ASTROCYTOMA

Astrocytoma

In the glioma family of tumors, astrocytomas are the most prevalent spine tumors. A rare tumor known as an astrocyte tumor of the spinal cord develops from astrocytes, which are star-shaped nerve support cells. They are not typically carcinogenic. The spinal cord may become dysfunctional as a result, therefore, doctors need to closely watch them. Only a tiny minority may act aggressively. Numerous types of cells make up the brain, including astrocytes, which provide neurons with the necessary structure and support to operate effectively. Neurons make up the electrical circuitry that controls brain activity. The most prevalent type of brain tumor in adult patients is an astrocytoma, which develops from astrocytes. Doctors diagnose Astrocytomas roughly 15,000 times a year in the US. It occurs more frequently after age 45 in males than in women. According to a ratio of 1.3/1, men appear somewhat more impacted than women.

Astrocytoma Defined

The glial cells known as astrocytes, which occur in the brain and spinal cord and have a star-like structure, can develop into a specific type of tumor known as an astrocytoma. The brain’s other regions may get affected by these uncommon malignancies. However, older men appear more likely to develop an astrocytoma than children or individuals of any age. Doctors categorize spinal cord Astrocytomas into four classes based on scientific studies in medicine:

Grade I

The surgical excision of certain benign tumors, including pilocytic astrocytoma, can cure them. Although they do not infiltrate other structures, if they are big enough, they can produce symptoms through a mass effect. Most cases of these low-grade astrocytomas are in youngsters.

Grade II

These are slow-growing and infiltrating spine tumors. Doctors need to regularly monitor them since they can become more aggressive.

Grade III

Also known as Anaplastic Astrocytomas, these aggressive tumors get treated as cancer.

Grade IV

These high-grade astrocytomas are normally malignant and the most aggressive and quickly expanding kind. Higher grade (Grade III) astrocytomas also signify a fast-growing, malignant tumor, while lower grade (Grade I and II) astrocytomas often refer to benign, slow-growing tumors. These cancerous tumors frequently infect neighboring healthy tissue, escalating the harm. Tumors of lower grades can advance to a higher grade.

Additionally, the Location of the Tumors Helps to Categorize Them:

Brainstem gliomas are astrocytomas that develop in this area of the brain. These astrocytomas are situated around the base of the patient’s skull and above the back of the neck, an area where the brainstem aids in controlling vital bodily processes like breathing and heart rate. Although these tumors can classify as any grade, brainstem gliomas often affect children and young adults and are typically high grade. Pineal astrocytic tumors are tumors that develop in the region of the pineal gland in the brain. The pea-sized gland responsible for producing the hormone melatonin, which controls the sleep-wake cycle, is located in this area. There are many grades of pineal astrocytic tumors. A few astrocytomas also have oligodendrocytes, a different kind of glial cell. Mixed gliomas or oligoastrocytomas identify the names of these tumors.

What are the Causes of Astrocytoma?

We do not know the exact cause of most astrocytomas. Therapeutic irradiation can lead to the development of astrocytomas. Other environmental exposures, though suspected, do not cause astrocytoma. There is evidence of a hereditary component in some instances, according to several researchers.

Symptoms of Spinal Cord Astrocytoma

The following symptoms may appear, depending on the location of the Spinal Tumor

1. chronic back pain
2. Emaciation and other sensory modifications
3. Inability to control one’s bladder or bowels Muscle weakness or spasms on one or both sides of the body
4. imbalance issues and unstable gait (ataxia)

Doctors identify herniated discs or spinal stenosis as much more likely the source of these symptoms. However, variations can occur that only a skilled expert might spot.

Risk Factors of Spinal Cord Astrocytoma

An astrocyte, or support cell of the nervous system, grows disorderly as a result of a genetic mutation, which results in the development of an astrocytoma. Although a benign or low-grade astrocytoma grows slowly, the effect on the nearby tissues might nonetheless result in symptoms. If more mutations take place, the tumor cells learn how to infiltrate and invade the tissues around them, which results in a malignant transformation. The precise etiology of these alterations is unclear, as it is frequently the case with primary spinal neoplasms. The following identifies known risk factors:

Age

In general, astrocytomas of the spine appear more frequently in children and young people and appear less harmful at this age. Adults over the age of 35 usually develop aggressive tumors — developing into malignancies.

