Treatment for Astrocytoma

Whether benign or malignant, a brain tumor can grow and press on nearby areas of the brain and stop that part of the brain from working as it should. Any tumor that causes symptoms needs treatment, although the methods and extent of therapies vary according to the type of brain tumor, its cell type, and exact location, as well as other factors, such as the health and age of the individual. Individuals with astrocytomas are best treated in large medical centers, where a wide variety of advanced treatment options are available from a multidisciplinary team that includes neurosurgeons, neurologists, neuro-oncologists, neuroradiologists, neuropathologists, radiation oncologists, physical therapists, social workers, and other specialists with advanced training and extensive experience in brain tumors.

Unfortunately, most astrocytomas in adults are malignant and need immediate treatment. If left untreated, some aggressive astrocytomas can be fatal within weeks or months.

Treatments may include surgery alone or in combination with chemotherapy, radiation therapy, and/or stereotactic radiosurgery. Although complete removal of an astrocytoma brain tumor through surgery is usually ideal, astrocytomas in adults tend to have diffuse margins and infiltrate the surrounding brain tissue, making complete removal often impossible. If the entire tumor cannot be removed, a neurosurgeon can remove as much as is safely possible to decrease the pressure and impact on surrounding brain tissue, which will reduce the risk of seizures, all while minimizing the risk of complications and enabling the administration of other treatments.

 

Types of Treatment for Astrocytoma

 

  • Treatment usually starts with surgery. The goal of surgery is to resect (remove) as much of the tumor as possible. An astrocytoma may be resected entirely or in part, depending on its features and location. Removing even part of the tumor can relieve symptoms caused by pressure on surrounding structures and reduce seizures. Further therapies are often recommended following surgery for astrocytoma brain tumors, even if it appears the tumor was completely removed.

Chemotherapy may be used to help shrink a tumor before surgery or as follow-up after surgery to kill off any cancer cells left behind. It is given systemically (meaning to the whole body, not just to the site of the tumor) and may be a pill, an injection, or an IV drip.  It is often used in the treatment of astrocytomas following surgery.

  • Radiation therapy may help control the growth of the tumor and is most often used following surgery, concurrent with chemotherapy, to destroy cancer cells left behind after surgery.

Stereotactic radiosurgery is not traditional surgery at all but highly focused beams of radiation aimed at a tumor from multiple angles. Radiosurgery can treat tumors in deep and otherwise inaccessible areas with a targeted approach to minimize side effects. Commonly known by the names of the machines used — including CyberKnife, Gamma Knife, or LINAC (linear accelerator) — stereotactic radiosurgery is an advanced specialty best performed by highly trained specialists in the field. (See more about the Stereotactic Radiosurgery Program.) Its use in astrocytomas is typically reserved for situations involving tumor recurrence (ie, a tumor  that grows back after surgery, chemotherapy, and/or radiation).

Other treatments may include steroid treatment to reduce swelling, or antiseizure medication.

Researchers are now investigating other treatments, including immunotherapy and gene therapy. Immunotherapy can activate a strong immune response and teach the immune system how to recognize and remember what cancer cells look like and then destroy them, providing long-term protection.  Gene therapy uses genetic material to modify cells to shrink or kill off cancerous tumors. Find out more about immunotherapy and gene therapy trials at Weill Cornell Medicine.

Careful monitoring following treatment for astrocytoma is crucial, as this condition has a high recurrence rate, but treatment can prolong life and preserve function while laboratory researchers continue to search for better alternatives.

Reviewed by: Rohan Ramakrishna, MD
Last reviewed/last updated: December 2020

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