How Pilocytic Astrocytoma Is Treated

Pilocytic astrocytoma (PA) is a tumor in the brain or spinal cord that most commonly occurs in children and young adults under age 20. The standard treatment for PA is surgery to remove the tumor, when possible. If the entire tumor is removed, the outlook is usually very good.

If the tumor is in a spot where it can’t be fully removed during surgery, adults and older children might need radiation therapy to help kill any tumor cells left in the area. Sometimes chemotherapy is used. 

In this article, we'll review the treatment options for PA, including surgery and more.

Operating room - child having a medical treatment

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Active Monitoring

PA tumors are slow growing, and treatment may not be needed immediately. If the tumor is not causing you problems, your doctor may suggest observation or active monitoring.

Active monitoring means regularly checking the tumor to discern if it is growing. Instead of starting treatment, you may see your healthcare provider for regular imaging scans. This can help your doctor know if and when to recommend treatment.

Surgery and Specialist-Driven Procedures

Surgery is the treatment of choice for this type of tumor. This is because total removal (resection) of the tumor is often curative.

The objective of surgery is to remove as much of the tumor as possible without harming any part of the brain or spinal cord. The surgery will likely be performed by a neurosurgeon with experience treating children or adolescents with tumors in the central nervous system, which is made up of the brain and spinal cord.

If the tumor is completely removed, further treatment may not be needed. Your medical team will continue to monitor you with regular magnetic resonance imaging (MRI) scans, with no treatment given, unless you develop new symptoms, your existing symptoms worsen, or your scan shows changes.

Sometimes surgery may not be possible if a tumor is in an area of the brain that is near major blood vessels or in the brain stem, where vital functions could be disrupted. It may also be impossible for you to have surgery if your body cannot safely tolerate the procedure.

Brain Surgery Risks

Like any surgery, brain surgery comes with possible risks. These include:

  • Problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions that may either last a short while or may not go away
  • Blood clot or bleeding in the brain
  • Seizures
  • Stroke
  • Coma
  • Infection in the brain, wound, or skull
  • Brain swelling

Radiation Therapy

Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, directing beams to precise points where the tumor is present.

Radiation therapy may be needed following surgery if the surgeon could not remove the entire tumor. However, any treatment for residual pilocytic astrocytoma after surgery is usually deferred until there is evidence of progression.

Radiation isn’t recommended for children under the age of 3 because it can affect brain development.

Chemotherapy

Chemotherapy, using medications to kill cancer cells, may be used to prevent brain tumors from growing, while the other prescription medications are used to control symptoms while the tumor is being treated.

Chemotherapy is usually reserved only for when surgery and radiation have been exhausted. In younger children, chemotherapy might be recommended after surgery to ensure the tumor doesn't come back.

Over-the-Counter (OTC) Therapies

Over-the-counter medications can help with some of the symptoms of PA, but they cannot treat the condition itself. 

There are a number of over-the-counter pain medications that you can take for headaches associated with PA. Tylenol (acetaminophen), Advil (ibuprofen), Aleve (naproxen sodium), and Excedrin (acetaminophen, aspirin, and caffeine) are commonly used.

Though you may have used these medications prior to being diagnosed with PA, know that some of them can increase the risk of bleeding—a particular concern during recovery from surgery.

Discuss the best options for pain relief with your healthcare provider so you can be sure that your approach is a safe one.

Complementary and Alternative Medicine (CAM)

PA cannot be treated with alternative therapies, although some studies suggest that complementary therapies may hold some promise when used along with traditional methods.

You can ask your health team to give you more information about complementary therapies and to help you get in touch with a certified therapist. Some treatments to try as part of a treatment plan include:

  • Acupuncture: Some people find that acupuncture, a traditional Chinese therapy in which thin needles are inserted into the skin, helps them with controlling pain, nausea, and fatigue.
  • Massage therapy and reflexology: People sometimes try traditional massage therapy or a form of massage called reflexology to help manage physical symptoms such as pain, muscle stiffness, and/or emotions such as stress and anxiety. 

Summary

Sometimes with pilocytic astrocytoma, no treatment is initially needed. When the tumor is causing symptoms and can be operated on, surgery can be a curative treatment. Sometimes, the entire tumor cannot be removed with surgery and other treatments, such as radiation and chemotherapy, may be needed.

A Word From Verywell

Surgery is the most common treatment for PA. While the thought of brain or spinal surgery seems frightening, skilled surgeons are able to remove many types of PA tumors and produce a favorable outcome.

Where surgery is not possible, there are other options that can be explored, such as radiation and chemotherapy. Your specialist will be able to discuss the pros and cons of the treatment options available to you or your child.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Cancer Institute. Childhood astrocytomas treatment (PDQ)–health professional version. Updated September 23, 2021

  3. Medlineplus Medical Encyclopedia. Brain surgery. Reviewed January 2021.

  4. American Cancer Society. Radiation therapy for brain and spinal cord tumors in children. Revised June 2018.