A brain tumour occurs when a cluster of cells grow abnormally in the brain. These can affect you in different ways. It may not contain cancerous cells, in which case it is termed benign, but it may grow to a size that presses on important areas of the brain to cause symptoms. Alternatively, it may contain cancerous cells, in which case it disrupts normal function of an area of the brain, even if it is a small size, and this is called a malignant tumour. If a benign tumour remains small and slow-growing, it may not cause any symptoms at all. Brain tumours can affect anyone at any age but are more common in adults than children. About 11,000 people are affected by brain tumours in the UK. In general, around 15 out of every 100 people with a malignant brain tumour will survive for over a decade after being diagnosed.
Symptoms can vary depending on which particular structures in the brain are being disrupted, and how big it has grown so which structures it is pressing on. This is known as a space-occupying lesion, and can have causes other than a tumour. Commonly people suffer headaches, but this can have all manner of causes. Nausea and vomiting can be common, especially first thing in the morning. Anyone who has a seizure should be checked out immediately – brain tumour is one of a number of causes. Progressive weakness on one side of the body and changes to your balance or co-ordination can occur. Problems with speech – either articulating or understanding it – may be a symptom and should be assessed. Changes to your vision are quite common with a brain tumour, but your optician should be your first stop, as it’s much more common to need glasses (or stronger glasses) than have a brain tumour. The UK’s Brain Tumour Charity has a helpful page on visual changes to be concerned about: https://www.thebraintumourcharity.org/brain-tumour-signs-symptoms/adult-brain-tumour-symptoms/changes-vision/ Mental and behavioural changes may be a subtle sign, but it’s significant if family, friends and work colleagues notice any changes.
The cause is largely unknown but there are certain things that increase your risk. They’re more common as you get older. There’s a genetic component to it, so having a family history increases the risk as well as some neurological conditions like neurofibromatosis or Tuberous sclerosis. Exposure to any radiation from aeroplanes, CT scans, radiotherapy or repeated X-rays of the head, all increase your risk.
Brain tumours are often the first thing people worry about with headaches – it seems to sit high in the public’s awareness, and cause a great deal of alarm. It’s worth considering that headaches are very common, and brain tumours are comparatively rare. So when to worry? If you start getting frequent headaches when you didn’t previously suffer, or they feel very different in nature to your usual, or they are very severe, these are all reasons to seek an urgent doctor’s appointment to discuss. A first seizure needs thorough investigation, and you should avoid driving until you’ve been given the all-clear. Any unusual symptoms affecting your vision, speech, balance, co-ordination or strength need to be checked out. Similarly, you should discuss any changes to your behaviour or memory. Your doctor will ask for detail about your symptoms and examine you – they will check the nerves in your head (cranial nerves) and the peripheral nerves to your arms and legs. They may refer you for further investigations, such as a scan of your head, or they may refer you to a neurologist, a specialist that deals with the brain and spinal cord or a neurosurgeon, a surgeon that operates on the brain and spinal cord. If they are concerned about brain tumour, they will refer you urgently.
Treatment for brain tumours varies depending on several factors, such as whether the tumour is benign or malignant, the type of cancerous cells, the location and impact of the tumour, other health conditions and your overall fitness. Surgery may be offered as a definitive treatment to cut out the abnormal cells, and chemotherapy or radiotherapy would have the same aim. Your team may consider that reducing the size of the tumour - “de-bulking” - will best relieve symptoms, especially if complete surgical removal is too risky to attempt. De-bulking usually refers to surgery, but oral steroids may be used to reduce inflammation and therefore size, which may ease symptoms. Depending on the symptoms you may also require medications to manage symptoms such as anti-sickness medication for nausea and vomiting, painkillers for headaches and anti-seizure medication if you suffer seizures. It’s tough to contemplate, but sometimes your treating team considers the best course is “watch and wait”, where they scan you regularly and keep an eye on any changes to the tumour size, surrounding brain structures and any symptoms you develop.