists is essential. That is why CNSO neurosurgeons, oncologists, radiologists, nurses, physical therapists, and occupational therapists work closely together to ensure personalized care. The CNSO medical team considers all aspects of a patient’s medical history and lifestyle when determining the right treatment plan.

Pre-operative Preparations

To prepare for surgery, patients must first undergo a thorough medical evaluation. The medical history assessment is a critical factor in determining how the neurosurgeon will deliver treatment. The CNSO team provides the resources to help navigate the processes and gives patients the support they need.

Surgical Techniques

To remove an astrocytoma tumor through surgery, neurosurgeons may use one of the following procedures:

• Stereotactic Radiofrequency Surgery: Uses imaging markers to map the location of the tumor.
• Craniotomy: This surgery involves direct visualization of the tumor by creating a small access opening in the skull.
• Endoscopic: For this access technique, neurosurgeons use endoscopic instruments to visualize tumors and allow access for their removal.
• Intraoperative MRI guidance: Neurosurgeons use real-time MRI technology to guide them throughout surgery.
• Linear Accelerator Therapy: Use of SRS technology and the Linear Acceleratory Equipment
• Gamma Knife Technique: Use of SRS technology and the Gamma Knife Equipment

CNSO neurosurgeons remove tumors through minimally invasive surgery. During minimally invasive brain surgery, neurosurgeons eliminate the tumor through small incisions or existing anatomical openings. For example, neurosurgeons can access some smaller tumors through the patient’s nostril.

Because this surgical method requires fewer incisions and less trauma, patients experience faster recovery times and more comfortable healing. However, not all tumors can be removed using minimally invasive approaches.

Recovery and Post-operative Care

Immediately following brain surgery, patients begin their recovery closely monitored as is provided within an intensive care unit (ICU). From there, the patient will begin the process of healing. If the brain tumor was causing significant symptoms before the surgery, the patient’s recovery will include a rehabilitation plan to regain their full functioning capacity. Before patients go home, neurological specialists will provide the patient with the continuation plan of their follow-up with the neurosurgeon and outpatient-based physical therapy plan, answering questions and providing clarity. They will then schedule follow-up appointments, which patients must attend so neurosurgeons can see how the surgery is healing.

Adjuvant Astrocytoma Treatments

Adjuvant cancer treatment is chemotherapy or radiation. Part of a patient’s care plan may involve radiation therapy and surgery or radiation alone. Neurosurgeons can treat many cancers using radiation therapy, including an astrocytoma. Radiation therapy uses high-energy, intense X-ray beams to shrink tumors and kill cancerous cells. In some cases, radiation therapy can replace surgery as a treatment. In other cases, the therapy can be used alongside surgical efforts.

Another targeted radiation therapeutic option is the use of proton radiation therapy. There are centers in both New Jersey and New York that are coordinated with the CNSO neurosurgeon’s care. Proton therapy is a consideration when the tumor is near extremely sensitive surrounding tissue or organ structures.

Chemotherapy is another cancer treatment option that may be used along with surgery and radiation or with only surgery. Chemotherapy is the use of specific medications that target tumor growth and stop it from progressing.

Managing Treatment Side Effects

Patients can manage some symptoms, like nausea or fatigue, with medications. CNSO brain care specialists offer medication management treatments and injections to help alleviate discomfort. Patients experiencing cognitive changes may need an occupational therapist. If there are physical limitations, physical therapy can assist with stretching and strengthening the affected musculoskeletal system and nervous system through neuromodulation techniques. Physical therapists can help patients regain strength and relearn bodily functions.

Advances in Astrocytoma Research

Developments in treatments for patients with astrocytoma are currently ongoing with positive results. In a study by the American Society for Clinical Oncology, researchers explore the efficacy of a new targeted therapy on Grade 2 astrocytoma tumors.

Additionally, the study revealed that targeting IDH glioma mutations was effective in treating astrocytoma cases. This opens new doors for researchers to continue testing new treatments.

Second Opinion and Patient Empowerment

Patients should always advocate for their own health and CNSO will help any patient receive the optimum treatment so they can continue living healthy lifestyles. If a patient receives a diagnosis of a brain tumor or has questionable imaging results and wants a second opinion, CNSO will review a patient’s images and provide a more detailed description along with treatment options. Patients can then feel comforted by the comparison of a second or even third opinion.

