Understanding Astrocytoma Brain Tumors
- Natasha Dering suffered a seizure at age 29 while on vacation with her then-fiance in February. She was later diagnosed with Grade 2 astrocytoma brain tumor, which is rare type of cancer and a low-grade glioma.
- After undergoing surgery to remove nearly 90 percent of her brain, Natasha is on the road to recovery amid her cancer journey and doing so with the love of her life by her side.
- Astrocytoma brain tumors develop from astrocytes, which are “star-shaped cells” found in the brain. The American Brain Tumor Association describes these tumors as “slow growing and tend to invade surrounding tissue.”
- The astrocytoma Dering was diagnosed with was declared a grade 2. At grade 2, there’s a chance astrocytoma may progress into a glioblastoma brain tumor, according to research published in the National Library of Medicine.
- When it comes to brain tumors, as new treatment approaches are continually being explored through clinical trials, the standard of care for glioblastoma has remained largely consistent since 2005. It combines maximal safe surgical resection (surgery to remove as much of the cancer as possible) followed by chemotherapy and radiation.
Astrocytoma brain tumors develop from astrocytes, which are “star-shaped cells” found in the brain. As per the American Brain Tumor Association, these types of tumors as “slow growing and tend to invade surrounding tissue.” This is a type of glial tumor and makes up “60 percent of the tumors,” according to research published in StatPearls. Additionally, research published in the National Library of Medicine, explains that grade 2 astrocytoma is usually seen in adults and “may progress to glioblastoma.”
Read More“It was a really dark time. I tried to keep moving forward by supporting her through all the biopsies, surgeries and everything else. But it was scary, especially because, for about seven months, we didn’t know the grade or specifics of the cancer.”
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Looking back on how Natasha’s journey has led to a lot of time spent in the hospital, Trevor commented on how he shared a video of him and his now wife practicing their first dance for their wedding, alongside her hospital bed.
He told People, “We’d been practicing at home before, and I just wanted to bring some joy to her in the hospital. So we set up the speaker, put on the Bee Gees, our first dance song, and just started practicing.
“It was a great distraction, something to take our minds off everything that was going on. It felt really special.”
The song they chose to dance to was “How Deep Is Your Love,” by the Bee Gees.
Trevor captioned the sweet footage shared on TIkTok, “This year was filled with the lowest of lows and the highest of highs… Even if today were the only day promised, I’d still be the luckiest man in the world for marrying you.”
@fijiblue This year was filled with the lowest of lows and the highest of highs… Even if today were the only day promised, I’d still be the luckiest man in the world for marrying you 💛 #hope #cancer #wedding
Referring to how his mom reacted while taking the footage, he told People, “She was definitely tearing up, and I’m glad she recorded it. But at the same time, it was just special to have that moment, a brief distraction from everything, even if only for a second.”
They ended up getting married on June 15 at a barn in Maine—and three months later, Natasha underwent brain surgery to get the tumor removed. The surgery followed inconclusive brain biopsy results and resulted in 80 percent to 90 percent of the mass being successfully taken out, which led to her low-grade glioma diagnosis.
To recap her cancer journey, Natasha shared a photo of herself in a hospital bed in October, writing, “This has been the hardest year of my life. TLDR [too long; didn’t read] — I have brain cancer. On February 29th, I had my first seizure of life while on a vacation in Mexico. I immediately got an MRI when I got home, where we discovered a mass in my brain. The next week was spent trying to diagnose the lesion and figure out what we had to do next.
“At first we thought it was tumefactive MS, but after more testing we found out it was a low-grade glioma. This was a huge shock especially since I started working as a PA in pediatric neurosurgery about a year ago.”
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She continued, “Two weeks ago, I had a resection of my tumor with an awake component and have been slowly recovering since. We recently received positive news, the pathology came back as an Astrocytoma, grade 2, with an IDH-1 mutation.
“Essentially this is the best we could have hoped for — this specific tumor can be treated with a new medication that was recently FDA approved. Which means chemo & radiation can likely be avoided for the time being. I’ll be starting this new medication soon & will be taking it for life.”
