Low grade glioma

Childhood gliomas, also called astrocytomas, are cancers that form in the tissues of the brain. They can be low-grade or high-grade tumors. The grade of the tumor describes how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Low-grade gliomas are slow-growing tumors that may require surgery, chemotherapy, radiation, or a combination of these therapies.  

Types

Gliomas are named based on the World Health Organization Scheme.

Class I & Class II. Low grade gliomas are slow growing and rarely spread to other parts of the body. They may affect the brain, optic pathway, brain stem, or spinal cord.

Pilocytic astrocytoma (PA) is a tumor that grows slowly but can become very large. Pilocytic astrocytoma occurs most often in the cerebellum, cerebrum, optic nerve pathway, and brainstem.

Optic pathway gliomas (OPG) grow in areas of the brain that allow vision and may be associated with the genetic syndrome neurofibromatosis 1.  Children with OPGs often present with loss of vision, which is usually irreversible.

Pilomyxoid astrocytomas have different features when looked at under a microscope and behave somewhat more aggressively than pilocytic astrocytomas.

Symptoms

Symptoms involved are often due to increased intracranial pressure and depend on location:

  • Morning headache                                              
  • Frequent nausea and vomiting
  • Vision, hearing, and speech problems
  • Loss of balance and trouble walking
  • Unusual sleepiness
  • Unusual changes in personality or behavior
  • Seizures
  • Increase in the head size (in infants)

Common Treatments

Surgery. Low grade gliomas may be removed through surgery, although in some cases such as optic pathway gliomas the location of the tumor makes removal unsafe.  Surgery may be followed by radiation or chemotherapy based on how many tumor cells remain, the location of the tumor cells, and the age of the patient. 

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation therapy to the brain must be administered carefully because it can cause growth and permanent developmental delays in children. Short term side effects of radiation therapy can include:

  • Nausea
  • Diarrhea
  • Fatigue
  • Skin changes

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy can either be taken by introducing it to the blood stream or by injecting it directly into the affected tissue.

Side effects of chemotherapy depend on:

  • The type of drugs
  • The amount taken
  • The length of time they are taken