Brain tumors are very rare, with only about 2 percent of all new cancer cases affecting the brain. However, when a brain tumor is diagnosed, it is a so-called astrocytoma in about a quarter of all cases. This makes astrocytomas among the most common cancers of the brain. Their degrees of severity, as well as the resulting chances of cure, differ greatly.
Wss is an astrocytoma?
Schematic diagram showing the location of a brain tumor in the brain. Click to enlarge. An astrocytoma develops from degenerated brain cells. More specifically, from degenerate astrocytes, also called stellate cells, which are part of the supporting tissue of the human brain and are called glial cells in their entirety. There are several types of astrocytomas, which differ greatly in severity as well as prognosis. Astrocytomas can be both benign and extremely malignant tumors. Physicians determine the severity of the disease by comparing the similarity of the tumor tissue to the surrounding healthy tissue. The more similar the degenerated tissue is to healthy tissue, the less serious the tumor. Astrocytomas are classified into WHO grades. The astrocytoma with the lowest WHO grade I, pilocytic astrocytoma, occurs almost exclusively in children and young adults, is benign, and has a positive prognosis. WHO grade II tumors, differentiated astrocytoma, are still benign but can degenerate into malignancy. Finally, anaplastic astrocytoma or WHO type III is malignant. Finally, the astrocytoma with the worst prognosis is glioblastoma. This exhibits very rapid and, more importantly, diffuse growth, meaning that it is not well-defined and therefore cannot usually be surgically removed. The younger a person is, the higher the probability of a benign astrocytoma. The malignant variants usually affect middle-aged men.
Causes
Little is known about the causes of astrocytomas. It is considered certain that brain tumors of this type occur particularly frequently after radiation treatment. For this reason, radiation treatment and imaging techniques should be used in medicine as rarely as possible and only when there is sufficient indication. Those suffering from the hereditary disease neurofibromatosis also have an increased risk of WHO type I astrocytomas. Further causes are not known or still unclear. However, various studies have found that cell phone radiation has no effect on the incidence of brain tumors.
Symptoms, complaints, and signs
The first signs of a possible brain tumor can be noticed by the patient himself. In most cases, memory and concentration problems occur. Everyday things are forgotten or simply cannot be remembered and managed. Often, the concentration problems are coupled with speech and word-finding disorders, which can develop into aphasia and complete loss of speech. Orientation problems are observed as well as balance and locomotion difficulties. For example, affected individuals are usually no longer able to independently travel to a desired destination by bicycle or car. In the initial phase, when the physical symptoms are still weaker, a trip is started but the destination is lost from sight on the way. Most patients initially notice their disorientation. Visual disturbances are also a possible symptom of astrocytoma or glioblastoma. Most often they manifest as double or multiple images. In rarer cases, a restriction of the field of vision is also reported; the affected person then perceives only sections of the whole image.
Diagnosis and course
Astrocytomas can arise in very different parts of the brain. Depending on the localization, the symptoms differ. However, typical signs of such a glioma are epileptic seizures, changes in personality, and increased intracranial pressure. The latter initially manifests itself as dizziness, nausea and vomiting. If the astrocytoma is located in the spinal cord, paralysis or even paraplegia may occur. Visual disturbances are also not an uncommon symptom. However, astrocytomas can only be detected with certainty using an imaging procedure – such as computer tomography or MRI.
Complications
Because of the limited space within the skull, space-occupying processes have a much more dramatic effect than in other regions of the body. Complications arise with astrocytomas primarily when the tumor grows rapidly or infiltrates surrounding brain structures. The faster the growth occurs, the greater the increase in pressure inside the skull. As a result of the intracranial pressure, there is local compression of nerve tracts and brain centers, which can lead to death without medical treatment. In higher malignant astrocytomas, extensive edema also occurs, further increasing the space-occupying effect. As a result of the tumor, temporary or permanent brain damage may occur. Complications of astrocytomas include neurological deficits (hemiparesis, alterations of character, visual field deficits), hydrocephalus, and cerebral hemorrhage. The main goal of astrocytoma treatment is to reduce the tumor mass. The therapies used may themselves have severe side effects and result in complications. To improve the baseline for further treatments, neurosurgeons try to reduce the tumor as much as possible without harming healthy tissue. Intracranial pressure increases and postoperative hemorrhage are potential complications after surgical procedures. Stereotactic radiotherapy for astrocytomas is used to specifically kill tumor cells. As a complication of endogenous inflammatory processes, massive brain edema as well as decompensated space-occupying lesions may subsequently occur.
When should you see a doctor?
If astrocytoma is suspected, a physician must be consulted immediately. Typical signs such as epileptic seizures, nausea, vomiting, dizziness or visual disturbances should be clarified immediately. Other warning signs include paralysis and seizures as well as general physical or mental deficits. If one or more of these symptoms occur, a physician should be consulted for further evaluation. This is especially true if the symptoms are noticed quite suddenly, occur after radiation treatment or in connection with the hereditary disease neurofibromatosis. Then the suspicion is obvious ,that it is a brain tumor. Immediate treatment is always necessary for astrocytomas, whether benign or malignant. If symptoms recur after treatment of an astrocytoma, the treating physician must be consulted. The sooner the diagnosis and therapy are carried out, the better the chances of cure, even in the case of new cases. This applies not only to astrocytomas, but to all types of tumors. Therefore, unusual complaints that cannot be attributed to any particular cause should be clarified immediately.
