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Childhood cerebral astrocytoma


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is childhood cerebral astrocytoma tumor
STAGE EXPLANATION
Low-grade cerebral astrocytoma
High-grade cerebral astrocytoma
Recurrent cerebral astrocytoma
TREATMENT OPTION OVERVIEW
Treatment by type
LOW-GRADE CHILDHOOD CEREBRAL ASTROCYTOMA
HIGH-GRADE CHILDHOOD CEREBRAL ASTROCYTOMA
RECURRENT CHILDHOOD CEREBRAL ASTROCYTOMA
Recurrent low-grade cerebral astrocytoma
Recurrent high-grade cerebral astrocytoma
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that provides up-to-date information on cancer and its prevention, detection, treatment, and supportive care. PDQ is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

Cancer in children and adolescents is rare. The majority of children with cancer are treated at cancer centers with special facilities to treat childhood cancers. There are organized groups of doctors and other health care professionals who work together by doing clinical trials to improve treatments for children with cancer.

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your child's doctor, who knows your child and has the facts about your child's disease. PDQ can also provide the names of additional health care professionals and hospitals that specialize in treating children who have cancer.

Before your child begins treatment, you may want to consider entering your child in a clinical trial. PDQ can be used to learn more about the trials. A clinical trial is a research study that attempts to improve current treatments or find new treatments for people with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers specific scientific questions in order to find new and better ways to help people with cancer. During clinical trials, information is collected about new treatments, their risks, and how well they do or do not work. When a clinical trial shows that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the "standard" treatment. Children who are treated in clinical trials have the advantage of getting the best available therapy. In the United States, about two thirds of children with cancer are treated in a clinical trial at some point in their illness.

Listings of current clinical trials are available on PDQ. In the United States, there are two major groups (called cooperative groups) that organize clinical trials for childhood cancers: the Childrens Cancer Group (CCG) and the Pediatric Oncology Group (POG). Doctors who belong to these groups or who take part in other clinical trials are listed in PDQ.

To learn more about cancer and how it is treated or to learn more about clinical trials for your child's kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer your cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


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 separate patient information summary containing information on brain cancer that occurs in adults is also available in PDQ.

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

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cerebral astrocytoma, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800- 332-8615. The call is toll-free and a trained information specialist can answer your questions.

The Cancer Information Service can also send you booklets. The following booklet about brain tumors may be helpful to you:

What You Need To Know About Brain Tumors

The following booklets on childhood cancer may be helpful to you:

Young People with Cancer: A Handbook for Parents
Talking with Your Child About Cancer
Managing Your Child's Eating Problems During Cancer Treatment
When Someone in Your Family Has Cancer

The following general booklets on questions related to cancer may also be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where material about cancer treatment and information about services are available. Check the hospital social service office for local and national agencies that help with finances, getting to and from treatment, care at home, and dealing with other problems.

Write to the National Cancer Institute at this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 09/1999


If you want to know more about cancer and how it is treated, or 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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