Brain tumour

What is a brain tumour?

A brain tumour is an abnormal growth of cells in or around the brain. The tumour can affect surrounding brain tissue by placing it under pressure or directly damaging it.

There are many different types of brain tumours. They are usually named after the type of cell they develop from or the part of the brain where they begin.

Some of these include:

• Meningiomas – tumours that develop on the protective membranes of the brain and spinal cord, called the meninges.

• Gliomas – tumours that develop from glial cells, which protect and support nerve cells. Glioblastomas are a cancerous, highly aggressive type of glioma.

• Pituitary tumours – tumours that develop in the pituitary gland, a small gland at the base of the brain that produces hormones.

What causes a brain tumour?

The cause of most brain tumours is unknown, but there are several risk factors that can increase the risk of developing one. These include:

• Older age;

• Exposure to radiation;

• Family history and certain genetic conditions.

Being overweight or obese can increase the risk of developing a meningioma.

Remember that having a risk factor does not necessarily mean someone will develop a brain tumour.

What happens in a brain tumour?

Brain tumours are classified with a grading system to describe how the tumour is likely to grow and behave.

Grade 1 and 2 brain tumours

These are called low grade. Most are non-cancerous and tend to grow more slowly. They tend to be less likely to come back after treatment. However, they can still damage the brain by taking up space and increasing pressure. Some low-grade tumours are described as benign or non-cancerous.

Grade 3 and 4 brain tumours

These are called high grade. They are usually cancerous, tend to grow more quickly and may grow into nearby brain tissue, damaging it as they spread. They are more likely to come back after treatment. These are also called malignant brain tumours.

Brain tumours can either start in the brain (primary brain tumours) or elsewhere in the body and spread to the brain (secondary brain tumours, also called brain metastases).

Symptoms of a brain tumour can develop slowly over time. These will depend on the tumour’s location, size and rate of growth. They may include:

• Headaches, especially if these feel different from usual headaches;

• Vision problems;

• Speech problems;

• Weakness;

• Feeling or being sick;

• Changes in personality, behaviour or thinking skills;

• Seizures.

If these symptoms do not go away or are getting worse, the person should ask for an urgent GP appointment or contact NHS 111.

Call 999 if you or someone else has a seizure for the first time. You should also call 999 for sudden facial weakness, weakness or numbness on one side of the body, speech problems, blurred vision or loss of sight. If you are experiencing these symptoms, do not drive yourself to A&E.

How are brain tumours treated?

Brain imaging such as computerised tomography (CT) and magnetic resonance imaging (MRI) can be used to help identify a possible brain tumour and assess its size and location. This can help with deciding on the best course of treatment for it.

A biopsy or examination of tissue removed during surgery may be needed to determine the tumour’s type and grade.

Treatment depends on the type, grade, size and location of the tumour, as well as the person’s health and individual circumstances.

If it is possible to reach the brain tumour through surgery, and surgery is considered to be a suitable option, this may be performed to remove all or part of it. Possible surgical procedures include craniotomy and neuroendoscopy.

Craniotomy

This is where part of the skull is temporarily removed to allow access to the brain. The piece of bone that is removed from the skull is called a ‘bone flap’. Surgical tools are used to break up the tumour and remove as much of it as possible. The bone flap is replaced after the procedure.

Neuroendoscopy

This is where a small hole is made in the skull (called a ‘burr hole’) and an endoscope is inserted. An endoscope is a long, thin tube that has a camera and surgical tools at the end, which allows surgeons to view the area and take a sample, or remove as much of the tumour as possible. This is also called keyhole brain surgery.

Both procedures are usually carried out under general anaesthetic. This means the person is asleep during the procedure. In some cases, a person may be awake for all or part of a craniotomy. This is called an awake craniotomy. The medical team will discuss details of the chosen procedure with the person beforehand, including what may happen during the recovery phase.

Where the whole tumour cannot be removed safely, or surgery is not suitable, radiotherapy or chemotherapy may be used to destroy tumour cells or control the tumour. Steroids and other medicines may be used to manage symptoms.

What happens after a brain tumour is treated?

Following treatment for a brain tumour, a person will usually need to stay in hospital to recover from their treatment. They will continue to be monitored by the medical team. The length of the hospital stay will depend on the treatment provided and the person’s individual needs.

The person may have rehabilitation to help manage the physical, cognitive or emotional impact of the brain tumour. Rehabilitation may take place in hospital, at a specialist rehabilitation unit or through community-based services.

The person may be able to return directly home from hospital, but they will need to continue resting. The time needed to recover and return to usual activities varies from person to person.

People who hold a driver’s licence must inform their licensing authority if they have had a brain tumour. More guidance on this is available on Driving.

For more information on these next stages, visit Treatment and rehabilitation.

Recovery from any brain injury can be a long process, but with support it is possible to improve life after brain injury. Find out more about the support we can offer by visiting Supporting you.