Frequently Asked Questions About Astrocytoma

What Is the Typical Recovery Time after Astrocytoma Surgery?

Recovery times can vary depending on the patient’s age, general health, and complications (if any) following surgery. Patients must remain in the hospital for a few days after surgery and continue healing at home for another six to 12 weeks. Recovery time depends on the mental and physical medical condition of the patient before the surgery.

Can Minimally Invasive Procedures Fully Remove High-Grade Tumors?

Minimally invasive procedures are ideal for smaller, lower-grade tumors and may not be the best option for a large, high-grade tumor. Ask the neurosurgeon for their opinion about the best approach to minimize the chances of recurrence.

How Do I Choose the Right Neurosurgery Center for Treatment?

Patients should feel as though they are working with the finest professionals, who are extremely attentive to detail. Also only consider a facility that puts patient comfort at the forefront of their concern and is conveniently located in proximity to the patient’s home. CNSO represents all these critical factors and also makes treatment convenient by offering locations in every county in Northern New Jersey. Further, CNSO has all aspects of consultations and follow-up care, including physical therapy and pain management.

What Are the Chances of Tumor Recurrence After Surgery?

While neurosurgeons can remove all or most of a low-grade tumor through surgery, many high-grade tumors are challenging to eliminate because of the way they infiltrate the brain in a tentacle-like growth pattern. This is why it is best not to wait until you have a diagnosis of a malignant brain tumor. While all tumors have a chance of returning after treatment, high-grade tumors are more likely to recur. This is especially true if part of a tumor or cancerous cells remain in the body.

Are There Alternative Treatments to Surgery for Astrocytoma?

If a tumor is low-grade, a neurosurgeon may advise the patient to opt for careful watching and monitoring. Patients can also undergo alternative therapies, like chemotherapy, radiation therapy, or proton radiation therapy.

Find Expert Neurosurgery at CNSO

Brain surgery is effective for patients with various grades of astrocytoma tumors. Adjuvant therapy may also be required for a long-lasting cure. Patients can find compassionate, award-winning surgical and medical care at CNSO.

Serving patients throughout northern New Jersey, including Bergen, Passaic, Essex, Morris, and Hudson counties, the dedicated surgical and non-surgical CNSO team provides comprehensive, coordinated care. To learn more about astrocytoma treatment, contact us today.

What Is Lymphoma in the Brain?

Lymphoma is a type of cancer that begins in the white blood cells called lymphocytes. These lymphocytes travel throughout the body and are integral to the functioning and strength of the immune system. When lymphocyte cells become cancerous, they can begin to form a tumor. A lymphoma is a tumor of the lymphocyte. A lymphoma in the brain also can be called a central nervous system (CNS) lymphoma. There are two main types of CNS lymphoma:

• Primary CNS lymphoma: This type of lymphoma is a tumor that originates in nervous tissue such as the brain, spinal cord, or nerves.
• Secondary CNS lymphoma: This type of tumor initially forms somewhere in the body other than the nervous system but then spreads to the nervous system.

Both types of CNS lymphomas are subtypes of high-grade non-Hodgkin B-cell lymphoma, which is rare and aggressive.

Signs and Symptoms of Lymphoma in the Brain

Because the brain controls various functions, movements, feelings, sensations, and behaviors, a tumor in the brain can cause symptoms that affect these functions, depending on where within the brain the tumor grows. Symptoms can change as the tumor grows and presses on surrounding structures. Some patients with lymphoma in the brain may experience fewer, milder symptoms, while others experience more frequent, severe symptoms. This will typically depend on the size and location of the tumor, as well as how fast it is growing. Symptoms of lymphoma in the brain can include:

• Confusion
• Headaches
• Personality or cognitive changes
• Loss of hearing
• Difficulty speaking
• Nausea and vomiting
• Weight loss
• Numbness, tingling, or pain
• Seizures

CNS lymphoma also can affect a patient’s vision, leading to problems like blurred vision. If CNS lymphoma spreads to the spinal cord, patients may experience back pain or weakness in the arms and legs or both.

