Astrocytomas are brain tumors that originate from a star-shaped type of glial cell. They are often found in the frontal lobe of the brain and spinal cord. They are usually low-grade, but can be high-grade.
Lower-grade astrocytomas grow very slowly and are more likely to be benign (not cancer). They may grow and cause symptoms such as headaches or mental status changes.
Astrocytomas are tumors (neoplasms) that start in cells called astrocytes, which are located in the brain and central nervous system. They are a type of glioma, which is a category of brain tumours that can be either benign or cancerous.
Most astrocytomas are low-grade and not considered cancerous. However, they can grow and enlarge over time, leading to symptoms like headaches, memory problems, vision changes and weakness on one side of the body. These symptoms are often caused by the increased pressure that the astrocytoma places on surrounding nerves and brain tissue.
Symptoms vary depending on what part of the brain the tumor is located in. The most common locations for astrocytomas are in the frontal lobes of the brain and the cerebellum. However, they can also occur in the brain stem and spinal cord.
Some astrocytomas are very localized, making it easy to distinguish them from surrounding brain tissue on MRI scans or during surgery. Doctors call these astrocytomas circumscribed. Others are diffuse, and blend in with surrounding tissue. These astrocytomas are called low-grade or grade II. Glioblastoma, or grade 4, astrocytomas are much more malignant than the other types of astrocytomas. They can either present as a progression from a lower-grade astrocytoma (10% of the time) or they can start in the brain as a grade 4 astrocytoma (90% of the time).
Researchers don’t know what causes most astrocytomas, but they do have some theories. For example, a mutation in the gene IDH (isocitrate dehydrogenase) contributes to the development of low-grade astrocytomas by producing a chemical that builds up inside healthy astrocytes and makes them grow abnormally. There is also a suggestion that ionizing radiation exposure, such as from radiotherapy, may be associated with the development of astrocytomas. Other possible risk factors include certain hereditary syndromes, including Li-Fraumeni syndrome and Von Hippel-Landau disease.
The first step in diagnosing astrocytoma is to have a physical examination and complete a neurological exam. The health care team will ask questions about your symptoms and perform a comprehensive neurological evaluation, including tests of cranial nerve function, motor strength, balance, coordination and reflexes. In some cases, a neurologist will order an MRI or CT scan of the brain and spine. These scans help doctors locate the area of the tumor and determine its grade. They may also perform an MRI with IV contrast, which shows the tumor more clearly by adding a dye that highlights it on images.
A neurologist (a doctor with special additional training in diagnosing disorders of the brain, spinal cord and nerves) performs a complete examination. Depending on your symptoms, they may order brain imaging tests to find the cause of your problem. These tests use a magnetic field and radio waves to create detailed pictures of your brain and spinal cord. The preferred test is magnetic resonance imaging (MRI). A computed tomography scan (CT or CAT scan) may be used in emergencies when the patient is in danger of losing consciousness.
MRI finds astrocytomas more accurately than a CT scan and is the diagnostic test of choice when a tumor is suspected. It can also provide important information on the grade of the tumor and whether it is IDH-mutant.
When you have a high-grade astrocytoma, your health care team may recommend surgery to remove the tumor. Your neurosurgeon works to remove as much of the tumor as possible while preserving normal brain function. If the tumor is in a place that makes it hard to remove, your doctor might suggest surgery combined with radiotherapy or chemotherapy.
Your doctor will also use imaging tests to help plan your surgery and determine the best way to remove it. These tests might include functional MRI or diffusion tensor imaging tractography. These techniques allow the surgeon to map out regions of the brain that control speech, movement and other functions to prevent damaging them during surgery.
After the operation, you will have regular appointments to check how well you are doing and monitor your condition. Your doctor might order a blood test to measure levels of certain hormones and chemicals in your body. These tests can help your doctor know if your astrocytoma is responding to treatment.
