Astrocytomas

What Is an Astrocytoma?

An astrocytoma is a group of abnormal cells (a tumor) that forms in the brain and spinal cord. The kind of astrocytoma (as-treh-sy-TOH-muh) that happens most often in kids is usually treatable and goes away for good.

What Happens With an Astrocytoma?

Astrocytomas develop from star-shaped brain cells known as astrocytes. Most astrocytomas in children are benign (they grow slowly and aren't likely to spread), but they can be cancerous (they grow quickly and are likely to spread).

What Causes Astrocytomas?

Doctors don't know what causes astrocytomas. But some kids are more likely to develop them, including those who:

• have some types of genetic conditions, like tuberous sclerosis complex or neurofibromatosis type 1
• had radiation therapy for a brain tumor

What Are the Types of Astrocytomas?

The main types of astrocytomas are low-grade and high-grade. Low-grade tumor cells look more like normal cells and grow more slowly than high-grade tumor cells. Most astrocytomas in children are low-grade.

Low-Grade Astrocytomas

Low-grade astrocytomas in kids grow slowly and usually don't spread. Often, surgeons can remove them. But some tumors can form in an area (like the optic nerve, between the eye and brain) that makes them hard to take out. Low-grade astrocytomas that can’t be removed are treated with chemotherapy (chemo) or radiation therapy.

High-Grade Astrocytomas

High-grade astrocytomas are more aggressive (they grow and spread quickly) than the low-grade kind. They're also harder to treat. Kids will need chemo and radiation therapy along with surgery.

What Are Signs & Symptoms of Astrocytomas?

Some astrocytomas don’t cause any signs or symptoms. But when they do, the signs can vary depending on where the tumor is and other things.

An astrocytoma can cause symptoms by pressing on parts of the brain near it. The tumor also can lead to a buildup of spinal fluid and pressure in the brain (hydrocephalus).

Signs and symptoms of an astrocytoma can include:

• vision problems or headaches
• seizures
• trouble standing or walking and weakness of the face, arms, or legs
• poor coordination
• confusion or slurred speech
• changes in behavior
• increased head size in babies and young toddlers
• head tilting
• vomiting

How Are Astrocytomas Diagnosed?

To diagnose an astrocytoma, doctors will ask about symptoms and do an exam. They’ll also order imaging tests like an MRI. These tests let them look inside the brain to see if any areas look different.

Doctors also do a biopsy (taking a piece of the tumor to look at under a microscope), which lets them find out what kind of tumor it is and whether it’s low-grade or high-grade. The biopsy may be done with a needle or during surgery to remove the tumor. Doctors also might order blood tests.

When the doctors have the information they need, they create a treatment plan.

How Are Astrocytomas Treated?

Treatment for an astrocytoma usually begins with surgery. That’s often the only treatment needed for low-grade tumors. For high-grade tumors, children also need chemo and radiation therapy.

After finishing treatment, kids will need regular follow-up so doctors can see how they’re doing. Because an astrocytoma can come back, kids will need an MRI several times a year for the first few years, then less often. This helps doctors find any problems early so they can work with families to make a treatment plan.

Research about genetic changes in tumors has led to treatments called targeted therapies. The treatments target the genetic changes. Targeted therapies are helping children with astrocytomas.

Doctors keep looking for new ways to treat astrocytomas. Some kids might be able to join a clinical trial. This is a study researchers do to see if a new treatment works well and is safe. To find out if it or a different treatment is a good choice for your child, talk with their doctor.

Who Is on the Care Team?

A team of specialists cares for a child with an astrocytoma. The team may include:

• a pediatric neuro-oncologist (a doctor who treats cancers of the brain or spine)
• a pediatric neurologist (a doctor who treats nervous system problems)
• a pediatric neurosurgeon (a surgeon who operates on the brain or spine)
• a pediatric radiation oncologist (a specialist who gives radiation therapy)
• pediatric rehabilitation medicine specialists, including speech therapists, physical therapists, and occupational therapists
• pediatric psychologists and social workers

What Else Should I Know?

If your child has an astrocytoma, find support from members of the care team, friends and family, and other parents who’ve gone through the same thing.

When talking about the tumor with your child, it’s best to be honest. But give information that fits their age and emotional maturity. Make sure kids know that the tumor isn’t because of anything they did. If you need help answering questions or don’t know what to say, a member of the care team can help.

The future for kids with brain tumors is better than ever. You can find more information and support online at:

• American Cancer Society
• National Cancer Institute
• Pediatric Brain Tumor Foundation