What is childhood cerebellar astrocytoma?
Childhood cerebellar astrocytoma is a type of brain tumor. A brain tumor
is an abnormal growth
of tissue contained within the skull, and can be benign (without cancer cells) or malignant (contains
cancer cells). The brain controls vital functions such as 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 and lymphoma, brain tumors are the
most common type of cancer that occurs in children.
This PDQ treatment summary refers only to tumors that originate in the
brain (primary brain
tumors). Metastatic brain tumors, which are secondary tumors formed by cancer cells that begin
in other parts of the body and spread to the brain, are not included. Brain tumors can occur in
both children and adults; however, treatment may be different for adults than for children. A
separate patient information statement containing information on brain cancer that occurs in adults
is also available in PDQ.
Astrocytomas are tumors that develop from brain cells called astrocytes.
occur in the area of the brain called the cerebellum, which is located at the back of the brain and
controls balance and complex motor activities, including walking and talking. Cerebellar
astrocytomas usually grow slowly and do not usually spread from the site in which they originated
to other parts of the brain or body, although they can invade large areas. Some astrocytomas form
cysts or are enclosed in a cyst.
If your child has symptoms that may be caused by a brain tumor, his
or her doctor may order a
magnetic resonance imaging (MRI) scan, a diagnostic test that uses magnetic waves to create
pictures of the body.
Often, surgery is required to determine whether there is a brain tumor
and what type of tumor it is.
The doctor may surgically remove a small sample of the tumor tissue, which is then examined
under a microscope. This is called a biopsy. Sometimes a biopsy is done by making a small hole
in the skull and using a needle to extract a sample of the tumor.
Your child's treatment and chance of recovery (prognosis) depend in
part on the tumor location
and the extent to which the tumor has spread.
Once childhood cerebellar astrocytoma is found, more tests will be performed
to learn more
about the tumor. If a biopsy specimen is taken, the tumor cells will be examined carefully under a
microscope to see how different they appear from normal cells. This will determine the grade of
the tumor. The grade of a tumor is determined by microscopic examination of its cells to see how
similar the cells are to normal cells. Cells from higher-grade, more abnormal-looking tumors
usually grow faster and are more malignant than cells from lower-grade tumors. Your child's
doctor needs to know the grade of tumor in order to plan treatment.
There is no staging for childhood cerebellar astrocytoma. The type of
treatment given depends on
the location and grade of the tumor and the patient's previous treatment.
Untreated childhood cerebellar astrocytoma
Untreated childhood cerebellar astrocytoma means that no treatment has
been given except to
Recurrent childhood cerebellar astrocytoma
Recurrent disease means that the cancer has come back (recurred) after
it has been treated. It
may recur in the brain or in another part of the body.
TREATMENT OPTION OVERVIEW
There are treatments for all children with cerebellar astrocytomas.
Three kinds of treatment are
surgery (removing the tumor in an operation)
radiation therapy (using high-dose x-rays to kill cancer cells)
chemotherapy (using drugs to kill cancer cells).
More than one method of treatment may be used, depending on the needs of the patient.
Experienced doctors working together may provide the best treatment
for children with cerebellar
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 your child to other
specialists, 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 primary treatment for childhood cerebellar astrocytoma.
Complete or near
complete removal of the tumor is often possible.
If the tumor cannot be completely removed, radiation therapy may be
given. Radiation therapy
uses high-energy radiation from x-rays and other sources to kill cancer cells and shrink tumors.
Radiation therapy for childhood brain tumors usually comes from a machine outside the body
(external radiation therapy).
Because radiation therapy can affect a child's growth and development,
chemotherapy may be
given to delay or eliminate the need for radiation therapy. Chemotherapy is the use of drugs to kill
cancer cells. Chemotherapy drugs may be taken by mouth or injected into a vein (intravenous) or
a 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.
Treatment by stage
Treatment for childhood cerebellar astrocytoma depends on the tumor
location, the extent to
which the tumor has spread, and the 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 enter 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 childhood brain tumors. For more information, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
UNTREATED CHILDHOOD CEREBELLAR ASTROCYTOMA
Treatment for previously untreated childhood cerebellar astrocytoma
depends on whether all of
the tumor can be surgically removed. If the tumor is completely removed, there may be no further
treatment. If any tumor remains after surgery, radiation therapy may be given following the
surgery, or may be delayed until the tumor starts to grow again. If the child is very young and all of
the tumor cannot be removed during surgery, chemotherapy may be given to delay the use of
RECURRENT CHILDHOOD CEREBELLAR ASTROCYTOMA
Recurrence or relapse may take place many years after initial treatment.
At the time of recurrence,
a complete evaluation is performed to determine the extent of the recurrence. Treatment for
recurrent childhood cerebellar astrocytoma depends on whether the tumor recurs in the location in
which it originated and the type of treatment that was previously given.
If your child was initially treated with surgery alone, treatment may
be additional surgery to
remove as much of the tumor as possible; if this is not feasible, radiation therapy may be given. If
patients who were initially treated with radiation therapy cannot be treated with surgery for their
recurrence, chemotherapy may be given. Clinical trials are currently evaluating the role of
chemotherapy for recurrent brain tumors.