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An astrocytic tumour is a type of brain tumour. This information describes astrocytic tumours, their symptoms, how they’re diagnosed and possible treatments. It should ideally be read with our general information about brain| or spinal cord tumours|.
We hope this information answers your questions. If you have any further questions, you can ask your doctor or nurse at the hospital where you are having treatment.
The central nervous system (CNS) is made up of the brain and spinal cord. Cells in the CNS normally grow in an orderly and controlled way. If for some reason this process gets out of control, the cells continue to divide and form a lump called a tumour.
A tumour may be either benign or malignant. Benign tumours may continue to grow, but the cells do not spread from the original site. In a malignant tumour, the cells can invade and destroy surrounding tissue and may spread to other parts of the brain.
Tumours affecting the CNS are fairly rare. Each year about 9,000 people in the UK are diagnosed with primary brain or CNS tumours. Around 5,000 of these tumours are malignant.
Diagram showing the lobes and functions of the brain
View a large version of the diagram showing the lobes and functions of the brain|
Within the brain and spinal cord are nerve cells, and cells that support and protect the nerve cells. The supporting cells are called glial cells. A tumour of these cells is known as a glioma.
Astrocytic tumours are the most common type of glioma and develop from a star-shaped cell called an astrocyte. They can occur in most parts of the brain and occasionally in the spinal cord.
People of any age can develop an astrocytic tumour. In adults they most commonly grow in the main part of the brain, the cerebrum and the chance of developing one increases as people get older. The cerebrum is made up of the frontal, parietal, temporal and occipital lobes (see diagram above). Tumours in the cerebellum are more common in children and young people.
Grading refers to the appearance of the tumour under a microscope. The grade gives an idea of how quickly the tumour may grow. There are four grades: grades 1 and 2 are low-grade, and grades 3 and 4 are high-grade.
Low-grade astrocytic tumours are usually slow growing and are not likely to spread. Grade 1 astrocytic tumours can sometimes be removed with surgery and are then unlikely to come back. Grade 2 tumours can sometimes be removed but may come back after surgery.
High-grade astrocytic tumours are more likely to grow quickly and spread to other parts of the brain. It is common for the tumour to come back after initial treatment. This is known as a recurrence. Further treatment will probably be necessary.
The four grades of astrocytic tumour are also sometimes known by names:
Grade 1 – pilocytic astrocytoma
Grade 2 – low-grade (diffuse) astrocytoma
Grade 3 – anaplastic astrocytoma
Grade 4 – glioblastoma multiforme (GBM).
As with most brain tumours, the cause is unknown. Research is being carried out into possible causes.
Symptoms of astrocytic tumours can develop slowly or more quickly depending on how fast the tumour grows and where it is in the brain. Some symptoms are caused by increased pressure within the skull (raised intracranial pressure).
Raised intracranial pressure can be caused by a blockage in the ventricles (fluid filled spaces in the brain). This then leads to a build-up of cerebral spinal fluid (CSF), which is the fluid that surrounds and protects the brain and spinal cord. It may also be caused by swelling due to the tumour. Symptoms of raised intracranial pressure may include headaches, being sick (vomiting|), neck pain, irritability and sight changes.
The position of the tumour in the brain can cause other symptoms such as fits (seizures) and changes in behaviour and personality:
Your doctors need to find out as much as possible about the type, position and size of the tumour so they can plan your treatment. You may have a number of tests and investigations.
The doctor will examine you thoroughly and test your reflexes and the power and feeling in your arms and legs. They will look into the back of your eyes using an ophthalmoscope to see if the nerve at the back of the eye is swollen. This can be caused by oedema (swelling of the tissues within the brain), which may occur because of an increase in the amount of fluid in the brain.
You may have a CT or MRI scan to find the exact position and size of the tumour.
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless but takes 10–30 minutes. CT scans use small amounts of radiation, which is very unlikely to harm you or anyone you come into contact with.
You will be given an injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it’s important to let your doctor know beforehand.
This test is similar to a CT scan but uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure it’s safe for you to have an MRI scan.
Before having the scan, you’ll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan show up more clearly.
During the test you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It’s painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy but you’ll be given earplugs or headphones.
To give an exact diagnosis, a sample of cells is sometimes taken from the tumour and examined under a microscope. The biopsy involves an operation and you may have to stay in hospital for a few days. There are different ways of doing the biopsy, depending on the position of the tumour in the brain. Your doctor will discuss with you whether a biopsy is necessary in your case and what it involves.