If your astrocytoma is IDH-mutant, you will receive adjuvant therapy with the chemotherapy drugs temozolomide and procarbazine, lomustine and vincristine (CCNUV). These medications kill cancer cells and can slow or stop tumor growth. You will also have radiation therapy after surgery, which uses high-energy rays to destroy the tumor and any remaining healthy cells.
The first step in assessing the symptoms of astrocytoma is a careful history and neurological examination, including a test of visual fields. A detailed history can provide clues to the onset, progression and nature of symptoms such as headache, nausea, vomiting or cognitive changes. It may also help doctors to locate the tumor in the brain and spinal cord, enabling them to make an accurate diagnosis.
If your doctor suspects that you have a tumor, they will order an imaging test to confirm the diagnosis. Magnetic resonance imaging (MRI) is the best test for identifying and diagnosing astrocytomas. This scan shows a picture of the brain and spinal cord, providing information about brain structure and function. It also can identify tumors, blood vessels and cysts. MRI is noninvasive, painless and highly accurate. CT scans are used when MRI is not available or when a patient is pregnant or has a metal implant in their body, such as a pacemaker.
Low-grade astrocytomas appear as well-defined, homogeneous, low-density masses on CT and do not show contrast enhancement. In contrast, many high-grade astrocytomas enhance on CT, suggesting increased blood flow and proliferation of cancer cells. These tumors are also more likely to have calcifications and cysts than lower-grade astrocytomas.
When surgery is possible, a brain surgeon, or neurosurgeon, removes as much of the tumor as is safely feasible. If the astrocytoma is located in an area of the brain that cannot be surgically removed, your doctor may recommend radiation or chemotherapy instead.
A biopsy is a sample of tissue that is removed from the tumor and sent to a laboratory for testing. The samples can be used to diagnose the astrocytoma, determine the prognosis and guide treatment. The biopsy may be performed during surgery or with a needle if the astrocytoma is in an area that is hard to reach with surgical tools.
Chemotherapy uses drugs to destroy cancer cells and prevent them from multiplying. Temozolomide (TMZ) is a commonly prescribed drug that works by changing the DNA of tumor cells, causing them to die unless they can repair the damage. It is now the standard treatment for all grade 3 and 4 astrocytomas, as well as some grade 2 astrocytomas that have not responded to surgery or radiation.
As with all tumors, the prognosis of astrocytoma depends on several factors, including grade, location, and treatment. Low-grade astrocytomas (pilocytic astrocytoma and diffuse astrocytoma) are generally more favorable than high-grade astrocytomas (grade 3-4 astrocytomas, or glioblastomas). The overall survival of astrocytoma patients is typically much higher with the use of radiation therapy in combination with chemotherapy than with surgical resection alone.
Your neurologist or neurosurgeon (a doctor with special additional training in disorders of the brain, spinal cord, and nerves) will perform a complete examination and take your medical history to learn about your symptoms, general health, and risk factors. A magnetic resonance imaging (MRI) scan or computed tomography (CT or CAT) scan will help locate the tumor and determine its type.
A biopsy is usually required to confirm the diagnosis and guide treatment. Because astrocytomas are composed of glial cells, they are usually non-invasive and do not spread to other parts of the body.
Diffuse astrocytoma may develop in any part of the brain and nervous system, but most commonly in the cerebellum, cerebrum, spinal cord, or central area of the brain. These tumors cause a variety of symptoms, depending on their location and size. Symptoms include seizures, headache, weakness, vision changes, problems with thinking, balance, or memory, and personality or behavior changes.
If the tumor is in a region that is accessible, the treatment goal is to remove as much of the tumor as possible through surgery. However, this is not always possible because of the risk of damaging other vital brain structures with surgical resection. Stereotactic biopsy can be used to obtain a tissue sample for diagnosis in cases where surgical resection is not possible or preferred. Alternatively, drainage of cerebrospinal fluid with a ventriculoperitoneal shunt or external ventricular drain (EVD) may be necessary to decrease intracranial pressure and improve patient outcome.
