Grade 3 Astrocytoma Anaplastic Astrocytoma

Overview

A grade 3 astrocytoma is a tumour that starts in the brain, in star-shaped support cells called astrocytes. Doctors also call it an anaplastic astrocytoma. "Grade 3" means the tumour cells look quite abnormal under a microscope and tend to grow faster than lower-grade tumours. It is a malignant (cancerous) brain tumour, but it usually grows inside the brain rather than spreading to other parts of the body. Because it grows inside the brain, it can press on nearby areas and cause symptoms. Treatment is planned by a specialist team and often combines surgery, radiotherapy and chemotherapy.

No. Brain tumours are uncommon overall, and grade 3 astrocytoma is one of the less common types. Most people will never develop one. If you or someone you care for has just been told this, it is normal to feel shocked — but you are not alone, and specialist teams are used to supporting people through this.

It can happen at any age, but it is most often found in adults, commonly in middle age. It is slightly more common in men than in women. Children can also develop astrocytomas, though the grade 3 type is rare in children. Nothing you or your family did caused it.

Symptoms

Common symptoms

• Headaches, often worse in the morning or when bending, coughing or straining
• Seizures (fits) — a first seizure is often what leads to a scan
• Weakness or numbness in an arm, leg or one side of the face
• Trouble finding words, speaking clearly or understanding speech
• Changes in personality, mood or behaviour that others notice
• Memory problems or trouble concentrating
• Feeling sick or being sick, especially in the morning
• Changes in eyesight, such as blurring or loss of part of the visual field
• Feeling very tired, clumsy or unsteady on your feet
• Drowsiness or confusion that gets worse over time

Symptoms in children

• Headaches, often with morning vomiting
• Irritability, behaviour changes or being unusually sleepy
• Weakness, clumsiness or a change in how a child walks
• Seizures
• In babies, a larger-than-expected head size, poor feeding or a bulging soft spot
• Delays or a step backwards in skills such as talking or walking

Symptoms in older adults

• Confusion or memory problems that may at first be mistaken for normal ageing
• Falls or new unsteadiness
• Low energy, withdrawn mood or changes in personality
• Subtle weakness in a hand or leg
• Headaches that are new or different from usual

Causes

Main causes

• In most people, the exact cause is not known. The tumour starts when cells in the brain develop changes (mutations) in their genetic material that make them grow out of control.
• Many grade 3 astrocytomas have changes in a gene called IDH, and doctors now use these gene patterns to plan treatment.
• A small number of cases are linked to rare inherited conditions that run in families.
• Previous radiotherapy to the head, especially in childhood, slightly raises the risk many years later.

Risk factors

• Having had radiotherapy to the head in the past
• Rare inherited conditions, such as certain gene conditions that raise tumour risk
• Increasing age — it is more common in adults than children
• Being male (slightly higher risk)
• There is no good evidence that mobile phones, head injury, diet or stress cause this type of tumour

When to see a doctor

See a doctor urgently if:

• You have a first seizure — call your local emergency number
• New weakness, speech trouble or confusion
• A headache that is severe, new, or worse when lying down or in the morning
• Repeated vomiting or unusual drowsiness
• Any sudden change in vision or balance

Book a routine appointment if:

• Headaches that keep coming back or are changing in pattern
• Memory or concentration problems that affect daily life
• A change in personality or mood that others have noticed
• Tiredness or weakness that is not explained by other causes

Diagnosis

Your doctor will start by asking about your symptoms and your health history, then do a neurological examination — simple tests of your strength, sensation, reflexes, coordination, memory and eyesight. If a brain tumour is possible, you will usually be sent for a brain scan, most often an MRI. A scan can show that something is there, but the grade can only be confirmed by looking at a small piece of the tumour under a microscope, usually taken during surgery.

Tests that may be done

• Neurological examination in the clinic
• MRI scan of the brain, usually with a dye (contrast) given into a vein
• CT scan, sometimes done first, especially in an emergency
• Biopsy or tumour sample taken during surgery, examined by a specialist pathologist
• Molecular tests on the tumour tissue, such as IDH and other gene markers, which help guide treatment
• EEG (brain wave test) if you have had a seizure
• Blood tests to check your general health before treatment

What to expect at your appointment

Waiting for scan results and then for biopsy results can be an anxious time, and it may take a week or two for the full picture to come together. Your case is usually discussed by a team of specialists — neurosurgeons, cancer doctors, radiologists and specialist nurses — who together recommend a plan. Ask as many questions as you like, and it can help to bring someone with you and to write questions down beforehand.

