Astrocytoma: Diagnosis and Treatment | Sheba

The first step in diagnosing any disease is often a physical exam. A doctor thoroughly examines the patient and looks for any signs that indicate their health isn’t optimal.

Additionally, they will review the patient’s medical history to get an overview of if they had any concerning issues in the past and how their health differs now from what it used to be.

As mentioned above, blurry vision can be one of the symptoms of astrocytoma. This cancer can cause issues with the patient’s eyesight because the tumor can create pressure on the optic nerve.

A medical professional can check whether this has happened with a visual field exam. This exam can determine how much vision the patient has in each eye, whether they have scotomas (blind spots) and if there are any issues typically caused by brain tumors.

with Gadolinium
When trying to diagnose a brain tumor, doctors often use imaging tests because they allow them to see all the abnormal physical changes that occur in the brain. And the best option to go with when looking for signs of astrocytoma is an MRI with gadolinium.

Gadolinium is a type of contrast medium that improves the clarity of the image the MRI produces. The patient will receive gadolinium intravenously before the MRI and after the results of the scan come back, the doctor will have a clear and precise image of the patient’s brain.

In some cases, an MRI can’t be performed, and this is usually the case when the patient has a pacemaker or a different implanted medical device. In those cases, or if perhaps the doctor wants a more detailed image, they will order a CT scan.

A CT scan uses multiple X-rays to take pictures of the body or certain body parts from multiple different angles and produces detailed images.

The tests we mentioned beforehand can help the doctor see whether a tumor or a mass might be present. However, it’s not enough to just know that a patient has astrocytoma, the doctor also needs to determine the type and grade of the tumor. This is done by performing a biopsy.

During a biopsy, a small piece of tissue from the tumor is removed by a neurosurgeon. Afterward, that tissue will be analyzed by a pathologist who will be able to give an accurate diagnosis.

As mentioned above, astrocytoma can appear in the brain or the spinal cord. To determine whether the tumor is in the spinal cord, the doctor will order a lumbar puncture, also known as a spinal tap.

A lumbar puncture will help determine whether there are any cancerous cells in the spinal cord.

Molecular testing is done to determine what specific subgroup of astrocytoma the patient is suffering from. This is done by taking a tissue sample from the tumor and running laboratory tests which will determine whether the patient has certain proteins and genes in their astrocytoma.

Finding out the exact type of astrocytoma the patient suffers from is important because it allows the medical professional in charge of the case to determine what treatment option would be the best for that specific case.

If a patient suffers from cancerous grade 1 astrocytoma, it’s still a mild form of the disease, and the most common cure for it is surgery. In some milder cases, surgery can also remove grade 2 astrocytomas.

This is a treatment option for all grades of astrocytoma, however, with some, surgery is enough to reach remission, and with others, it’s only the first line of defense.

During the procedure, a surgeon will remove most of the tumor or all of it, depending on its grade and size. However, even if they don’t remove all of it, the surgery will still be beneficial because the patient will get relief from the pressure caused by the tumor, while the medical professionals in charge of the case will be able to do testing on the tumor tissue.

This testing will allow them to determine what kind of medication would be most effective for that specific type of astrocytoma.

For those patients who are suffering from higher-grade osteosarcoma, after they receive surgery, the next step in their treatment is usually chemotherapy. Chemotherapy for astrocytoma is given in multiple rounds and typically requires the use of two or three different chemo drugs.
There are many different drugs that can be used for chemotherapy, and so the specific type, as well as the dosage and the frequency of the patient’s chemotherapy session will depend on a few different factors.

These factors include:

• The stage of the cancer
• The patient’s age, body weight and overall health
• Whether the patient has received any previous cancer treatments
• If the patient has any other pre-existing medical conditions or allergies that would make certain medications unsuitable

Radiotherapy, also known as radiation therapy, is a treatment option that uses high-powered X-rays to target cancerous cells. This can be used either as a standalone treatment option or in combination with chemotherapy, and it’s considered to be very effective.

Grade 3 and grade 4 astrocytomas usually require both chemotherapy and radiotherapy because they’re very aggressive and fast-growing. Unfortunately, grade 4 astrocytoma usually can’t be treated, but it can be managed with radiotherapy.

with High Dose Chemotherapy
As we mentioned beforehand, chemotherapy is given to most astrocytoma patients, except those who can be treated with surgery alone. Chemotherapy as a treatment option, while effective, is also very aggressive, which can cause issues for the patient.

Apart from the usual side effects chemotherapy can cause such as hair loss, weakness, nausea, fatigue, etc., it can also lead to a more serious issue. While chemotherapy does kill cancerous cells, it also destroys healthy cells.

These cells are vital for the body and the immune system to function properly, and so in some cases, patients who receive high-dose chemotherapy also might need a bone marrow transplant.

During a bone marrow transplant, the patient is injected with healthy stem cells that, over time, develop into healthy blood-forming cells. This is done to replace all of the healthy cells that were destroyed during chemotherapy.

Targeted therapy is one of the least invasive cancer treatment options because, unlike chemotherapy and radiotherapy, it can find and target only the cancerous cells.

This type of treatment finds the specific proteins, genes, or tissue environment that is responsible for the growth and survival of the tumor. The main goal of targeted therapy is to block the tumor cells from spreading to the rest of the body and damaging healthy cells.

It’s important to note that targeted therapy is always catered to the specific patient and, before they are given this treatment, the doctor in charge of the case will have to perform some tests. These tests are done to determine what treatment would be the best option.