Brain tumours

A brain tumour is a growth of abnormal cells in the brain. Brain tumours can be benign (non-cancerous, grow slowly, usually don't spread) or malignant (cancerous, grow faster, can spread within the brain or spinal cord). They can also be primary (starting in the brain) or secondary/metastatic (spreading to the brain from a cancer elsewhere, such as lung or breast cancer — more common than primary brain tumours).

Common types

• Gliomas — including glioblastoma (aggressive), astrocytomas, oligodendrogliomas
• Meningiomas — most are benign, arise from the brain's covering layers
• Pituitary tumours — usually benign, can affect hormones and vision
• Acoustic neuromas / vestibular schwannomas — affect the nerve for hearing and balance
• Medulloblastomas — most common in children
• Secondary/metastatic tumours — from another cancer site

Symptoms

Symptoms depend on the tumour's size, type, and location:

• Persistent or worsening headaches — often worse in the morning or with straining
• Seizures (fits) — especially in an adult who has never had one before
• Nausea and vomiting
• Vision changes — blurred vision, double vision, loss of peripheral vision
• Weakness, numbness, or loss of sensation on one side of the body
• Speech, balance, or walking problems
• Confusion, memory problems, personality change
• Unusual tiredness

Many of these symptoms are common and usually caused by less serious conditions — but persistent or unexplained symptoms, especially seizures or new neurological signs, deserve investigation.

Diagnosis

• Neurological examination
• MRI of the brain — the primary imaging test
• CT scan — used in emergencies or when MRI is not available
• Biopsy — a sample of tumour tissue examined under a microscope; confirms the type
• Additional tests depending on type (hormone levels for pituitary, hearing tests for acoustic neuroma, etc.)

Treatment

Treatment depends on the type, size, location, and grade of the tumour:

• Surgery — to remove as much tumour as safely possible; often the first treatment
• Radiotherapy — targeted radiation to destroy remaining tumour cells
• Chemotherapy — drugs to kill cancer cells, given orally or intravenously; delivered systemically or sometimes via implants
• Targeted therapies and immunotherapy — newer treatments for specific tumour types
• Stereotactic radiosurgery (Gamma Knife / CyberKnife) — precise radiation without open surgery
• Steroids (dexamethasone) — to reduce brain swelling around the tumour
• Anticonvulsants — to prevent or control seizures
• Rehabilitation — physiotherapy, occupational therapy, speech therapy, counselling