Prognosis and the likelihood of full recovery in the anaplastic astrocytoma
Astrocytoma is called a malignant tumor that arises from star-shaped cells in the brain. At the moment, anaplastic astrocytoma recognized as the most common cancer disease that affects the brain. It can be ill people of any age and gender, but more often the tumor occurs in men aged 20 to 50 years.
risk Factors pathology
Despite the fact that the tumor refers to tumors of the middle level of malignancy, the chances of a full recovery of the patient are extremely low. Here the prognosis depends on such factors as:
- age of the patient (young people harder to tolerate the disease)
- localization and size of lesions;
- surgical intervention;
- presence and degree of neurological abnormalities, which are side effects of the tumor process;
- stage of tumor development.
Often worsens the prognosis is the late diagnosis. Like all glial brain tumors (glioma), astrocytoma has a density approximating the density of brain matter, and hardly differs from it in color. This greatly complicates the detection of pathology and diagnosis. In most cases the diagnosis is established already in the late stages of tumor development.
Although the exact cause of the disease is not established yet, clearly defined factors that have a negative impact on neural cells, the astrocytes. Primarily, these factors include:
- the presence of cancer in close relatives;
- neurofibromatosis, tuberous sclerosis and other genetic diseases in anamnesis;
- work in hazardous industries;
- permanent effect on the body of dangerous chemicals;
- viral infections.
In addition, there is a perception that pathology often develops during pregnancy or after childbirth. But scientifically, this statement is not confirmed and not refuted since special researches in this area have not been conducted.
The First symptoms of the disease may occur long before the discovery of astrocytoma and diagnosis. As a rule, they are neurological in nature.
The growing tumor presses on the brain cells, resulting in manifest:
- impaired balance when walking;
- vomiting and nausea occurring in the morning;
- headache or dizziness;
- blurred vision and memory;
- change in behavior;
- frequent mood swings
- jump in blood pressure;
depending on the location of the tumor differ in the following States:
- in the right cerebral hemisphere – paresis, weakness, tremor of the extremities, situated in the left part of the body;
- in the left cerebral hemisphere – similar phenomena in the limbs the right side of the body;
- in the temporal lobes – memory impairment, coordination of movements and speech;
- in the frontal areas – changes character, the occurrence of instability of the mind;
- occipital lobe – the deterioration of visual function, the appearance of hallucinations;
- in the cerebellum – impaired balance when walking and running;
- in the parietal region – the feelings change, disturbed fine motor skills.
The Development of neoplasms in children often leads to damage of the optic nerve.
Neoplasms in pregnant women
Almost 75% of cases of occurrence of intracranial tumors in women occurs between the ages of 20 to 40 years. The development of glial tumors during pregnancy is often due to the fluid retention in the body bearing the fetus of the woman.
Factors that aggravate the pathogenic processes, become:
- hormonal changes
- metabolic and neuroendocrine abnormalities.
The Clinical manifestations of tumors are subdivided into focal and cerebral. The main symptom first becomes a headache. It occurs in 90% of cases, thus being the earliest and constant symptom of the disease.
for many women, pregnancy is accompanied by nausea and vomiting. It is important to differentiate vomiting from morning sickness when vomiting in malignant processes. For anaplastic astrocytomas characterized by attacks of vomiting, occurring in morning hours and not associated with food intake, the gastrointestinal tract or the feeling of nausea.
Retching may occur when changing the position of the head or torso. According to research, vomiting becomes the main symptom of the disease in the location of the neoplasm in the cerebellum or the medulla oblongata.
Despite the lack of research in this field, scientists do not deny that pregnancy is a physiological process that can become the impetus for the development ofcancer.
The treatment of patients is complicated not only while carrying the baby, but after birth.
If the patient is pregnant, doctors may use diagnostic methods that are potentially dangerous to the fetus. In this case, for diagnosis are magnetic resonance (MRI) and computed (CT) tomography.
The Clinical situation at birth are totally dependent on the severity of the neoplastic process. There are several options for management of pregnancy and childbirth:
- Tumor treated and cured. Self delivery is possible but better with the exception of attempts.
- Tumor treated with signs of relapse. Carried out dynamic observation, if necessary, is performed neurosurgical operation. The process ends up giving birth through caesarean section.
- Tumor, previously diagnosed. With increasing alarming symptoms of hydrocephalus, decreased vision, generalized epileptic seizures – is the urgent removal of tumors on the background of pregnancy prolongation, selected anticonvulsant drugs. Births be conducted by caesarean section.
If the tumor has not been diagnosed before pregnancy and during its course has no threatening symptoms, doctors conduct dynamic monitoring of the patient. After delivery by cesarean section is performed neurosurgical intervention to remove the tumor.Several years ago, pregnant with anaplastic astrocytoma were forced to resort to abortion, today they have great chances to have a healthy baby.
Methods of treatment and clinical management of patient
As already mentioned, the chances of a full recovery in the anaplastic astrocytoma can be very small. Provided an integrated approach to treatment, the average survival of patients is more than 3 years, but most after a specified period of relapses, leading to death.
An Integrated approach includes 3 main methods:
- surgery in which the tumor is removed with subsequent administration of corticosteroids
- radiotherapy (focal radiation);
- chemotherapy with taking these drugs: Procarbazine, Lomustine, Vincristine, etc.
After the completion of each stage of treatment or to assess its effectiveness studies using MRI and CT.
neuro Oncology in pregnant women, Lubnin A. Yu., Ashlagian K. N., Research Institute of neurosurgery named after.Acad.N. N. Burdenko, MONIIAG, Moscow, 2014.