Treatment

Treatment is planned around you — your age, your general health, where the tumour is, its molecular features and what matters to you. The main aims are to remove as much of the tumour as is safely possible, control its growth, relieve symptoms and keep your quality of life as good as possible. Most people have a combination of treatments rather than just one.

Self-care at home

• Take any medicines exactly as prescribed and ask your pharmacist before starting anything new, including supplements
• Follow your team's advice about driving — in many places you must stop driving after a seizure until you are cleared
• Keep a simple diary of symptoms, seizures and side effects to share at appointments
• Get plenty of rest and pace yourself — tiredness is common and manageable with planning
• Stay gently active and keep eating and drinking well
• Ask for help with practical things and tell your team early about money, work or care worries

Medical treatments

Surgery is usually the first step, to remove as much of the tumour as is safe and to get a sample for testing. After surgery, most people are offered radiotherapy — carefully targeted X-ray treatment that helps control the tumour in the brain. Radiotherapy is often combined with chemotherapy, which is medicine that travels through the body to slow tumour growth and is usually taken as tablets or given into a vein. Some people are offered newer treatments such as targeted medicines that work on specific gene changes in the tumour, or special treatment devices used in some countries. Medicines to reduce brain swelling and to prevent or control seizures are also often used. Your team will explain the choices, the likely benefits and the possible side effects, and you can always ask for a second opinion or to join a clinical trial.

When is surgery considered?

Surgery is usually offered as soon as possible after diagnosis when the tumour can be reached safely. The aim is a "maximal safe resection" — removing as much tumour as possible without damaging important brain areas. Sometimes only a small sample (biopsy) is taken if the tumour is in a very sensitive area. Surgery can also help relieve pressure and improve symptoms.

Living with this condition

Life after a brain tumour diagnosis settles into a new rhythm. You will have regular scans and clinic appointments, and possibly rehabilitation such as physiotherapy, speech therapy or occupational therapy. Some people need to adjust work, study or driving for a while. It helps to build a routine, keep a list of questions for appointments, and accept offers of help. Your specialist nurse is often the best first call for day-to-day worries.

Lifestyle tips

• Rest when your body asks, and plan demanding tasks for when you have most energy
• Keep up gentle movement — short walks and light activity can lift mood and energy
• Follow any driving, swimming or work safety advice from your team, especially if you have seizures
• Limit alcohol and avoid smoking, as these affect your general health and recovery
• Keep in touch with friends and family, and let people help with meals, lifts and chores
• Ask your team before flying, taking on strenuous activity or starting new supplements

Diet and exercise

There is no special diet that treats a brain tumour, so be wary of anyone who says otherwise. Aim for a balanced, varied diet with plenty of vegetables, fruit, whole grains and protein, and drink enough fluids. If treatment affects your appetite or taste, ask to see a dietitian — small, frequent meals often help. Gentle regular exercise, such as walking, is good for mood, sleep and fitness during and after treatment; build up slowly and check with your team first.

Mental health and emotional wellbeing

Fear, sadness, anger and uncertainty are completely normal after this diagnosis — for you and for the people close to you. Many people also notice changes in memory, concentration or mood that are linked to the tumour or its treatment. These feelings are not a sign of weakness, and help is available: talking therapies, counselling, medication for anxiety or low mood, and support groups can all make a real difference. If you ever feel hopeless or have thoughts of harming yourself, please reach out straight away — contact your local crisis line or emergency number, or tell a trusted person or your healthcare team. You deserve support, and you do not have to cope alone.

Prevention

There is no known way to prevent a grade 3 astrocytoma. It is not caused by anything you did or did not do, and it is not caused by stress, diet or using a mobile phone. Research is ongoing to understand why these tumours start.

Vaccines

There is no vaccine that prevents this type of brain tumour.

Screening programmes

There is no routine screening test for brain tumours. Scans are done when symptoms suggest a problem.

Complications

If left untreated

• The tumour can keep growing and press on nearby brain areas, causing worsening weakness, speech or vision problems
• Raised pressure inside the head, with severe headaches, vomiting and drowsiness
• More frequent or harder-to-control seizures
• Fluid building up in the brain (hydrocephalus), which may need treatment
• Changes in thinking, memory and personality that affect daily life
• The tumour can come back after treatment, and over time it may behave more aggressively

Long-term outlook

The outlook varies a lot from person to person, depending on age, general health, the tumour's gene changes, how much can be safely removed, and how it responds to treatment. Many people live for several years after treatment, and some live much longer. Treatments are improving, and clinical trials are testing new options all the time. It is natural to want numbers, but statistics describe groups of people, not you as an individual. Your specialist team can talk honestly with you about what to expect, and support is available at every stage.

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