Radiation exposure

A major contributing element to the development of spinal astrocytomas is prior ionizing radiation exposure. Radiation therapy, nuclear pollution, and X-rays are examples of ionizing radiation. There is no proof linking the development of astrocytomas in the spinal cord to electromagnetic radiation from power lines, microwaves, or mobile phones.

Genetic factors

There is not much proof that hereditary factors play a role in the development of spine astrocytomas.

Diagnosis of Spinal Cord Astrocytoma

Diagnosis begins with a thorough evaluation by a spine specialist. This includes a complete medical history and a neurological examination to identify even subtle defects. If done well, your medical history and physical condition will determine which parts of the spine are affected. MRI is the test of choice for confirming the diagnosis of astrocytoma and providing a clear anatomical picture of tumor location, size, and morphology. Once the tumor has been localized and the involvement of surrounding structures has been analyzed, the patient will likely be scheduled for a tissue biopsy, which can be done separately or in combination with tumor resection. increase.

A surgical procedure called a biopsy enables the surgeon to take a tiny sample of the damaged tissue while the patient is asleep in the operating room. A neuropathologist will examine the tissue obtained during the biopsy under a microscope in the laboratory. An examination of the tumor will disclose if it is benign or malignant.  The tumor’s grade and cell of origin will also be determined by the biopsy. The prognosis and treatment strategies are determined by each of these variables.

Treatment of Spinal Cord Astrocytoma

Finally, the location, size, grade, age, general health status, and medical history all have a role in the course of treatment for spinal astrocytomas. If a low-grade astrocytoma doesn’t show any symptoms of development or spread, watchful waiting with or without radiation therapy is an option for treatment. The best safest surgical excision of the tumor without harming the spinal cord is the recommended course of therapy for big or aggressive tumors. Preserving spinal cord function is always the aim. Uncompleted resection can lessen symptoms and limit the spread of the disease, despite the fact that it won’t cure the ailment. In order to remove tumors as safely and effectively as possible, a neurosurgeon employs a number of techniques, including lasers and intraoperative ultrasonography. Infection, hemorrhage, cerebrospinal fluid leak, weakness, sensory loss, imbalance, and tumor recurrence are possible post-operative side effects. Chemotherapy and radiation treatment are frequently used after surgery.

Surgery

Surgery to remove all or as much of the tumor as possible is likely the first step. The exception is when gliomas grow in areas where surgery becomes too risky. Surgery may suffice to cure grade 1 tumors, but it usually does not remove all high-grade tumors.

Radiation Therapy

Radiation is not advised as the first line of treatment for newly diagnosed spinal cord astrocytoma, although it can improve survival when given as adjuvant therapy following surgery. The treatment of recurrent astrocytomas includes radiotherapy as well. The use of radiation therapy (RT) is common:

• To reduce tumors in the spinal cord that do not require surgical removal.
• To reduce the size of the tumor before removal to facilitate surgery.
• To eradicate any remaining tumor cells following an inadequate excision.

A radiation oncologist performs radiation treatment, using a specialized device that accurately directs a beam of high-energy particles (such as X-rays or protons) toward the tumor. Along with other side effects including nausea, headaches, fatigue, and appetite loss, radiation therapy can also cause red, painful, and irritated skin. Additionally, tingling, weakness, or unbalance may occur.

Chemotherapy 

The treatment of glioblastoma and anaplastic astrocytoma with chemotherapy is common. Using it either before or after radiation is possible. Implanting chemotherapeutic wafers during surgery is a possibility in some circumstances. Although refractory spinal cord Astrocytomas are now the most prevalent use of chemotherapy, their routine usage as adjuvant therapy is on the rise. After surgery, the doctors will discuss having chemotherapy with or without radiation with the parents.

Targeted therapy

Doctors may use a more recent kind of therapy called targeted therapy.  This treatment may reduce the size of the tumor. In that it targets certain proteins that promote tumor growth, this differs from chemotherapy in how it functions.

Electric-field therapy

Electric-field treatment employs electrical fields to target tumor cells while sparing healthy cells from damage. Electrodes are placed right on the body to perform the procedure. The system is known as Optune. Following surgery and radiation, it is administered together with chemotherapy. Both those with a recent diagnosis and those whose glioblastoma has returned are eligible for its FDA-approved treatment.