For anaplastic astrocytoma, which is considered a more malignant evolution of a lower-grade astrocytoma, surgery is not curative and must be followed by radiation and almost always by chemotherapy. The chemotherapy drug temozolomide (TMZ) works by changing the DNA of cancer cells, which makes them die. This is the first-line adjuvant treatment for all grades 3-4 astrocytoma and sometimes also for grade 2 astrocytoma, depending on WHO classification.
Astrocytomas are a type of brain tumor. They form from astrocytes, star-shaped supportive cells that are found throughout the central nervous system.
These tumors are divided into different grades, based on how abnormal the cells look under a microscope and how quickly they grow. Your doctor will decide on a treatment plan based on the grade of your astrocytoma and where it is located.
Seizures are the most common symptom of an astrocytoma and can occur in people of any age. They happen when a tumor puts pressure on brain nerves, which can affect the way we think, learn, focus, and solve problems. Seizures are a serious symptom that shouldn’t be ignored or left untreated.
If you have seizures, your doctor will want to do a neurological exam and may recommend an MRI scan or CT scan. The test will help them find out which part of your brain is affected and what type of seizure you’re having.
It’s important to let your provider know how often and how severely the symptoms are affecting you. This can help them decide what treatment is best for you. They might recommend draining excess fluid from your skull (draining the cisterna magna) or taking medicine to help reduce pressure inside your head.
Symptoms are different for everyone, but they can include feelings like headache or changes in your personality. The severity of the symptoms will also depend on the size and location of the tumour and how much brain is affected.
Lower-grade astrocytomas are more likely to cause seizures than higher-grade ones. This is because they’re more likely to displace brain tissue instead of destroying it, and they tend to be associated with less brain swelling than malignant astrocytomas. Seizures can also be a symptom of other, lower-grade tumours such as oligodendrogliomas and ganglioblastoma. They are more likely to affect the temporal lobe than other types of brain tumours, and can be linked to hereditary epilepsies, head injury, or radiation exposure during childhood. The kh2 maps of low-grade astrocytoma show that there are significant clusters in both hemispheres involving the temporal and insular cortex, whereas other symptoms such as weakness in the limbs or difficulty thinking and speaking are more often found in frontal lobe locations.
Headaches are a common symptom of brain tumors. However, headaches alone are not a significant early symptom. In fact, most headaches can be caused by a variety of factors, including stress, lack of sleep, or over-the-counter painkillers. Headaches are often the first symptom of malignant astrocytoma, but they may also be present in people with benign tumors or other types of brain tumors.
When a brain tumor is growing, it can cause increased pressure inside the skull (intracranial pressure). This can lead to symptoms such as headaches, nausea and vomiting and changes in mental status.
These tumors develop in the central nervous system (CNS) from star-shaped cells called astrocytes. They are one of several types of brain cells called glial cells that provide supportive tissue in the CNS. When these cells grow out of control, they can form a brain tumor called an astrocytoma.
Astrocytomas are classified by their grade. The higher the grade, the more likely the tumor is to spread and invade other brain tissue. In general, astrocytomas that do not invade other brain tissues grow more slowly than those that infiltrate other brain tissue.
In a study of 111 patients with a brain tumor, headaches were present in 48%. The majority of the headaches were bifrontal and worse ipsilaterally. The headaches were similar to migraine or tension-type headaches and most occurred in the morning. The headaches were also made worse by bending over or lying down. For most patients with a brain tumor, the treatment for the tumour will include treating the associated symptoms. This is known as palliative care and can help improve quality of life while the tumour is being treated.
When a tumor grows, it can create pressure on the skull and cause symptoms like nausea. This pressure can also affect other areas of the central nervous system, such as the spinal cord, which can cause weakness and changes in sensation and movement. The type of symptoms may vary depending on where the astrocytoma is located and what grade it is.