Causes and Risk Factors of Lymphoma in the Brain

Although there is no clear cause of lymphoma of the brain, there are a few risk factors that can increase a person’s chance of developing this condition:

• Age: This type of tumor tends to be more common in men than in women.
• Gender: This type of tumor occurs more often among people in their 50s, 60s, and 70s, with a median diagnosis age of 55.
• Compromised immune system: Having a compromised immune system due to HIV/AIDS, an organ transplant, previous cancer, etc. can increase a person’s risk of developing lymphoma in the brain.

If a patient has advanced lymphoma in another part of the body, they are also at a higher risk of developing secondary lymphoma in the brain.

Diagnosing Lymphoma in the Brain

To diagnose lymphoma in the brain, a range of diagnostic tests are used. These may include:

• Physical and neurological exam: The doctor will inspect the patient, check for symptoms, and assess mental status, coordination, reflexes, etc. to gain more insight into the patient’s condition.
• Imaging scans: Scans like MRIs are used to visualize the brain, identify possible tumors, and see their location and size.
• Biopsy: A biopsy involves removing a sample of the tumor to examine the tissue and see if it is cancerous, usually through a stereotactic method.
• Lumbar puncture: This procedure involves inserting a needle into the lower back to collect samples of fluid that bathes the spine and brain to see if any evidence of cancer is present there.
• Slit-lamp eye exam: If a patient has symptoms with their vision, this test using a special microscope with a bright, narrow slit of light may be used to check the outside and inside of the eye.

After brain lymphoma is diagnosed, it is often given a stage to indicate how large the tumor is and whether it has spread. The neurosurgeons at Centers for Neurosurgery, Spine & Orthopedics often use multiple diagnostic tests to determine whether a patient has lymphoma of the brain or other tumor, then develop the best treatment plan.

Treatments for Lymphoma in the Brain

There is no standard treatment option for lymphoma of the brain. The best option for each patient will depend on factors such as age, other health conditions, HIV status, and stage of cancer. Treatment plans for lymphoma of the brain often will consist of one or more of the following options:

Chemotherapy

Chemotherapy (chemo) often is an initial treatment option for patients with lymphoma in the brain, especially if recently diagnosed. It is a powerful drug treatment that helps kill cancer cells in the body to prevent cancer from spreading or growing larger. It is most often administered intravenously through an IV and may be given daily, weekly, or monthly. A specific type of chemotherapy drug often is used for lymphoma in the brain because it has a chemical structure that lets it permeate the blood-brain barrier.

Radiation Therapy

Radiation therapy is another treatment option for patients with lymphoma in the brain. This therapy uses strong energy beams to kill cancer cells or stop them from growing. It is often used in combination with chemotherapy but can be used alone or with other treatments.

Targeted Therapy

Targeted therapy is a treatment option for some patients. This therapy uses medicines or substances like proteins and antibodies to target specific parts of cancer cells that help them grow and survive. For lymphoma in the brain, targeted therapy treatment often will include monoclonal antibodies that attach to specified targets on the cancer cells, causing them to die or shrink.

Steroid Therapy

Another possible treatment option for lymphoma in the brain and its tendency to cause swelling is steroid therapy, or the administration of corticosteroid medicines. These drugs can help reduce inflammation in the body, shrink cancer cells, and provide symptom relief. Steroid therapy also can help alleviate side effects of chemotherapy like nausea, vomiting, and pain.

Proton Therapy

A treatment option for patients with chemotherapy-resistant lymphoma tumors is proton therapy, which uses targeted high-dose radiation. Because it is extremely precise, this treatment is beneficial for treating tumors that are hard to reach or near sensitive structures.

Surgery, Clinical Trials, and Other Options

Lymphoma may require its removal via brain surgery. At CNSO, the neurosurgeons use minimally invasive techniques to minimize scarring and reduce recovery time.

Regarding clinical trials, depending on the type of lymphoma and location within the brain, some patients may benefit from participation in a clinical trial, a stem cell transplant, or even a combination surgery.

At Centers for Neurosurgery, Spine & Orthopedics, neurosurgeons and other specialists collaborate to develop an appropriate treatment plan for each patient with lymphoma in the brain.

