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The Treatment Options For Astrocytoma Beyond Surgery
A recent event at Buckingham Palace honoured one brave young lady who has been suffering from a condition not much known about beyond the medical profession - a brain tumour known as an astrocytoma.
The girl in question was 11-year-old Lyla O’Donovan from Catterick in North Yorkshire, one of two children invited to the Palace for tea after being unable to make a garden party for charity fundraisers there a few weeks ago.
Her health had prevented her from making the trip, while the other child and his family had been stuck in traffic, the Daily Telegraph reported.
While their meeting with Queen Camilla was a heart-warming occasion, the fact that Lyla was so ill highlighted the fact that she had had no fewer than 20 operations to treat her pilocytic astrocytoma, which was diagnosed when she was three.
A regular symptom of her condition has been seizures, which accounted for her absence from the garden party.
As well as seizures, common symptoms include fatigue, nausea, vomiting, headaches, delirium, dementia, speech and motor problems.
Not all astrocytomas are cancerous. The World Health Organization classifies them into four grades. Grade 1 includes pilocytic astrocytoma, the type Lyla O’Donovan suffers from. This is slow-growing, non-cancerous and commonly develops in the cerebellum.
While this can impact the brain in a way that causes seizures, if it is removed no chemotherapy or radiotherapy is required afterwards post-surgery. However, as is evident in the case of the 11-year-old Palace guest, complete and final excision is not always possible and multiple operations may be required.
A pleomorphic xanthoastrocytoma is another kind, which tends to grow on the temporal lobe and is a very common cause of seizures, while a subependymal giant cell astrocytoma, which is associated with tuberous sclerosis, grows in ventricles. The last of these is genetic, but like other type 1 astrocytomas, surgery is normally the solution.
Overall, those with type 1 astrocytomas have the best survival rates, typically living ten years or more. This compares with five years for grade 2, between two and five years for grade three and only around a year for grade 4.
Type 4 is the most aggressive, featuring rapid spread and growth. Although occasionally arising as a progression from lower-grade astrocytomas, nine out of ten begin as grade 4.
Another key difference between the grades of astrocytomas is age. Grade 1 tumours tend to affect children, grade 2 tend to impact those aged 20-60, grade 3 affect those 30-60, and grade 4 are usually suffered by those aged over 50.
The last category is also by far the most common, accounting for almost a quarter of all brain tumours, whereas the other kinds each account for five per cent or lower.
In some cases of grade 1 and 2 tumours and all cases of 3 and 4, adjuvant therapy is needed to supplement surgery. As well as chemotherapy and radiation therapy, it can involve the injection of drugs aimed at curbing the growth of blood vessels in tumours, which hinders their growth, or the use of tumour-treating electrical fields.
Astrocytomas are usually caused by genetics (IDH mutant) and it is clear from the grading system that those with high levels are faced with significantly shorter life expectancy and the prospect of more extensive and gruelling treatment to battle the tumour.
However, for younger patients like Lyla O’Donnell, the likely prognosis may be much better, with the condition being non-cancerous, the potential for surgery to eventually provide a cure greater and the life expectancy longer.
Indeed, the last of these may offer extra hope as it creates opportunities for research to produce new and better treatments.
The girl in question was 11-year-old Lyla O’Donovan from Catterick in North Yorkshire, one of two children invited to the Palace for tea after being unable to make a garden party for charity fundraisers there a few weeks ago.
Her health had prevented her from making the trip, while the other child and his family had been stuck in traffic, the Daily Telegraph reported.
While their meeting with Queen Camilla was a heart-warming occasion, the fact that Lyla was so ill highlighted the fact that she had had no fewer than 20 operations to treat her pilocytic astrocytoma, which was diagnosed when she was three.
A regular symptom of her condition has been seizures, which accounted for her absence from the garden party.
Understanding Astrocytoma
This gives an insight into what this condition does, but to understand what can be done about it the first thing anyone seeking treatment for themselves or a loved one needs to know is that astrocytomas come in different kinds and can grow in various places. While they typically form on the brain, they can also appear on the spinal cord.As well as seizures, common symptoms include fatigue, nausea, vomiting, headaches, delirium, dementia, speech and motor problems.
Not all astrocytomas are cancerous. The World Health Organization classifies them into four grades. Grade 1 includes pilocytic astrocytoma, the type Lyla O’Donovan suffers from. This is slow-growing, non-cancerous and commonly develops in the cerebellum.
While this can impact the brain in a way that causes seizures, if it is removed no chemotherapy or radiotherapy is required afterwards post-surgery. However, as is evident in the case of the 11-year-old Palace guest, complete and final excision is not always possible and multiple operations may be required.
A pleomorphic xanthoastrocytoma is another kind, which tends to grow on the temporal lobe and is a very common cause of seizures, while a subependymal giant cell astrocytoma, which is associated with tuberous sclerosis, grows in ventricles. The last of these is genetic, but like other type 1 astrocytomas, surgery is normally the solution.
Overall, those with type 1 astrocytomas have the best survival rates, typically living ten years or more. This compares with five years for grade 2, between two and five years for grade three and only around a year for grade 4.
Cancerous Astrocytomas
The main reason survival prospects are worse for grades 2-4 is that these types of astrocytoma are cancerous. This includes grade 2, which tends to spread to other brain tissue and might not be resolvable by surgery alone. While they might need radiotherapy or chemotherapy, grade 3 tumours almost always do and are more aggressive.Type 4 is the most aggressive, featuring rapid spread and growth. Although occasionally arising as a progression from lower-grade astrocytomas, nine out of ten begin as grade 4.
Another key difference between the grades of astrocytomas is age. Grade 1 tumours tend to affect children, grade 2 tend to impact those aged 20-60, grade 3 affect those 30-60, and grade 4 are usually suffered by those aged over 50.
The last category is also by far the most common, accounting for almost a quarter of all brain tumours, whereas the other kinds each account for five per cent or lower.
Treating Cancerous Astrocytomas
Unfortunately, this means the most common forms of astrocytoma are the kind that cannot be cured through surgery. These can only be aided by chemotherapy and radiotherapy. How this is applied, especially in the case of radiotherapy, depends on whether the tumour is in the brain or spinal cord and, if it is in the former, what part.In some cases of grade 1 and 2 tumours and all cases of 3 and 4, adjuvant therapy is needed to supplement surgery. As well as chemotherapy and radiation therapy, it can involve the injection of drugs aimed at curbing the growth of blood vessels in tumours, which hinders their growth, or the use of tumour-treating electrical fields.
Astrocytomas are usually caused by genetics (IDH mutant) and it is clear from the grading system that those with high levels are faced with significantly shorter life expectancy and the prospect of more extensive and gruelling treatment to battle the tumour.
However, for younger patients like Lyla O’Donnell, the likely prognosis may be much better, with the condition being non-cancerous, the potential for surgery to eventually provide a cure greater and the life expectancy longer.
Indeed, the last of these may offer extra hope as it creates opportunities for research to produce new and better treatments.