People with astrocytomas often describe feeling tired and fatigued. This can be a sign that the astrocytoma is in an area of the brain that controls important functions, such as motor control. It can also be related to the presence of a tumor in the cerebellum, which can cause balance and coordination issues. People with astrocytomas in the brain can also experience changes in their personality or mood, including feelings of depression. They may also have trouble sleeping or experience changes in their appetite.
Astrocytomas are tumors that form from the star-shaped cells known as astrocytes, which are essential for supporting the functions of neurons in the brain and nervous system. They are part of the group of tumors called glial cells, which also includes oligodendrocytes and ependymal cells. These cells can grow uncontrollably, forming a mass or tumor. Astrocytomas are usually classified as low- or high-grade, with lower-grade astrocytomas being slow-growing and less aggressive.
The most common treatment for astrocytomas is surgical removal, which usually helps reduce the symptoms they cause. The tumor can be removed through a craniotomy (opening in the skull) or via stereotactic volumetric techniques. The surgeon can then evaluate the tumor for microscopic diagnosis using MRI scans, which can help determine its grade and other characteristics. Following surgery, patients are often treated with chemotherapy to prevent the tumor from returning.
Astrocytomas are the most common type of brain tumor. People often have vomiting as a symptom because the growing tumor puts pressure on the brain and can affect other functions, such as speech and vision. Other symptoms include headache, weakness or numbness in one part of the body, memory loss, and changes in personality.
The brain tumor may also cause a general feeling of being unwell, although this can vary depending on where the tumor is located in the brain and how fast it’s growing. If the tumor causes seizures, a person might have trouble thinking clearly and might be confused or unable to make decisions. If the astrocytoma is in the frontal lobe, it can cause changes to speech or problems with balance and coordination.
Your doctor can tell you more about your astrocytoma, including whether it’s a low-grade tumor that’s likely to be cured by surgery or a high-grade tumor that might grow rapidly and spread beyond the area of the brain where it originated. Your doctor will create a treatment plan based on the type of astrocytoma, where it is in your brain, how fast it’s growing, and your symptoms.
The doctor will examine you and might order special tests that show how abnormal the astrocytoma cells look under a microscope, as well as information about genes and proteins in those cells. These tests can help your doctor understand how quickly the tumor might grow and whether it’s more likely to spread than other types of brain cancer, such as a glioblastoma. Your doctor will also use this information to create a prognosis, which is a prediction of how your treatment will work and your chances of survival.
If you have a brain tumour, your doctor will need to find out as much about the type, position and size of the tumour so that they can plan treatment. You’ll have an MRI scan or brain CT to check the area and may have a biopsy to get a small sample of the tumour to test. You’ll also have treatment for your symptoms, sometimes called palliative care, while you’re having the main treatment or for a while after it finishes.
General symptoms caused by the tumor growing and creating pressure inside your skull include headache and vomiting. These symptoms are usually mild but can be more severe, particularly if the astrocytoma is grade III or above (called glioblastoma). A rapidly growing tumor can lead to changes in your mental status and personality. This can cause drowsiness, lethargy and a lack of interest in things. It can also affect your memory and emotions, and cause a range of motor (movement) problems including problems with balance and coordination, difficulty speaking and trouble with your vision.
Gliocytomas are tumors that develop in your central nervous system and grow from star-shaped astrocyte cells. They can be either benign (noncancerous) or cancerous (malignant).
A pilocytic astrocytoma is usually a low-grade tumor that looks like normal cells under a microscope and grows slowly. It doesn’t usually spread to other parts of the body and removing it can cure the condition. However, if it returns, your doctor will need to know its molecular characteristics to determine the best treatment option for you. These include surgery, radiation therapy, chemotherapy/immunotherapy and clinical trials. These treatments are used to manage the symptoms of the tumor and prevent it from coming back.
Astrocytomas are the most common brain tumor in adults. It’s not clear what causes most astrocytomas, but radiation exposure and genetic changes increase your risk.
