Pilocytic astrocytoma (PA) is a tumor in the brain or spinal cord that most commonly affects children and young adults under the age of 20. The standard treatment for PA is surgery to remove the tumor, if possible. If the entire tumor is removed, the outlook is usually very good.
If the tumor is in an area where it cannot be completely removed during surgery, adults and older children may need radiation therapy to kill any tumor cells in the area. Sometimes chemotherapy is used.
In this article, we’ll discuss treatment options for PA, including surgery and more.
PA tumors grow slowly and treatment may not be needed immediately. If the tumor isn’t causing any problems, your doctor may suggest observation or active monitoring.
Active monitoring involves checking the tumor regularly to see if it is growing. Instead of starting treatment, see your healthcare provider for regular imaging scans. This can help your doctor know if and when treatment should be recommended.
Surgery and Specialist Procedures
Surgery is the treatment of choice for this type of tumor. Total removal (resection) of the tumor is often curative.
The goal of surgery is to remove as much of the tumor as possible without damaging any part of the brain or spinal cord. The surgery will likely be performed by a neurosurgeon experienced in treating children or adolescents with tumors in the central nervous system, which consists of the brain and spinal cord.
If the tumor is completely removed, further treatment may not be necessary. Your medical team will continue to monitor you with regular magnetic resonance imaging (MRI) scans without treatment, unless you develop new symptoms, your existing symptoms worsen, or your scan shows changes.
Sometimes surgery is not possible if a tumor is in an area of the brain that is near major blood vessels or in the brainstem, where vital functions can 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 carries potential risks. Of which:
Problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions that either last for a short time or do not go away
Radiation therapy uses high-energy rays, 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 rays to precise points where the tumor is present.
Radiation therapy may be needed after surgery if the surgeon is unable to remove the entire tumor. However, any treatment for residual pilocytic astrocytoma after surgery is usually delayed until there is evidence of progression.
Radiation is not recommended for children under 3 years of age because it can affect brain development.
Chemotherapy, which uses drugs to kill cancer cells, can be used to stop brain tumors from growing, while the other prescription drugs 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 may be recommended after surgery to keep the tumor from coming 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 themselves.
There are a number of over-the-counter pain relievers you can take for headaches related to PA. Tylenol (acetaminophen), Advil (ibuprofen), Aleve (naproxen sodium), and Excedrin (acetaminophen, aspirin, and caffeine) are commonly used.
While you may have taken these medications before you were diagnosed with PA, some of them can increase your 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 your approach is safe.
Complementary and Alternative Medicine (CAM)
PA cannot be treated with alternative therapies, although some research suggests that complementary therapies may show promise when used in conjunction with traditional methods.
You can ask your health care team to give you more information about complementary therapies and to help you connect with a certified therapist. Some treatments you can try as part of a treatment plan include:
Acupuncture: Some people find that acupuncture, a traditional Chinese therapy that involves inserting thin needles into the skin, helps them manage 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.
Sometimes pilocytic astrocytoma does not require treatment initially. When the tumor is causing symptoms and surgery can be performed, surgery may be a curative treatment. Sometimes the entire tumor cannot be surgically removed 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 may seem daunting, skilled surgeons are able to remove many types of PA tumors and produce a beneficial outcome.
Where surgery is not possible, there are other options that can be explored, such as radiation and chemotherapy. Your specialist can discuss the pros and cons of the treatment options for you or your child.