The treatment for an astrocytic tumour depends on a number of things, including your general health and the size, grade and position of the tumour. The results of your tests will enable your doctor to decide on the best type of treatment for you.
There are some risks with treatment to the brain and your doctor will discuss these with you.
Your treatment will usually be planned by a team of specialists known as a multidisciplinary team (MDT|). The team will usually include:
If you have raised intracranial pressure, it's important this is reduced before treatment begins. You may be given medicines (steroids|) to reduce swelling around the tumour. If you have raised pressure due to a build-up of CSF, a tube (shunt) may be inserted into your brain to drain off the excess fluid. If you experience seizures, you may be given anticonvulsant medicines| to help prevent them.
Before you have any treatment, your doctor will tell you about its aims and what it involves. They will usually ask you to sign a form saying that you give your permission (consent|) for the hospital staff to give you the treatment. No medical treatment can be given without your consent.
Treatment can be given for different reasons and the potential benefits will vary depending on the individual situation. If you have been offered treatment that aims to cure your cancer, deciding whether to have the treatment may not be difficult. However, if a cure is not possible and the treatment is to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
If you feel that you can’t make a decision about the treatment| when it’s first explained to you, you can always ask for more time to decide. You are free to choose not to have the treatment and the staff can explain what may happen if you do not have it. You don’t have to give a reason for not wanting to have treatment but it can be helpful to let the staff know your concerns so that they can give you the best advice.
The following information describes the different types of treatment for an astrocytic tumour:
Where possible, surgery| is the first type of treatment for an astrocytic tumour. The aim of surgery is to remove as much of the tumour as possible without damaging the surrounding brain tissue. Depending on the size, position and spread of the tumour, it may not be possible to remove it completely and you may need further treatment.
Grade 1 astrocytic tumours in the cerebellum can often be removed completely by surgery.
Grade 2 tumours and high-grade tumours are more difficult to treat because of their tendency to spread.
For grade 3 and 4 tumours, surgery is usually carried out first and then followed by radiotherapy| and sometimes chemotherapy|.
Some tumours can’t be reached by surgery or the risk of damage to the surrounding brain cells may be too high. Your doctor will discuss other forms of treatment if surgery is not possible.
Radiotherapy treatment uses high energy x-rays to destroy the cancer cells. It’s often used after surgery to destroy any remaining tumour cells. It may be used alone to treat an astrocytoma, or with chemotherapy if surgery is not possible.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs, which destroy cancer cells. It may be given alone to treat an astrocytic tumour, or with surgery and radiotherapy.
One way of giving chemotherapy is by placing an implant into the brain during an operation to remove or debulk the tumour. These implants, called Gliadel® implants|, are small wafers or discs, which contain the chemotherapy drug carmustine. The surgeon will place up to eight wafers in the space where the tumour was. As the wafers dissolve, the drug is slowly released. This method of giving chemotherapy is only suitable for some people with high grade tumours. Your doctors will let you know if it’s suitable for you.
If you experience seizures you may be given a medicine called an anticonvulsant to help prevent them.
You may find the idea of a tumour affecting your brain extremely frightening. You may have many emotions| including anxiety, anger and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition.
Many people find it helpful to talk things over with their doctor or nurse, or one of our cancer support specialists|. Family members and close friends can also offer support.
In some circumstances, you may not be allowed to drive for a period of time. If you have had an epileptic fit, the Drivers and Vehicle Licensing Association (DVLA) will not allow you to drive for a year after your last fit. You can then drive again, provided you remain well.
After treatment, you will not be able to drive for at least 1–2 years, depending on the grade of your tumour. However, this period will be extended if the tumour comes back.
You may not be allowed to drive some types of vehicle, such as an LGV (large goods vehicle) or a PCV (passenger carrying vehicle).
It is your responsibility to contact the DVLA and your doctor will advise you how to do this.
The DVLA| advises GPs and other members of the medical profession on the medical standards of fitness to drive. Patients should seek advice from their doctors.
This information has been compiled using a number of reliable sources, including:
With thanks to Dr Nick Plowman, Senior Clinical Oncologist, and the people affected by cancer who reviewed this edition. Reviewing information is just one of the ways you could help when joining our Cancer Voices network|.
Content last reviewed: 1 January 2013
Next planned review: 2015
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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