Surgery cures most grade 1 astrocytomas that are located in surgically accessible areas. Radiation therapy and some medications help prevent recurrence.
Your health care team will test the biopsy tissue for signs of other types of brain cancer and look for mutations in your genes. This helps guide your treatment.
Astrocytomas are noncancerous tumors that grow from star-shaped astrocyte cells, which are part of the glial (supportive) tissue in your central nervous system. They are part of a group of tumors called gliomas, which also includes oligodendrocytes and ependymal cells. These tumors develop in the brain and spinal cord. They can be benign or cancerous (malignant).
There are several treatments for astrocytomas. Which one you get depends on the grade of your astrocytoma, where it is located in your brain and whether it spreads. Your doctor may also consider whether you have certain mutations in your genes.
Your doctor may give you a chemotherapy drug, such as temozolomide (Temodal), to destroy cancer cells and prevent them from multiplying. This is an adjuvant therapy, which means it is used along with surgery and radiation to treat astrocytomas. You may also receive antiseizure medication to prevent seizures, if they are a problem. Typically, these are drugs that suppress your brain’s nerve cell activity, such as levetiracetam (Keppra).
Low-grade astrocytomas can usually be cured by surgery, especially if your neurosurgeon can safely remove all of the tumor. Radiation to partially resected high-grade astrocytomas increases postoperative survival rates, but the treatment doesn’t cure the disease.
If you have a recurrent or aggressive grade 3 or 4 astrocytoma, your doctors might give you adjuvant therapy to help prevent it from coming back after surgery and radiation. This is often a combination of the chemotherapy drug procarbazine, lomustine and vincristine (PCV) plus radiation therapy.
You might have a port (or shunt) inserted during surgery to deliver chemotherapy or other medications directly into your body. You may also use a catheter, which connects the port to a large vein in your chest.
You might be able to participate in a clinical trial that tests new treatments for astrocytomas, including immunotherapy and gene therapy. These treatments boost your immune system so it can recognize and kill cancer cells. They might be more effective than standard treatment options. Talk with your doctor about participating in a clinical trial.
Astrocytoma treatment requires a multidisciplinary team of neuro-oncologists, neurosurgeons, radiation oncologists, and neurologists. The use of molecular diagnostics, particularly IDH mutation status, informs prognosis and guides treatment strategy. The goal is maximal safe resection with a minimum of neurological deficits. The most effective management also involves addressing potential risk factors, empowering patients with knowledge of their disease and treatment options, and encouraging patient advocacy and participation in shared decision-making.
A pleomorphic astrocytoma is well-circumscribed and grows slowly, usually in the cerebellum. This is a low-grade tumor that does not invade into surrounding brain tissue, and it can be completely resected with surgery alone. Radiation oncology can improve outcomes in this patient group by prolonging PFS at 5 and 10 years compared to observation.
Diffuse or infiltrating astrocytomas grow into nearby areas of the brain. They can be cured with surgery and are typically grade 2 tumors. They most often affect young adults. Radiation can help control symptoms and may be used in combination with chemotherapy.
Anaplastic astrocytomas are more aggressive than other types of astrocytoma and grow at a faster rate. They can spread to other parts of the brain and have a more malignant appearance, requiring more intensive therapy including radiation and chemotherapy.
Low-grade astrocytomas may develop as a result of ionizing radiation exposure during childhood or from warfare chemicals, especially Agent Orange, in Vietnam veterans. They can also occur in people who have tuberous sclerosis, a genetic condition that causes tumors to grow in the ventricles (fluid-filled spaces deep inside the brain). It is important for people to be aware of the symptoms of astrocytoma and visit their doctor regularly, so they can be treated early.
A brain tumor biopsy can provide information about astrocytoma’s type and grade, as well as the likelihood that it will grow or recur. It also gives doctors a sample of the tumor for laboratory testing to find out what proteins and mutations are present, which may be helpful for choosing therapies. There are many clinical trials that test combinations of surgery, radiation and chemotherapy for astrocytoma.
