Astrocytoma : Astrocytoma symptoms , Astrocytoma Types , Causes , Diagnosis , Treatment

Astrocytoma meaning in hindi


  • Astrocytoma meaning in hindi
  • Astrocytoma Symptoms
  • Astrocytoma Causes
  • Astrocytoma Types
  • Astrocytoma Histology
  • Astrocytoma Treatment


Astrocytoma

Astrocytoma is a type of cancer that can form in the brain or spinal cord. Astrocytoma begins in cells called astrocytes that support nerve cells.

Astrocytoma signs and symptoms depend on the location of your tumor. Astrocytomas that occur in the brain can cause seizures, headaches and nausea. Astrocytomas that occur in the spinal cord can cause weakness and disability in the area affected by the growing tumor.

Astrocytoma can be a slow-growing tumor, or it can be an aggressive cancer that grows quickly. The aggressiveness (grade) of your astrocytoma determines your prognosis and treatment options.

Tumor Grading

According to the World Health Organization (WHO) classifications of brain tumors, astrocytomas range from grade 1 (most benign) to grade 4 (most malignant). This grading, which is made by analyzing the tumor cells under the microscope is based on the following features: 1) how abnormal the cells look like (atypia); 2) how much they grow (mitosis); 3) presence of newly made blood vessels within the tumor (vascular proliferation). This is further integrated by the analysis of tumor’s genetic features, i.e. the DNA analysis of the tumor cells. Generally, with the exception of grade 1 tumors, which are most common in the pediatric population, most astrocytomas affect patients older than 40. Also, the older the patient, the higher the chances of the astrocytoma to be of higher grade.

Grade 1

Pilocytic Astrocytoma is a well circumscribed tumor and grows slowly. Most common in the cerebellum, i.e. the part of the brain located in the back of the head, just above the neck. It does not invade into the surrounding brain, thus when resected completely it is considered cured, and it does not require either chemotherapy or radiotherapy.

Pleomorphic Xantoastrocytoma most frequently originates in the temporal lobes and is commonly associated with seizures. Its cells can have many different shapes (pleomorphic), but usually do not show evidence of proliferation. Surgery is usually curative.

Subependymal Giant Cell Astrocytoma (SEGA) is most common in the younger population, usually in association with a familiar syndrome called tuberous sclerosis. It characteristically grows inside the ventricles, which are fluid-filled spaces deep into the brain, and can often block the normal outflow of this fluid, thus causing hydrocephalus. Surgical resection is usually curative.

Grade 2

Diffuse Astrocytoma is an invasive tumor, so there is no clear separation from the surrounding brain, and surgery itself might not be enough for its cure (this depends on several other factors described below). The tissue appearance is only moderately different from a normal brain, but cells appear abnormal under the microscope and slightly increased in number.

Grade 3

Anaplastic Astrocytoma is considered a more malignant evolution of a previously lower grade astrocytoma, which has acquired more aggressive features, including a higher pace of growth and more invasion into the brain. Histologically, it displays a higher degree of cellular abnormalities, and evidence of cell proliferation (mitoses), in comparison to grade 2 tumors. Surgery is never considered curative for these tumors, and needs to be followed by radiation and almost always chemotherapy.

Grade 4

Glioblastoma (GBM) is the most malignant, aggressive and common (60%) form of astrocytomas. Histologically, it is characterized by very abnormal-appearing cells, proliferation, areas of dead tissue and formation of new vessels. GBM can present either as a malignant progression from a previously existing lower grade astrocytoma (usually in 10% of cases) or originate directly as a grade 4 tumor (90% of cases). The former scenario is most common in younger patients, while the latter is most common after age 60. Regardless of its presentation, this tumor is a highly aggressive cancer, with pronounced brain invasion and destruction and very fast progression.

Symptoms

The clinical presentation of astrocytomas depends much more on their location within the brain, rather than their biologic characteristics. There are regions of the brain that can accommodate very large tumors before they become symptomatic (for example, the regions in the forehead), while there are other locations where even a small tumor can cause problems early on, like limb weakness or difficulty with speech or vision.

Generally, low grade astrocytomas tend to be of bigger size before they become symptomatic, as compared to more aggressive, higher grade astrocytomas. This is because lower grade tumors tend to displace the brain rather than destroying it, and also because they are associated with less brain swelling than malignant ones.

Common symptoms of astrocytomas are the following:

  1. Persistent headaches
  2. Headaches which are worse in the morning or cause awakening from sleep ( a sign of increased intracranial pressure)
  3. Double or blurred vision
  4. Speech problems
  5. Decreased cognitive abilities
  6. Grasp or limb weakness
  7. New seizures


Diagnosis

Tests and procedures used to diagnose astrocytoma include:

  • Neurological exam. During a neurological exam, your doctor will ask you about your signs and symptoms. He or she may check your vision, hearing, balance, coordination, strength and reflexes. Problems in one or more of these areas may provide clues about the part of your brain that could be affected by a brain tumor.
  • Imaging tests. Imaging tests can help your doctor determine the location and size of your brain tumor. MRI is often used to diagnose brain tumors, and it may be used along with specialized MRI imaging, such as functional MRI, perfusion MRI and magnetic resonance spectroscopy.

    Other imaging tests may include CT and positron emission tomography (PET).

  • Removing a sample of tissue for testing (biopsy). A biopsy can be done with a needle before surgery or during surgery to remove your astrocytoma, depending on your particular situation and the location of your tumor. The sample of suspicious tissue is analyzed in a laboratory to determine the types of cells and their level of aggressiveness.

    Specialized tests of the tumor cells can tell your doctor the types of mutations the cells have acquired. This gives your doctor clues about your prognosis and may guide your treatment options.

Treatment

Astrocytoma treatments include:

  • Surgery to remove the astrocytoma. Your brain surgeon (neursurgeon) will work to remove as much of the astrocytoma as possible. The goal is to remove all of the cancer, but sometimes the astrocytoma is located near sensitive brain tissue that makes that too risky. Even removing some of the cancer may reduce your signs and symptoms.

    For some people, surgery may be the only treatment needed. For others, additional treatments may be recommended to kill any cancer cells that might remain and reduce the risk that the cancer will return.

  • Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, directing beams to precise points in your brain.

    Radiation therapy might be recommended after surgery if your cancer wasn't removed completely or if there's an increased risk your cancer will return. Radiation is often combined with chemotherapy for aggressive cancers. For people who can't undergo surgery, radiation therapy and chemotherapy may be used as a primary treatment.

  • Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy drugs can be taken in pill form or through a vein in your arm. In certain situations, a circular wafer of chemotherapy medicine can be placed in your brain after surgery where it slowly dissolves and releases the medication.

    Chemotherapy is often used after surgery to kill any cancer cells that might remain. It can be combined with radiation therapy for aggressive cancers.

  • Clinical trials. Clinical trials are studies of new treatments. These studies give you a chance to try the latest treatment options, but the risk of side effects may not be known. Ask your doctor whether you might be eligible to participate in a clinical trial.
  • Supportive (palliative) care. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.


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