Astrocytoma of the brain: consequences, complications, prognosis

Astrocytoma of the brain is one of the most common tumors of the head or spine. Since this neoplasm appears in the brain (from its cells) - the main controlling organ, it cannot but affect the patient's quality of life. Constant headaches, nausea, vomiting exhaust the patient, reducing his ability to work. As the tumor grows, the symptoms intensify and acquire new ones: impaired sensitivity, paresis and paralysis, visual and hearing disorders, decreased mental abilities, etc.

Even a benign astrocytoma, if not removed, can make a person disabled. Thus, a pilocytic astrocytoma of the 1st degree of malignancy is a nodular tumor with multiple cysts inside, which tend to grow (albeit not quickly) and reach large sizes. The risk of degeneration of such a tumor is extremely small even after some time, but this does not mean that a person does not need to be treated. [ 1 ]

It's scary to imagine what consequences such a tumor can cause if it is found in a child. Pilocytic astrocytoma can grow for several years, and gradually parents will notice how their child is simply becoming stupid before their eyes, lagging behind peers in development, becoming an outcast, not to mention the painful symptoms that haunt the baby.

The hope that after the tumor is removed, the impaired mental functions will be restored, fades as the child grows up, because most of them are easily formed only in preschool age. If you do not teach a child to speak before 6-7 years, it will be almost impossible to do so later. The same applies to other higher mental functions, which at a young age should develop, not degrade. Poor memory and insufficient concentration will cause poor performance at school, developmental delays, which will be difficult to catch up with.

If the tumor grows to a huge size, which is easy to notice even externally, it actually kills the brain, without even "eating" its cells. By squeezing the vessels, it deprives the brain of normal nutrition, and it dies from hypoxia. It turns out that you can die even from a benign neoplasm.

The smaller the tumor, the easier it is to remove it, and thus avoid dangerous consequences and complications during surgery. Yes, such complications are also possible. Most often, postoperative complications are detected in advanced malignant tumors or removal of deep-seated rather large neoplasms. It is clear that the competence and experience of the neurosurgeon play a significant role.

When agreeing to surgery, a person has the right to know what the positive and negative consequences may be. Positive consequences may include both complete recovery and stopping the growth of the tumor (even if only temporarily). Possible negative consequences include: paresis and paralysis of the limbs, loss of vision or hearing, development of epilepsy, mental disorders, ataxia, aphasia, dyslexia, etc. The risk of bleeding during or after surgery should not be ruled out.

If the operation is unsuccessful, there is a risk that the person will not be able to take care of himself and will become a "vegetable", incapable of performing elementary actions. But again, the risk of negative consequences is higher, the more advanced the tumor is, the deeper it penetrates into the brain structures.

It is clear that the greatest number of complications arise when treating malignant neoplasms that can take root (metastasize) not only in the brain, but also in other vital organs. It is almost impossible to completely remove such a tumor, since it is extremely difficult to track the paths of its cells. Diffuse tumors prone to degeneration penetrate into different parts of the brain, quickly spreading to the surrounding space, destroying its cells. Removing such a tumor does not always help to restore lost functions. [ 2 ], [ 3 ]

Recurrence of astrocytoma after surgery is not an exception even in the case of a benign tumor. If not all the cells of the tumor were removed, but the tumor was disturbed, this can increase the risk of its degeneration into a malignant one. And such a risk exists to one degree or another in all brain astrocytomas. [ 4 ], [ 5 ]

Whether to agree to the operation, everyone decides for themselves (or the child's parents), but it is important to understand that all the described complications occur even in the absence of treatment. Only in this case their probability approaches 100%.

Life expectancy for astrocytoma

Brain astrocytoma manifests itself differently in different people, so it is simply impossible to say exactly how long patients live. In the case of low-grade malignancy tumors, surgical intervention gives hope for a long life. If the tumor is not treated, over time it can not only increase in size, compressing the brain and causing a lot of unpleasant symptoms, but also, under certain conditions, develop into a malignant form, the treatment of which has a worse prognosis for life.

