Astrocytoma

As a tumour grows, it can press on or grow into nearby areas of the brain. This can cause symptoms because it stops that part of the brain from working normally. Some symptoms can happen because the tumour causes a build-up of pressure inside the skull. This is called raised intracranial pressure.

Symptoms can depend on the size and position of the tumour and how slowly or quickly it grows. They may develop suddenly or slowly over months or even years.

Common symptoms include headaches and seizures (fits).

Other possible symptoms include:

• feeling sick
• problems with balance and coordination
• problems with sight
• being confused
• problems with memory
• changes in mood and personality.

The tumour may also cause other symptoms, depending on which part of the brain is affected.

We have more information about possible symptoms of a brain tumour.

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 will have a brain MRI scan or brain CT scan to find out the exact position and size of the tumour.

You may also have a biopsy to take a small sample of the tumour to test. Brain tumour biopsies are usually done at the same time as surgery to remove the tumour.

Your doctor may also:

• check your reflexes and the power and feeling in your arms and legs
• shine a light at the back of your eye to check if there is swelling
• ask you some questions to check your reasoning and memory
• arrange for you to have blood tests to check your general health and to see how well your kidneys and liver are working

Biomarker (or molecular marker) tests are extra tests that are done on samples removed from the tumour during surgery. The samples are tested for signs of gene changes.

This may give doctors information about:

• which treatment is likely to be the most effective
• how the tumour may develop.

For gliomas, biomarker tests look for changes in genes called IDH, 1p/19q and ATRX. Doctors may also test the sample to check the levels of a protein called MGMT in glioma tumour cells.

You may have to wait some time for the results of these tests. Your doctor can tell you if biomarker tests might be helpful in your situation.

Being diagnosed with a brain tumour can make you feel shocked, frightened, angry or upset. There is no right or wrong way to feel. It may help to get support from family, friends or a support organisation.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00
• Chat to our specialists online
• Visit our brain cancer forum to talk with people who have been affected by brain tumours, share your experience, and ask an expert your questions.

You may also want to get support from a brain tumour charity, such as:

• Brain Tumour Action
• The Brain Tumour Charity
• Brainstrust.

Most people diagnosed with a brain tumour will not be allowed to drive for a time after their diagnosis. Your doctor, surgeon or specialist nurse will tell you if this applies to you.

If you have a driving licence, you must tell the licensing agency you have been diagnosed with a brain tumour.

You could be fined if you do not tell them. You could also be prosecuted if you have an accident.

Treatments used for astrocytomas include surgery, radiotherapy and chemotherapy. You may have a combination of treatments. Your treatment may depend on:

• the size and position of the tumour
• the grade of the tumour
• the symptoms you have
• sometimes, the biomarker results.

A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and disadvantages of different treatment types. They will also explain the risks and side effects.

You may be given a choice of treatment options. You will have time to talk about this with your hospital team before you make any treatment decisions.

You will need to give permission (consent) for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist if you need more information or more time to decide on a treatment.

If the tumour is not causing you problems, your doctor may suggest active monitoring. Treatment can cause side effects and some of these may be permanent. Active monitoring means regularly checking the tumour to find out if it is growing. Instead of starting treatment, you may see your specialist doctor regularly to have scans. This can help your doctor know if and when to recommend treatment.

If you need treatment, you may have surgery to remove the tumour. If you have a grade 1 tumour, this may be the only treatment you need. If the surgeon has not been able to remove all of the tumour, you may have active monitoring after surgery. This means that if you do not have symptoms that are causing problems, you may be able to delay having further surgery or radiotherapy.

Sometimes there is a risk that an astrocytoma will come back after surgery or develop into a higher-grade tumour. To reduce this risk, your doctor may advise you to have further treatment after surgery. This may be radiotherapy, chemotherapy, or both. Radiotherapy uses high-energy rays to destroy the tumour cells. Chemotherapy uses anti-cancer drugs to destroy tumour cells.

If surgery is not possible, or if the tumour cannot be completely removed, you may have radiotherapy, chemotherapy or both. Your doctor will talk to you about your treatment options.

High-grade tumours grow more quickly and need to be treated straight away. If surgery is possible, the surgeon will remove as much of the tumour as they can. After surgery, you will usually have radiotherapy or chemotherapy, or both.

Chemotherapy can be given at the same time as radiotherapy, after radiotherapy, or on its own. Rarely, chemotherapy can also be given as a single treatment directly into the brain, during surgery.

When surgery is not possible, the main treatment is usually radiotherapy. This could be with or without chemotherapy. Some people may have chemotherapy alone as their main treatment.

If you have chemotherapy, you may have a chemotherapy drug called temozolomide. Or you might have a combination of chemotherapy drugs called PCV (procarbazine, CCNU (lomustine) and vincristine).

Your specialist doctor or nurse will explain your treatment and possible side effects. Most side effects are short term and will improve gradually when the treatment is over. Some treatments can cause side effects that do not get better. These are called long-term effects. You may also get side effects that start months or years later. These are called late effects.

We have more information about coping:

• before and after surgery
• with side effects of radiotherapy
• with side effects of chemotherapy

When chemotherapy is given at the same time as radiotherapy, it can cause more side effects than having either of the treatments alone.

You may need treatment for the symptoms of an astrocytoma before you have any treatment for the tumour. You may also need your symptoms managed during your main treatment or for a while after it has finished.

You may have:

• drugs called anti-convulsants to prevent seizures
• steroids to reduce swelling around the tumour
• surgery to drain off excess fluid, to reduce pressure inside the skull. 

Sometimes a brain tumour cannot be removed or controlled anymore. If this happens, you can still have treatment for any symptoms. You will have supportive care (sometimes called palliative care) from a specialist doctor or nurse who is an expert at managing symptoms.

We have more information about coping with advanced cancer.

After your treatment has finished, you will have regular check-ups, tests and scans.

Some side effects can start months or years after treatment has finished. You can use your follow-up appointments to talk about these side effects, or about any other worries or problems you have.

Many people find they get very anxious before appointments. This is natural. It may help to get support from family, friends or a specialist nurse.