|NCI/PDQ® Patients: Childhood Cerebral Astrocytoma/Malignant Glioma|
|National Cancer Institute|
| Last Modified: August 6, 2002
Childhood cerebral astrocytoma is a type of brain tumor in which cancer(malignant) cells begin to grow in the tissues of the brain. The braincontrols memory and learning, the senses (hearing, sight, smell, taste, andtouch), and emotion. It also controls other parts of the body, includingmuscles, organs, and blood vessels. Other than leukemia or lymphoma, braintumors are the most common type of cancer that occur in children.
Astrocytomas are tumors that start in brain cells called astrocytes. Acerebral astrocytoma occurs in the area of the brain called the cerebrum, whichis 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 somewhereelse in the body and has spread (metastasized) to the brain. This is calledbrain metastasis.
A magnetic resonance imaging (MRI) scan, which uses magnetic waves to make apicture of your child's brain, may be done.
Often, surgery is required to see whether there is a brain tumor and to tellwhat type of tumor it is. The doctor may cut out a piece of tissue from thebrain 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.
Once childhood cerebral astrocytoma is found, more tests will be done to findout the type of tumor. If a biopsy specimen is taken, the cancer cells will belooked at carefully under a microscope to see how different they are from thenormal cells. This will determine the histologic grade of the tumor. Yourchild's doctor needs to know the type and grade of tumor in order to plantreatment.
Brain tumors are grouped by their location within the brain and the type ofcells where the cancer began. Cerebral tumors occur in the part of the brainlocated at the top of the head.
Low-grade tumors (tumors that look similar to normal astrocytes) do not usuallygrow quickly or spread from where they start.
High-grade tumors (tumors that do not look much like normal astrocytes) growquickly and often spread from where they start to other parts of the brain.
Recurrent disease means that the cancer has come back (recurred) after it hasbeen treated. It may come back in the brain or in another part of the body.
There are treatments for all children with brain tumors. Three kinds oftreatment are used:
Experienced doctors working together can often give the best treatment forchildren with cerebral astrocytoma. Your child's treatment will often becoordinated by a pediatric oncologist, a doctor who specializes in cancer inchildren. The pediatric oncologist may refer you to other doctors, such as apediatric neurosurgeon (a specialist in childhood brain surgery), a pediatricneurologist, a psychologist, a radiation oncologist, and other doctors whospecialize 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 doctormay remove as much of the tumor as possible. If the tumor cannot be totallyremoved, radiation therapy and chemotherapy may also be given. If the canceris in a place where it cannot be removed, surgery may be limited to a biopsy ofthe cancer.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrinktumors. Radiation therapy for childhood cerebral astrocytoma usually comesfrom a machine outside the body (external radiation therapy). The use ofradiation put into the brain through thin plastic tubes (internal radiationtherapy) is under study. For some types of brain tumors, clinical trials areevaluating radiation therapy given in several small doses per day(hyperfractionated radiation therapy). Radiation therapy can affect growth andbrain development, so clinical trials are testing ways to decrease or delayradiation therapy, especially for younger children.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken bypill, 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 thebloodstream, travels through the body, and can kill cancer cells throughout thebody. Chemotherapy is being studied to delay the use of radiation therapy insome patients. Clinical trials are studying different chemotherapy drugs forcerebral astrocytoma.
Treatment for cerebral astrocytoma depends on the type and stage of the diseaseand your child's age and overall health.
Your child may receive treatment that is considered standard based on itseffectiveness in a number of patients in past studies, or you may choose tohave your child go into a clinical trial. Not all patients are cured withstandard therapy and some standard treatments may have more side effects thanare desired. For these reasons, clinical trials are designed to test newtreatments and to find better ways to treat cancer patients. Clinical trialsare ongoing in most parts of the country for cerebral astrocytoma. If you wantmore information, call the Cancer Information Service at 1-800-4-CANCER(1-800-422-6237); TTY at 1-800-332-8615.
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 followingsurgery, or the doctor may wait until the cancer has started to grow againbefore giving radiation therapy. Chemotherapy is being studied in treatingsome groups of children, including those younger than 5 years of age.
Your child's treatment will probably be surgery followed by radiation therapyand chemotherapy. Clinical trials are evaluating surgery followed bychemotherapy with or without radiation therapy. Children younger than 3 yearsof age may be given chemotherapy to delay radiation therapy or so a lower doseof radiation may be given.
Treatment for recurrent disease depends on the type of tumor, whether the tumorcomes back in the same place or in another part of the brain, and the treatmentthat was given before.
Surgery and chemotherapy may be given. You may want to consider having yourchild enter a clinical trial of new chemotherapy drugs.
Surgery may be given. You should consider having your child enter a clinicaltrial of new chemotherapy drugs or new ways of giving therapy.
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 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.
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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, 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.
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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. 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 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.