Natasha concluded by telling her followers she’s continuing to recover and is grateful for all the support she’s received along her cancer journey.
“Although our treatment plan is just beginning, we are extremely hopeful for what the future holds and are remaining optimistic as we get ready for what’s next,” she concluded.
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Understanding Brain Tumors
Brain tumors account for 85-90% of all primary central nervous system (CNS) tumors, according to the American Society of Clinical Oncology (ASCO). In 2023, the ASCO estimated that 24,810 adults (14,280 men and 10,530 women) in the United States would be diagnosed with primary cancerous tumors of the brain and spinal cord.
The central nervous system consists of the brain and spinal cord and acts as the main “processing center” for the body’s nervous system. The normal function of the brain and spinal cord can become difficult if there’s a tumor putting pressure on or spreading into normal tissue close by.
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There are many different types of brain and spinal cord tumors and some of which are more likely to spread into nearby parts of the brain or spinal cord than others. Slow-growing tumors may be considered benign, however, even these types of tumors can lead to serious problems.
Meanwhile, symptoms of brain tumors, as a whole, are usually caused by increased pressure in the skull. This pressure can stem from tumor growth, swelling in the brain, or blockage of cerebrospinal fluid (CSF), the American Cancer Society explains.
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General symptoms may include:
- Headache
- Nausea
- Vomiting
- Blurred vision
- Balance problems
- Personality or behavior changes
- Seizures
- Drowsiness or even coma
Additionally, MD Anderson Cancer Center notes that changes in the ability to smell can also be a sign of brain tumors, and, more specifically, “strange smells” can be a symptom of seizures, which can result from brain tumors.
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It’s important to note that these symptoms are not exclusive to brain tumors. Still, you should always speak with your doctor if you’re experiencing any health problems.
Meanwhile, treatment options for brain cancer depend on a variety of factors, including the size and type of the tumor as well as the grade of the tumor.
Surgery, radiation, and chemotherapy are options doctors use to treat brain tumors. Cancer warriors are encouraged to talk to their doctor about their situation and the best treatment options.
Understanding Gliomas
There are various types of brain cancers and tumors that someone may be diagnosed with, so it’s important to understand that a glioma is a tumor originating in the central nervous system (CNS), specifically in the brain or spinal cord. A glioma originates in glial cells. Glial cells are supportive cells in the brain that protect and maintain the neurons. These types of tumors can either be benign (non-cancerous) or malignant (cancerous).
“Glioma is a broad term that refers to a whole range of different types of primary brain tumors,” Dr. Alexandra Miller, Director of the Neuro-Oncologist Division at NYU Langone Health, tells SurvivorNet.
“They’re tumors that originate in the brain and very rarely spread outside the brain to other parts of the body,” Dr. Miller continued.
Glioblastoma (GBM) is the most aggressive and lethal form of primary brain tumor. Classified as a Grade 4 glioma by the World Health Organization (WHO), glioblastoma presents significant challenges for treatment due to its highly invasive nature, rapid growth, and resistance to most conventional therapies.
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According to the National Cancer Institute, the average survival rate is 15 months with treatment and less than six if left untreated. While there is a five-year survival rate of averaging 6 percent, those individuals will never be cancer-free. They must continue receiving radiation and chemotherapy for the rest of their lives.
Clinical trials help doctors better understand cancer and discover more effective treatment methods. They also allow patients to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), which can potentially be life-changing.
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Within the U.S., all new drugs must go through clinical trials before the FDA approves them. Although the rewards of clinical trials can be great, they also come with risks. Talking to your doctor about this before enrolling in a trial is important.
The Grading System of Gliomas
Gliomas are graded on a scale of I to IV, with higher grades indicating a more aggressive tumor. This grading is based on several factors including the type of glioma, the genetics of the cancer, as well as the appearance of the tumor cells under a microscope. The more abnormal the cells look, the higher the grade, and the faster the tumor is likely to grow and spread. Here’s a quick overview:
- Grade I-II gliomas – These are considered low-grade and tend to grow slowly. “The grade one is a very indolent, benign tumor that basically can be cured with surgery alone,” Dr. Henry Friedman, Deputy Director of the Preston Robert Tisch Brain Tumor Center at Duke, tells SurvivorNet.
