Astrocytoma: what it is, whether it is cancer, types and grades

The word "astrocytoma" in an MRI report or in a conversation with a doctor sounds frightening, and the first thing one wants to understand is whether it is cancer or not. The short answer: it varies. Astrocytoma is a tumor arising from astrocyte cells, and its nature depends on the grade of malignancy, which is determined by the structure of the cells and the rate of growth.

What astrocytoma is and how it relates to gliomas

Astrocytoma is a glial tumor of the brain that arises from astrocytes. It is the most common tumor among neuroectodermal tumors. Gliomas are a type of brain tumor that can be low grade (2) or high grade (3 or 4). Astrocytoma belongs to this group. In adults, astrocytoma occurs predominantly in the cerebral hemispheres; in children, in the cerebellar hemispheres as nodes with cysts. It is characterized by expansive-infiltrative growth.

Astrocytoma: cancer or benign tumor

Brain tumors are divided by grade: 1 and 2 are low grade, 3 and 4 are high grade. Most low-grade tumors are not cancerous: they grow slowly and recur less often after treatment. Malignant tumors are usually high grade; they more often grow back after treatment. Therefore, the question "is astrocytoma cancer or not" is decided not by the name but by the grade: pilocytic astrocytoma is benign, while anaplastic astrocytoma and glioblastoma are malignant.

Pilocytic astrocytoma and other types

The types of astrocytoma differ in grade of malignancy, borders, and the age at which they most often occur:

• Pilocytic astrocytoma (grade I) is a benign tumor with clear borders that grows slowly; more common in children, localized in the cerebellum, brainstem, and optic nerves.
• Fibrillary astrocytoma (grade II) has no clear borders and grows slowly; occurs in patients aged 20–30 years.
• Anaplastic astrocytoma (grade III) is malignant, has no clear borders, grows rapidly and infiltrates brain tissue; patients are aged 30–50 years, and men are affected more often.
• Glioblastoma (grade IV) is the most malignant, has no clear borders, and grows very rapidly; patients are aged 40–70 years, and men are affected more often.

Astrocytoma in adults: symptoms

Symptoms depend on which part of the brain is affected and on age. Common manifestations are headaches, nausea and vomiting, loss of balance and difficulty walking, impaired writing and slowed speech, lethargy and drowsiness, weight loss or gain. Brain tumors may also cause seizures, persistent nausea, vomiting and drowsiness, changes in memory or personality, increasing weakness or paralysis on one side of the body, and problems with vision or speech. Sometimes there are no symptoms at first at all, or they develop very slowly. If a headache is unlike the usual one or worsens, this is a reason to see a doctor: a tumor may not be confirmed, but such symptoms are investigated.

How it is diagnosed: MRI and biopsy

Diagnosis begins with a doctor's examination and investigations. To detect a tumor, computed tomography (CT) and magnetic resonance imaging (MRI) are performed. If a tumor is suspected, a biopsy is mandatory: the skull is opened, a sample of brain tissue is taken, and it is examined under a microscope for tumor cells. If they are found, as much of the tumor as possible is removed. The doctor assesses the type of tumor, its location, size and spread, the degree of cell atypia, and the person's general condition and health. Ask questions directly: what grade this is, what investigations have already been done, and what each line in the report means.

Astrocytoma by itself is not a reason to call an ambulance; 103 or 112 — if seizures appear, increasing weakness or paralysis on one side of the body, or impairment of vision or speech.

This material is for reference: it helps to understand the terms and prepare for a conversation with a doctor, but it does not replace consultation with a specialist who sees your scans and medical history.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer