Brain tumours

Brain tumours may be cancerous or noncancerous. Unlike most tumours in other parts of the body, cancerous and noncancerous brain tumours can be equally serious. The seriousness of a tumour depends on its location, size, and rate of growth. Both types of tumour can compress nearby tissue, causing pressure to build up inside the skull.


Tumours that first develop in brain tissues are called primary tumours. They may arise from support cells in the brain (gliomas) or from meningiomas, cells in the meninges (the membranes covering the brain). Gliomas are often cancerous, but most meningiomas are noncancerous. Primary brain tumours are slightly more common in men and usually develop between the ages of 60 and 70. Some types only affect children.

Secondary brain tumours (metastases) are more common than primary tumours. They are always cancerous, having developed from cells that have been carried in the blood from cancerous tumours in areas such as the breast or the lungs. Several metastases may develop in the brain simultaneously.

What are the symptoms?

Symptoms usually occur when a primary tumour or metastasis compresses part of the brain or raises the pressure inside the skull. They may include:

- Headache that is usually more severe in the morning and is worsened by coughing or bending over.
- Nausea and vomiting.
- Blurred vision.

Other symptoms tend to be related to whichever area of the brain is affected by the tumour and may include:

- Slurred speech.
- Unsteadiness.
- Double vision.
- Difficulty in reading and writing.
- Change of personality.
- Numbness and weakness of the limbs, on one side of the body.

A tumour may also cause seizures. Sometimes, a tumour blocks the flow of the cerebrospinal fluid, which circulates in and around the brain and spinal cord. As a result, the pressure inside the ventricles (the fluid-filled spaces inside the brain) increases and causes further compression of brain tissue. Left untreated, drowsiness can develop, which may eventually progress to a state of coma and death.

How are they diagnosed?


If your doctor suspects a brain tumour, he or she will refer you to for immediate assessment by a neurologist. You will have CT scanning or MRI of the brain to look for a tumour and check its location and size. If these tests suggest that a tumour has spread from a cancer elsewhere in the body, you may need to have other tests, such as chest X-rays or mammography, to check for tumours in the lungs or breasts. Cerebral angiography may be performed to look at blood flow around the tumour. You may also need to have a brain biopsy, in which a sample of the tumour is removed surgically under general anaesthesia. The sample is then examined in a laboratory to find the type of cell from which the tumour has arisen.

What is the treatment?

Treatment for brain tumours depend on whether there is one tumour or several, the precise location of the tumour and the type of cell affected. Primary brain tumours may be treated surgically. The aim of surgery is to remove the entire tumour, or as much of it as possible, with minimal damage to the surrounding brain tissue. Surgery will probably not be an option for tumours located deep within the brain tissue. Radiotherapy may be used in addition to surgical treatment, or as an alternative to it, for both cancerous and noncancerous primary tumours.

A brain metastases are often multiple, surgery is not usually an option. However, in cases where there is a single metastasis, surgical removal may be successful. Multiple tumours are usually treated with radiotherapy or, less commonly, with chemotherapy.

Other treatments may be necessary to treat the effects of brain tumours. For example, the drug dexamethasone may be given to reduce the pressure inside the skull, and anticonvulsant drugs may also be prescribed to prevent or treat seizures. If a tumour blocks the flow of cerebrospinal fluid in the brain and fluid builds up in the ventricles, a small tube may be inserted through the skull to bypass the blockage.

You may also benefit from treatments for the physical effects of the tumour, such as physiotherapy to help with mobility problems or speech therapy for speech problems.

What is the prognosis?

The general outlook for brain tumours depends on their location, size, and rare of growth. The outcome is usually better for a noncancerous tumour that grows slowly, many people with this type are completely cured by surgery.

The outlook for other tumours depends on the type of cell they affect and whether they can be surgically removed. About 1 in 4 people is alive 2 years after diagnosis of a primary cancerous brain tumour, but few people live longer than 5 years. Most people with brain metastases do not live longer than 6 months, although in rare cases, a person with a single metastatic tumour may be curred.