Our physicians are focused on family-centered care: From your first visit, you’ll work with a team of professionals who are committed to supporting all of your family’s physical and psychosocial needs.
Children treated on an outpatient basis through Dana-Farber/Boston Children’s Cancer and Blood Disorders Center are cared for at the Jimmy Fund Clinic on the third floor of the Dana-Farber Cancer Institute. If your child needs to be admitted to the hospital, he will stay at Boston Children’s Hospital on the ninth floor of the Berthiaume Building.
Your child’s physician will determine a specific course of astrocytoma treatment based on several factors, including:
- your child's age, overall health and medical history
- type, location, and size of the tumor
- extent of the disease
- your child's tolerance for specific medications, procedures or therapies
- how your child's doctors expect the disease to progress
There are a number of treatments we may recommend for astrocytoma. Some of them help to treat the tumor, while others are intended to address complications of the disease or side effects of the treatment. These treatments include:
Surgery for astrocytoma
The surgeons will try to get as much of the tumor out as possible, since aggressive tumor removal is associated with better long-term outcomes. Surgery is often limited due to the deep, central placement of both the thalamus and hypothalamus within the brain. In addition, removal of the whole tumor can result in damage to critical brain areas.
If the tumor recurs after initial surgical removal, or if the tumor re-grows after partial surgical removal, your child’s doctor may recommend a second attempt at removing as much of the tumor as possible.
Chemotherapy for astrocytoma
Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors.
A number of combinations of chemotherapy drugs are being used to stabilize and, in some cases, to shrink the size of the tumor. These include:
- vincristine with carboplatin
- vincristine with CCNU, procarbazine and thioguanine
- other chemotherapy combinations
How is chemotherapy given?
Your child may receive chemotherapy:
- orally, as a pill to swallow
- intravenously (or "IV"), directly to the bloodstream
Does chemotherapy cause side effects?
While chemotherapy can be quite effective in treating certain cancers, the drugs cannot tell the difference between normal healthy cells and cancer cells. Because of this, your child may experience adverse side effects during treatment. Knowing what these side effects are can help you and your child prepare for, and, in some cases, prevent these symptoms from occurring.
What are common side effects and how are side effects managed?
Common side effects to chemotherapy given for treatment of thalamic/hypothalamic astrocytomas include fatigue, headache, diarrhea and constipation. These side effects can usually be effectively managed with standard medical approaches.
Our Pediatric Brain Tumor Program also has access to specialists who deliver complementary or alternative medicines. These treatments, which may help control pain and the side effects of therapy include the following.
- therapeutic touch
- dietary recommendations
Talk to your child’s physician about whether complementary or alternative medicine might be a viable option.
Our doctors may also use precisely targeted and dosed radiation therapy to kill cancer cells left behind after your child’s surgery. This treatment is important to control the local growth of tumor.
We usually don’t use radiation therapy unless your child’s tumor has regrown after chemotherapy. Due to the potential long-term side effects of radiation therapy, including effects on learning and hormone function, it is best avoided if your child is young (especially under age 10 years of age).
What is the long-term outlook for thalamic/hypothalamic astrocytoma?
Fortunately, children with astrocytomas of the thalamus and/or hypothalamus have a high rate of survival. The survival rate is not as high if the tumor can’t be removed completely during surgery or if it returns.
There are many standard and experimental treatment options for children with progressive or recurrent low-grade astrocytomas, including thalamic/hypothalamic astrocytomas.