- Grade III gliomas – These are considered high-grade and tend to grow more rapidly. Grade III gliomas are typically classified as malignant and typically require more aggressive treatment which can include surgery, radiation, and chemotherapy.
- Grade IV gliomas – These are the most aggressive gliomas which are locally aggressive and require treatment intensification. Glioblastomas are the most common grade IV glioma, “which is by far the most well known and most feared tumor in the lay population and quite frankly, the medical population as well,” Dr. Friedman explains.
Although Grade IV gliomas are the most aggressive glioma and may require several types of treatment including surgery, radiation, and chemotherapy, there can be challenges in treating low grade gliomas as well. When making decisions on treatment, several factors are taken into consideration including location of the tumor, ease of surgery and ability to resect, neurologic deficits, patient age, tumor size, and overall health.
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Gliomas can present a variety of ways. The symptoms are often non-specific, meaning there is no slam-dunk symptom or key finding that is common to all gliomas. Symptoms can also be related to tumor location, and more commonly the increased pressure caused by the mass inside the skull, which can disrupt blood flow and block the flow of cerebral spinal fluid. Based on the location of the glioma there can be associated symptoms that arise including personality and speech changes.
With increased pressure in the skull you can experience symptoms such as headaches, nausea, vomiting, and changes in vision.
Other symptoms that can sometimes be seen include:
- Seizures
- Cognitive difficulties, like memory loss or trouble concentrating
- Weakness or numbness in certain parts of the body
- Vision or speech problems
Again, none of these symptoms are specific to gliomas and can be caused by a variety of medical conditions. There are several steps in the workup needed before you can be diagnosed with a glioma.
When it comes to treatment, “The first step is always the neurosurgery. How much can you take out? Is it safe to do surgery? Do you have to rely on a biopsy? Can you even do a biopsy?” says Dr. Friedman. These are all questions and considerations that need to accounted for when deciding what treatment is most appropriate.
Why Some Gliomas Return After Surgery or Radiation Therapy
Once the biopsy is obtained and the diagnosis of glioma is made, various treatment options can be recommended. The recommendations take into account the type of the glioma, the tumor grade, and well as patient specific factors including tumor location, size, your age, and overall health.
The main treatment options are:
- Observation – Some gliomas that are benign, small, and without symptoms or tumors located in inoperable locations can be recommended for observation.
- Surgery – Surgery is often the first-line treatment for gliomas, with the goal of achieving maximal safe resection where the largest amount of tumor is removed without causing significant neurologic deficits. For low-grade gliomas, surgery alone can sometimes be curative.
- Radiation therapy – This uses high-energy x-rays to target and kill tumor cells. Radiation is often used after surgery to target residual tumor cells.
- Chemotherapy – These medications kill or slow the growth of cancer cells. Chemotherapy can be used alongside radiation, or following radiation and is often used in higher-grade tumors.
- Targeted therapy and immunotherapy – These are newer treatments that are designed to target specific genetic mutations in the tumor or to stimulate the immune system to fight the cancer. Their role in the treatment for gliomas is continuing to evolve.
The important thing to remember is that every treatment plan and recommendation made by your healthcare team is personalized based off of details specific to your disease, your overall health, and treatment goals.
Living with a Glioma
Low-grade gliomas can sometimes be cured, but they may come back, which is why it is important to be monitored closely with regular examinations and imaging.
“Gliomas are unique tumors in that they’re very infiltrative tumors,” Dr. Miller adds. “So it’s almost like if you throw up a handful of sand, you can never pick up every grain of sand. We know that there are always tumor cells that are scattered beyond the margins we can see on an MRI. Even if a best case scenario where a surgeon can take out the majority of the tumor, we know that there are residual cells that are there that have to be monitored over time.”
In higher-grade gliomas, like glioblastomas, the follow up and post-treatment course can present more of a challenge as they can often recur. The important thing to consider is that the decision to provide treatment is always made with the goal of providing the best possible outcome while also managing symptoms and side effects.
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Contributing: SurvivorNet Staff
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