Surgical removal of the tumor, or as much of it as possible, is usually the first treatment option for any type of astrocytoma. The goal is to relieve pressure on surrounding areas of the brain and skull and prevent the growth of additional tumors. In addition to removing the underlying tumor, surgery may also include biopsy to confirm diagnosis and identify molecular characteristics that might indicate whether the cancer is likely to recur. If a recurrent astrocytoma is detected, radiation therapy or chemotherapy may be recommended.
The most common astrocytomas are grade 1 and 2, which grow slowly and do not spread to other areas of the brain. Surgical removal of these tumors can often completely cure them. In contrast, grade 3 and 4 astrocytomas are very aggressive and usually grow rapidly. The survival rates for astrocytomas vary by grade, age and location of the tumor in the brain. The exact statistics can be confusing, so it is important to talk with your healthcare team about what to expect for you.
Pilocytic astrocytomas are well circumscribed tumors that grow slowly. They tend to be more common in the cerebellum, which means they may be able to be removed completely without damaging patients’ normal function. The prognosis for these tumors is favorable, especially when compared to other brain tumors such as glioblastoma multiforme (GBM).
Diffuse or infiltrating astrocytomas, which grow into and into other areas of the brain, are harder to treat and have lower survival rates than ploidy astrocytomas. Patients with these tumors may require adjuvant therapy to help destroy cancer cells that aren’t completely eliminated by surgery and/or radiation.
A multidisciplinary approach to treatment is essential for patients with astrocytoma. This includes neurosurgeons, neurologists, radiation oncologists, neuropathologists and others with advanced training and extensive experience in treating astrocytomas and other types of brain tumors. Ideally, you should seek care at large medical centers where specialists work together to provide patients with comprehensive treatment. Our expert teams can offer a variety of cutting-edge treatment options, including stereotactic radiosurgery, which uses highly focused beams of radiation to target tumors in deep or otherwise difficult-to-reach places.
In addition to surgery and radiation, we offer a variety of other options for the treatment of astrocytomas in adults. These include immunotherapy and gene therapy. These therapies use drugs or genetic material to activate your body’s immune system so it can recognize and destroy cancer cells, as well as other cells that might be causing symptoms. They are available through Weill Cornell Medicine’s clinical trials program.
Glial tumors like astrocytomas are part of a larger group of brain tumors called gliomas. They grow from star-shaped glial cells that support neurons in the brain and spinal cord. These cells can grow and press on the brain, preventing it from functioning properly. Most astrocytomas are noncancerous (benign) and do not spread to other parts of the brain. However, some astrocytomas are malignant (cancerous) and grow quickly. These astrocytomas may spread to other areas of the brain and cause other symptoms.
The most common way to treat an astrocytoma is through surgery. A brain surgeon, also known as a neurosurgeon, will try to remove as much of the tumor as possible. Surgical removal can lower symptoms caused by the tumor, such as pressure on nerves or seizures. However, the tumor is often located in a spot that makes it difficult or impossible to remove completely. If this is the case, other treatments are usually given after surgery.
If the astrocytoma is malignant, it will likely come back even after surgery and other treatments. That’s why we continue to look for new treatments. Our experts work together to develop personalized treatment plans for each patient.
Some astrocytomas are low-grade, meaning they grow slowly and are not considered cancerous. Your health care team will consider whether the astrocytoma is low-grade or high-grade when creating your treatment plan.
Other types of astrocytomas grow more quickly and are cancerous, but the prognosis is still relatively good for these tumors. These include circumscribed astrocytoma, pediatric-type diffuse low-grade gliomas and glioneuronal and neuronal tumors. These are all part of a group of brain tumors called gliomas and are found in different parts of the central nervous system. However, tumors that occur in the brain stem have a poor prognosis, including diffuse intrinsic pontine glioma (DIPG) and ependymoma.
