Astrocytes are a type of cell that helps with nerve functions in the brain, spinal cord, and central nervous system. When these cells mutate and clump together, they form tumours known as astrocytomas. Astrocytomas can be either cancerous or non-cancerous, depending on how they mutate. They can form anywhere in the central nervous system, including the spinal cord, but they most commonly occur in the brain as brain tumours.
While astrocytomas can be cancerous or noncancerous, they should always be removed, as they can put pressure on parts of the brain or spinal cord. There are several different treatments to cure astrocytoma tumours, and the right treatment for you will depend on the size of the tumour, its location, and whether it has spread to other parts of the body.
The most common course of treatment for astrocytomas is to have them surgically removed. The goal of surgery is to remove the tumour from the brain or spinal cord completely. However, even if the tumour location does not allow your surgeon to remove all of it, they may remove as much of it as possible, which is known as a subtotal resection.
A subtotal resection is helpful for two reasons. First, it removes part of the tumour and takes pressure off of the affected area. Second, it allows your doctor to test the tumour tissue for the presence of cancer to see if further treatment is necessary. If it is cancerous, further treatment will be needed. However, if the tumour is benign, your doctor may recommend monitoring the tumour but not proceeding with further treatment.
If the entire tumour is removed, it will still be tested for cancer. If it is cancerous, your doctor may recommend precautionary chemotherapy or radiation, just in case the cancer has spread undetected. While surgery is always a recommended treatment for astrocytomas, it is only 100% effective if the cancer has not spread.
When surgery is not a viable treatment or cannot remove all of the tumour because of its location or because it has spread, radiation therapy is typically the next option. Radiation therapy uses high-powered X-rays of energy that target and kill cancer cells. It is often used in conjunction with chemotherapy after surgery has not successfully removed all the cancer from the body. Radiation therapy can also be used post-surgery as a precaution to ensure any remaining cancer is eradicated.
Chemotherapy is another highly effective and common treatment for astrocytomas. Chemotherapy consists of medications that cause DNA changes within cancerous astrocytes and kill them. However, it also kills healthy astrocytes, so chemotherapy often has unwanted side effects, such as nausea, hair loss, vomiting, diarrhoea, and more. Temozolomide is currently the most effective medication used in chemotherapy.
Chemotherapy is often used in conjunction with radiation therapy and is a common treatment when surgery does not remove the entire tumour. Chemotherapy is also used to shrink the tumour prior to surgery or to treat it if the cancer has spread.
Tumour treating fields therapy is one of the newer treatment options for astrocytomas. It is used for especially aggressive forms of cancer, known as glioblastomas, and helps prevent cancer from spreading. It does this by slowing the growth and production of existing cancer cells.
Because tumour treating fields therapy merely slows cancer down and does not kill it, it is often combined with chemotherapy and radiation. The tumour treating fields therapy slows the cancer’s spread, while chemo and radiation kill it.
The key to successfully treating and curing astrocytomas is an early diagnosis. Grade 1 and 2 astrocytomas are much easier to treat than Grade 3 astrocytomas and glioblastomas. As long as the cancer has not spread, surgery is often effective at removing the tumour. However, if it spreads, you will need additional treatments, such as chemotherapy, radiation, and tumour treating fields therapy.