Treatment and therapy
If possible, tumors are removed surgically to the greatest extent possible. This is followed by tissue examination to determine the WHO grade of the glioma. Not all astrocytomas are operable, however; this possibility depends on the location of the tumor in the brain as well as its diffuseness. The more clearly a tumor differentiates itself from healthy tissue, the sooner surgery can be performed. However, even if the entire brain tumor cannot be cut out, the treating physicians at least try to remove parts of the astrocytoma. Depending on the severity of the tumor, the surgery is followed by radiation treatment and possibly chemotherapy. Remaining tumor is risky because these cells can continue to grow. However, at least partial removal initially means a reduction in the size of the tumor and thus an improvement in symptoms as well as reduced growth – ergo more life gained. In most cases, the brain tissue around the astrocytoma swells considerably, which is why the administration of cortisone preparations is necessary prior to surgery. These bring down the swelling of the tissue. The administration of antiepileptic drugs may also be considered necessary. As a rule of thumb, the lower the WHO grade of the astrocytoma, the more likely it is to be completely removed.
Outlook and prognosis
The prognosis of an astrocytoma is individualized based on several factors. Depending on the location and size of the brain tumor, the prospect of cure is directed. In addition, there is the patient’s age, possible previous diseases, and the stability of his or her immune system. If the tumor is small and located in an easily accessible region of the brain, there is a good chance of a cure.If the patient is also in middle adulthood and suffers from no other impairments, he has a good chance of being discharged as cured within a few months. The older the patient and the more preexisting conditions, the poorer the prospects for recovery. In the case of a brain tumor that is located in an area of the brain that is difficult to access, the chances of recovery dwindle even further. Often, only parts of the diseased tissue can be successfully removed or there is no way to free the patient from the tumor at all. The subsequent cancer therapy additionally weakens the organism. Patients who have successfully survived the surgery and therapy still live at risk of recurrence of the disease. In many cases, the tumor has spread and new metastases are formed in other parts of the body. Therefore, timely diagnosis of a brain tumor is essential for a prognosis of astrocytoma.
Prevention
Because the causes of astrocytomas are unknown, specific preventive measures cannot be taken. However, it is recommended to minimize exposure to radiation and to avoid contact with carcinogens. A lifestyle that is as healthy and active as possible also helps prevent cancer.
Aftercare
Astrocytoma (glioblastoma) is prone to recurrence. Therefore, consistent follow-up care is very important. This consists primarily of the patient conscientiously keeping follow-up appointments with the treating physicians. In addition, the doctor should always be consulted if there are any unusual observations. Paralysis and sensory disturbances in limbs are among the warning signs, as are seizures or headaches that occur permanently. In these cases, the doctor may be visited outside of scheduled follow-up appointments. If therapies such as radiation or chemotherapy as well as surgery have recently been completed, aftercare also refers in particular to the consequences of these treatments. For example, the wound conditions of a head surgery should be checked and weakness that may have resulted from chemotherapy or radiotherapy should be monitored and treated if necessary. It may also be necessary to involve the physiotherapist or occupational therapist in the aftercare in order to restore tumor or therapy consequences such as functional limitations in joints, muscles and nerves as best as possible. This also applies to speech disorders, which are often associated with a brain disease. The psychological component must also be included in aftercare. The awareness of a brain disease frightens many people and causes concern about a relapse. Targeted psychological support can help in coping with the disease and give the affected person a better quality of life. Psychologists and psychotherapists are valuable contacts here.
What you can do yourself
Self-help in everyday life can be divided into the physical and mental areas in the case of astrocytoma and glioblastoma, respectively. Physically oriented self-help depends on the region of the brain where the glioma is located and which symptoms of failure or loss of function are noticeable. Everyday help can be, for example, motor exercises that improve a functional disorder in the extremities that may have occurred after surgery. The same applies to speech or memory exercises if the tumor has been or is located in an area of the brain that is responsible for this. Anyone suffering from the effects of radiation or chemotherapy can strengthen their immune system at home in consultation with their doctor. A tumor in the brain also places a psychological burden on many patients. Help and information in this context are offered by relevant self-help groups or the Cancer Information Service, which can be found on the Internet and offers telephone counseling. Conversations with friends can also have a relieving effect. Sports and relaxation exercises help to improve well-being. In addition to light endurance training and strength training for weakened muscles, relaxation methods such as progressive muscle relaxation or autogenic training often help to improve well-being. Yoga, with its proven mix of physical and breathing exercises, relaxation and meditation, is also suitable for improving the tense situation of the affected person and increasing the quality of life despite astrocytoma or glioblastoma.
