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Information from PDQ for Patients
Childhood cerebral astrocytoma/malignant glioma
208/05741
** DESCRIPTION **
-- What is childhood cerebral astrocytoma tumor --
Childhood cerebral astrocytoma is a type of brain tumor in which cancer
(malignant) cells begin to grow in the tissues of the brain. The brain
controls memory and learning, the senses (hearing, sight, smell, taste, and
touch), and emotion. It also controls other parts of the body, including
muscles, organs, and blood vessels. Other than leukemia or lymphoma, brain
tumors are the most common type of cancer that occur in children.
Astrocytomas are tumors that start in brain cells called astrocytes. A
cerebral astrocytoma occurs in the area of the brain called the cerebrum, which
is at the top of the head.
This PDQ treatment information summary covers tumors that start in the brain
(primary brain tumors). Often cancer found in the brain has started somewhere
else in the body and has spread (metastasized) to the brain. This is called
brain metastasis.
A magnetic resonance imaging (MRI) scan, which uses magnetic waves to make a
picture of your child's brain, may be done.
Often, surgery is required to see whether there is a brain tumor and to tell
what type of tumor it is. The doctor may cut out a piece of tissue from the
brain and look at it under a microscope. This is called a biopsy.
There are many types of brain tumors in children and the chance of recovery
(prognosis) depends on the type of tumor, where it is located within the brain,
and your child's age and general health.
** STAGE EXPLANATION **
Once childhood cerebral astrocytoma is found, more tests will be done to find
out the type of tumor. If a biopsy specimen is taken, the cancer cells will be
looked at carefully under a microscope to see how different they are from the
normal cells. This will determine the histologic grade of the tumor. Your
child's doctor needs to know the type and grade of tumor in order to plan
treatment.
Brain tumors are grouped by their location within the brain and the type of
cells where the cancer began. Cerebral tumors occur in the part of the brain
located at the top of the head.
-- Low-grade cerebral astrocytoma --
Low-grade tumors (tumors that look similar to normal astrocytes) do not usually
grow quickly or spread from where they start.
-- High-grade cerebral astrocytoma --
High-grade tumors (tumors that do not look much like normal astrocytes) grow
quickly and often spread from where they start to other parts of the brain.
-- Recurrent cerebral astrocytoma --
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the brain or in another part of the body.
** TREATMENT OPTION OVERVIEW **
There are treatments for all children with brain tumors. Three kinds of
treatment are used:
surgery (taking out the cancer in an operation)
radiation therapy (using high-dose x-rays to kill cancer cells)
chemotherapy (using drugs to kill cancer cells).
Experienced doctors working together can often give the best treatment for
children with cerebral astrocytoma. Your child's treatment will often be
coordinated by a pediatric oncologist, a doctor who specializes in cancer in
children. The pediatric oncologist may refer you to other doctors, such as a
pediatric neurosurgeon (a specialist in childhood brain surgery), a pediatric
neurologist, a psychologist, a radiation oncologist, and other doctors who
specialize in the type of treatment your child requires.
Surgery is the most common treatment for a child with cerebral astrocytoma.
Depending on where the cancer is and the type of cancer, your child's doctor
may remove as much of the tumor as possible. If the tumor cannot be totally
removed, radiation therapy and chemotherapy may also be given. If the cancer
is in a place where it cannot be removed, surgery may be limited to a biopsy of
the cancer.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink
tumors. Radiation therapy for childhood cerebral astrocytoma usually comes
from a machine outside the body (external radiation therapy). The use of
radiation put into the brain through thin plastic tubes (internal radiation
therapy) is under study. For some types of brain tumors, clinical trials are
evaluating radiation therapy given in several small doses per day
(hyperfractionated radiation therapy). Radiation therapy can affect growth and
brain development, so clinical trials are testing ways to decrease or delay
radiation therapy, especially for younger children.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in a vein or muscle.
Chemotherapy is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells throughout the
body. Chemotherapy is being studied to delay the use of radiation therapy in
some patients. Clinical trials are studying different chemotherapy drugs for
cerebral astrocytoma.
-- Treatment by type --
Treatment for cerebral astrocytoma depends on the type and stage of the disease
and your child's age and overall health.
Your child may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or you may choose to
have your child go into a clinical trial. Not all patients are cured with
standard therapy and some standard treatments may have more side effects than
are desired. For these reasons, clinical trials are designed to test new
treatments and to find better ways to treat cancer patients. Clinical trials
are ongoing in most parts of the country for cerebral astrocytoma. If you want
more information, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237); TTY at 1-800-332-8615.
** LOW-GRADE CHILDHOOD CEREBRAL ASTROCYTOMA **
Treatment depends on whether all of the cancer can be removed during surgery.
If the cancer can be removed during surgery, there may be no more treatment.
If there is cancer left after surgery, radiation therapy may be given following
surgery, or the doctor may wait until the cancer has started to grow again
before giving radiation therapy. Chemotherapy is being studied in treating
some groups of children, including those younger than 5 years of age.
** HIGH-GRADE CHILDHOOD CEREBRAL ASTROCYTOMA **
Your child's treatment will probably be surgery followed by radiation therapy
and chemotherapy. Clinical trials are evaluating surgery followed by
chemotherapy with or without radiation therapy. Children younger than 3 years
of age may be given chemotherapy to delay radiation therapy or so a lower dose
of radiation may be given.
** RECURRENT CHILDHOOD CEREBRAL ASTROCYTOMA **
Treatment for recurrent disease depends on the type of tumor, whether the tumor
comes back in the same place or in another part of the brain, and the treatment
that was given before.
-- Recurrent low-grade cerebral astrocytoma --
Surgery and chemotherapy may be given. You may want to consider having your
child enter a clinical trial of new chemotherapy drugs.
-- Recurrent high-grade cerebral astrocytoma --
Surgery may be given. You should consider having your child enter a clinical
trial of new chemotherapy drugs or new ways of giving therapy.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
In the United States, about two-thirds of children with cancer are treated in a
clinical trial at some point in their illness. A clinical trial is a study to
answer a scientific question, such as whether one treatment is better than
another. Trials are based on past studies and what has been learned in the
laboratory. Each trial answers certain scientific questions in order to find
new and better ways to help cancer patients. During treatment clinical trials,
information is collected about new treatments, the risks involved, and how well
they do or do not work. If a clinical trial shows that a new treatment is
better than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. For additional help in
locating a childhood cancer clinical trial, call the Cancer Information Service
at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
The PDQ database contains listings of groups specializing in clinical trials.
The Children's Oncology Group (COG) is the major group that organizes clinical
trials for childhood cancers in the United States. Information about
contacting COG is available on Cancer.gov (http://cancer.gov) or from the
Cancer Information Service at 1-800-4-CANCER (1-800-422-6237), TTY at
1-800-332-8615.
The PDQ database contains listings of cancer health professionals and hospitals
with cancer programs.
Because cancer in children and adolescents is rare, the majority of children
with cancer are treated by health professionals specializing in childhood
cancers, at hospitals or cancer centers with special facilities to treat them.
The PDQ database contains listings of health professionals who specialize in
childhood cancer and listings of hospitals with cancer programs. For help
locating childhood cancer health professionals or a hospital with cancer
programs, call the Cancer Information Service at 1-800-4-CANCER
(1-800-422-6237), TTY at 1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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This information has been brought to you by
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licenced by the National Cancer Institute as a distributor of CancerNet.