Recovery From Lymphoma in the Brain

Since lymphoma of the brain is a fast-growing and aggressive cancer, it can be challenging to treat. One challenge is the existence of the blood-brain barrier, which protects the brain from potentially hazardous chemicals and can limit the effectiveness of chemotherapy to enter the brain and begin shrinking the tumor. Another is that lymphoma tumors are often located deep inside the brain, making open brain tumor surgery difficult sometimes, but not impossible. These challenges can affect patients’ prognoses and recovery.

The five-year survival rate for people under 70 with CNS lymphoma is 30%, but this is a general number and doesn’t factor in other considerations that can affect survival. A patient’s survival rate will depend on several factors, like their age, overall health, HIV status, and the size and location of their tumor. Patients diagnosed with lymphoma in the brain should speak to their oncologist or neurosurgeon about treatment options and reoccurrence chances to understand their specific recovery outlook.

Why Choose Centers for Neurosurgery, Spine & Orthopedics?

Centers for Neurosurgery, Spine & Orthopedics is New Jersey’s most comprehensive brain and spine treatment center, treating a wide variety of conditions and diseases. The multi-specialty medical team at CNSO takes a conservative approach, working in conjunction with oncologists, radiologists, and other supportive specialists as their patient moves through medical and surgical treatment.

The comprehensive care team consists of board-certified neurosurgeons, reconstructive surgeons, orthopedic spine surgeons, pain management physicians, physiatrists, and physical therapists, carefully creating customized treatment plans for every patient. The compassionate doctors make sure to explain the possible treatment options and which method they believe would be most effective for the patient’s diagnosis. Along with high-quality medical care, patients at CNSO also benefit from:

• A medical team that is fluent in multiple languages (English, Spanish, Korean, Russian, Serbo-Croatian, Mandarin Chinese, and Hebrew)
• Award-winning specialists who have been educated at the top institutions in the country
• Availability of both surgical and non-surgical treatment options
• State-of-the-art technology for inter-operative monitoring, stereotactic radiosurgery, minimally invasive brain surgery, etc.
• Office locations throughout northern New Jersey in Bergen, Passaic, Essex, Hudson, and Morris counties
• Telemedicine appointments available to increase accessibility and reduce downtime

From diagnosis to treatment, the team at CNSO is here to help patients with brain, spine, and nerve conditions get the care they need to feel better.

Frequently Asked Questions about Lymphoma in the Brain

How rare is lymphoma in the brain?

Lymphoma in the brain is rare, accounting for around 2 to 5 percent of all primary brain tumors. About 1,500 people in the United States are diagnosed with lymphoma in the brain each year.

How does lymphoma in the brain affect people with HIV/AIDS differently?

First, people with HIV or AIDS are more likely to develop lymphoma in the brain because of their immunocompromised bodies. Primary CNS lymphoma is 1,000 times more common in HIV-infected people than in the general population. Therefore, screening for lymphoma in the brain is recommended for people with HIV/AIDS.

Patients who have HIV/AIDs and are receiving treatment for lymphoma in the brain should continue their antiretroviral therapy (ART).

Can lymphoma in the brain be treated with open surgery?

A lymphoma in the brain is often treated with brain surgery to remove the tumor. The treatment also requires other medications to prevent the regrowth of the tumor.

How does a stem cell transplant work for treating lymphoma of the brain?

A stem cell transplant can be used to treat lymphoma of the brain in combination with chemotherapy. High-dose chemotherapy destroys blood-forming cells that are needed to fight cancer. A stem cell transplant replaces the damaged cells with healthy ones after high doses of chemo to allow the bone marrow to recover and blood cells to reproduce. These new blood cells can then create an immune response that will destroy the cancer.

When is treatment for lymphoma in the brain most effective?

Treatment of lymphoma in the brain is most effective when the tumor hasn’t spread outside the cerebrum, the patient is younger than 60, and the patient is not immunocompromised. However, every patient and case is different, and some people who don’t meet these parameters often experience successful treatment.

Find Brain Lymphoma Treatment at CNSO

Patients who have recently been diagnosed with lymphoma in the brain should get prompt treatment for the best prognosis. By having lymphoma treatment from the best brain surgeons like those at Centers for Neurosurgery, Spine & Orthopedics, patients receive the highest quality care and compassion. The multi-specialty neurosurgical team at CNSO is well-versed in treating brain lymphoma and other types of brain tumors at multiple office locations across northern New Jersey. For more information about lymphoma treatment options available, contact CNSO today.