For example, if anaplastic astrocytoma is not treated, the patient can survive for a couple of years at best. But surgical treatment of a malignant tumor of stage 3, even with an adequate response to chemo- or radiation therapy, often ends in a relapse of the disease and the death of the patient. On average, the life expectancy of such patients is 3-4 years, although some exceed the control 5-year survival threshold. The 5-year survival rate for diffuse astrocytoma aged 20 to 44 years is 68%, and for anaplastic astrocytoma - 54%. With highly differentiated astrocytoma, patients under 43 years of age and those who received chemotherapy had a better overall survival [ 6 ]. With stage II astrocytoma, the average survival time is 5-8 years, they also have a high relapse rate. [ 7 ]

With glioblastoma multiforme, the prognosis is even worse - from several months to 1 year, although with the right approach to treatment and the use of a ketone diet can reduce the rate of their progression [ 8 ]. With optimal treatment, patients with glioblastoma have an average survival of less than one year. About 2% of patients survive for three years. [ 9 ] Low-grade glioma (LGG) is an incurable, fatal disease of young people (average age 41 years), with an average survival of about 7 years. [ 10 ]

Doctors clearly answer the question: is a complete recovery possible with an astrocytoma of the spinal cord or brain?

• More than 90 out of 100 people (more than 90%) with grade 1 astrocytoma survive for 5 or more years after diagnosis.
• About 50 out of 100 people (about 50%) with grade 2 astrocytoma survive 5 years or more after diagnosis.
• More than 20 out of 100 people (20%) with grade 3 astrocytoma survive 5 or more years after diagnosis.
• About 5 in 100 people (about 5%) with grade 4 astrocytoma survive 5 years or more after they are diagnosed.[ 11 ]

In leading Israeli clinics, doctors successfully perform such operations and report not only a high survival rate, but also a complete recovery for most patients.

But with diffuse tumors, the localization of which is difficult to visualize, even in the case of a benign neoplasm, it is difficult to promise recovery. Without determining the exact boundaries of the tumor, it is impossible to say with complete certainty that all its cells will be removed. Radiation therapy, of course, can improve the prognosis of treatment, but its impact on the body in the future is difficult to predict. True, modern technologies (linear accelerators) help minimize the harmful effects of ionizing radiation on healthy cells, but radiation therapy still remains a serious blow to the immune system.

As for malignant astrocytomas, doctors are of the opinion that it is impossible to completely cure them. Sometimes it is possible to achieve a fairly long remission (3-5 years), but sooner or later the tumor begins to relapse, repeated treatment is perceived by the body more difficultly than the first, requires a reduction in the dosage of chemotherapeutic drugs and radiation, as a result, its effectiveness is lower.

Disability in case of benign astrocytoma (operated, non-operated, with a questionable diagnosis) occurs not in case of detection of a tumor, but when manifestations of the disease become an obstacle to the performance of professional duties. The patient is assigned the 3rd group of disability and is recommended work not associated with physical and neuropsychic stress, excluding contact with harmful environmental factors. In the future, if the patient's condition worsens, the conclusion of the Medical and Social Expertise Commission may be revised.

If the symptoms of the disease cause a significant limitation of life activity, i.e. the person can no longer work even at light work, the patient is assigned a disability group 2.

In case of malignant tumors, the presence of pronounced neurological symptoms, irreversible disruptions in the functioning of vital organs, as well as in the case of the last stage of cancer, when a person cannot take care of himself, he receives the 1st group of disability.

When determining a disability group, many factors are taken into account: the patient’s age, the degree of malignancy, whether there was an operation, what are the consequences, etc. Therefore, the commission makes a decision for each patient individually, based not only on the diagnosis, but also on the patient’s condition.

Prevention

Cancer prevention usually comes down to a healthy lifestyle, avoiding contact with carcinogens and radiation, giving up bad habits, healthy eating, and preventing injuries and infections. Unfortunately, if everything were that simple, the problem of brain tumors would not be so acute. Perhaps in the future, we will know the causes of brain astrocytoma, and geneticists will learn to “repair” pathological genes, but for now we have to limit ourselves to the above measures to minimize the possible risk. Three prospective cohort studies have proven a link between caffeine consumption (coffee, tea) and the risk of developing gliomas in adults [ 12 ]. The possibility of using stem cells to prevent glioblastoma recurrence is being studied [ 13 ]

Astrocytoma of the brain is a disease that leaves its dark mark on a person's life. But while the disease is in its early stages, it should not be perceived as a death sentence. This is a test of strength, faith, patience, an opportunity to reassess your life and do everything possible to regain your health or at least save a few years of a more or less full life. The earlier the disease is detected, the greater the chances of overcoming it, emerging victorious from a difficult but extremely important battle. After all, every moment of a person's life has value, and especially the one on which the future depends.