Grade 3 Astrocytoma (Formerly Known as Anaplastic Astrocytoma)

What is a grade 3 astrocytoma (anaplastic astrocytoma)?

A grade 3 astrocytoma (anaplastic astrocytoma) is a fast-growing brain tumor made up of astrocyte cells. Astrocytes are star-shaped cells in your brain and spinal cord that support and protect neurons (nerve cells).

The World Health Organization (WHO) reclassified anaplastic astrocytoma as a “grade 3 astrocytoma.” The reclassification helps clarify the type of tumor for diagnostic purposes. You might see the term “anaplastic astrocytoma” used in pathology reports before the change in 2021.

As a grade 3 tumor, this classification means that it grows faster and is more aggressive than grades 1 and 2. While less common, it can spread to neighboring brain tissue from where the tumor started growing. It’s also known as a malignant (cancerous) or high-grade astrocytoma.

Astrocytomas are subtypes of gliomas, which encompass several other tumor types, including astrocytomas, ependymomas and oligodendrogliomas.

While this tumor is more severe than other types of astrocytomas, it’s treatable with surgery followed by radiation and chemotherapy. Clinical trials are also available.

How common is a grade 3 astrocytoma (anaplastic astrocytoma)?

Worldwide, approximately 5 to 8 people out of every 100,000 receive a grade 3 or a grade 4 astrocytoma tumor (glioblastoma) diagnosis each year. Among children, grade 3 astrocytomas and glioblastomas account for 10% of all childhood central nervous system tumors.

What are the symptoms of a grade 3 astrocytoma (anaplastic astrocytoma)?

Symptoms of a grade 3 astrocytoma vary based on the size and location of the tumor but could include:

• Headaches.
• Drowsiness or lethargy.
• Vomiting.
• Personality changes.
• Vision changes.
• Trouble with coordination.
• Weakness in arms and legs.
• Seizures.

Additional symptoms can happen if the tumor sits on certain parts of your brain. For example, you might experience memory problems if the tumor is in your frontal lobe or trouble with communication if the tumor is in your parietal lobe.

Where does a grade 3 astrocytoma (anaplastic astrocytoma) grow?

A grade 3 astrocytoma is a central nervous system tumor, which includes your brain and spinal cord. This tumor is most common in the largest portion of your brain called the cerebrum, specifically in your:

• Frontal lobe.
• Temporal lobe.
• Parietal lobe.
• Occipital lobe.

What causes a grade 3 astrocytoma (anaplastic astrocytoma)?

An overproduction of astrocyte cells causes a grade 3 astrocytoma. Research is ongoing to learn more about why this happens, but studies suggest it could be the result of:

• Genetic changes (in less than 5% of people diagnosed).
• Exposure to ionizing radiation as part of treatment of other cancers like leukemia or lymphoma.

What are the risk factors for a grade 3 astrocytoma (anaplastic astrocytoma)?

A grade 3 astrocytoma can affect anyone at any age, but it’s most common among children between ages 5 and 9 and adults between 30 and 50. It affects men and people assigned male at birth more often than women and people assigned female at birth.

A grade 3 astrocytoma may happen alongside other genetic conditions like:

• Neurofibromatosis Type 1.
• Li-Fraumeni syndrome.
• Tuberous sclerosis.

What are the complications of a grade 3 astrocytoma (anaplastic astrocytoma)?

Complications of a grade 3 astrocytoma could include:

• Pressure within your skull (intracranial pressure).
• Paralysis on one side of your body.
• Fluid buildup in your brain (hydrocephalus).

Complications may be life-threatening.

How is a grade 3 astrocytoma (anaplastic astrocytoma) diagnosed?

A healthcare provider will diagnose a grade 3 astrocytoma after a physical exam and testing. During the exam, your healthcare provider will ask you questions about your symptoms and medical history. Then, they’ll order tests to rule out conditions with similar symptoms. Noninvasive imaging tests identify the tumor and lead to a diagnosis. A biopsy, where a healthcare provider removes a small sample of the tumor to examine it, can also lead to a diagnosis.

Grade 3 astrocytoma (anaplastic astrocytoma) radiology

Your healthcare provider will order imaging tests like an MRI or a CT scan to see the size and location of the tumor. These tests can help your provider learn more about the tumor to plan for treatment. After a diagnosis and treatment, you may need additional imaging tests to verify that treatment was successful or to monitor the tumor’s progress.

How is a grade 3 astrocytoma (anaplastic astrocytoma) treated?

Treatment for a grade 3 astrocytoma includes a combination of the following:

• Surgical removal of the tumor.
• Radiation.
• Chemotherapy.

Most treatment plans incorporate all three types of treatment. Surgery is usually the first step. Depending on the size and location of the tumor, a surgeon might only be able to safely remove a portion of the tumor. Following surgery, you’ll undergo radiation therapy and chemotherapy.

Clinical trials (research studies on people) are available for this type of tumor. Trials help researchers create new forms of treatment and study prevention methods for certain conditions. Your healthcare provider may recommend clinical trials.

What medications treat a grade 3 astrocytoma (anaplastic astrocytoma)?

The U.S. Food and Drug Administration (FDA) approved temozolomide, a chemotherapy medication, for adults diagnosed with a grade 3 astrocytoma. Your healthcare provider might recommend this medication if the tumor doesn’t respond well to other forms of treatment. There isn’t a medication approved for use in children yet.

Are there side effects of the treatment?

Yes, side effects are possible with treatment for a grade 3 astrocytoma. Your healthcare provider will discuss these with you before your treatment and they’ll let you know what to look out for after treatment.

Side effects of surgery may include:

• Bleeding.
• Infection.
• Headaches.
• Hydrocephalus.
• Pain.
• Seizures.

Side effects of radiation and chemotherapy may include:

• Bleeding or infection.
• Constipation.
• Diarrhea.
• Fatigue.
• Headaches.
• Hair loss.
• Nausea and vomiting.
• Reduced appetite.

What’s the outlook for a grade 3 astrocytoma (anaplastic astrocytoma)?

The prognosis (outlook) for a grade 3 astrocytoma is fair. This varies for each person based on your general health, the size and location of the tumor, and more. An early diagnosis and treatment lead to a good outcome if your care team can completely remove the tumor. Your healthcare provider can give you the most accurate information about your prognosis based on your situation.

How long can you live with a grade 3 astrocytoma (anaplastic astrocytoma)?

One study reported the five-year survival rate for a grade 3 astrocytoma is 52% to 58%. Your life expectancy improves if treatment can completely remove the tumor.

Is a grade 3 astrocytoma (anaplastic astrocytoma) curable?

While the tumor isn’t curable, it’s treatable with the ongoing advancement in surgical techniques, radiation therapy and chemotherapies. Research suggests that the size, shape and location of the tumor can make a complete removal challenging, but it’s not impossible.

When should I see a healthcare provider?

Contact a healthcare provider if you experience symptoms of a grade 3 astrocytoma. If you’re undergoing treatment and notice any side effects, let your provider know. Throughout your diagnosis and treatment, reach out to your care team if you have any questions about what to expect or what to look out for.

What questions should I ask my healthcare provider?

• What type of treatment do you recommend?
• What are the side effects of treatment?
• Are chemotherapy medications an option to treat the tumor?
• How do I take care of myself when undergoing radiation and chemotherapy?
• What is my prognosis?
• Are there any available clinical trials for my condition?