Our grateful thanks to Brain Tumour Research for their contribution to our on-air report (which you can hear again via the audio player below) and for the use of the support information below, To find out more about brain tumours and 'Wear a Hat Day' to raise money for brain tumour research - click here.
What is a brain tumour? A brain tumour occurs as a result of an abnormal growth or spread of cells from within the brain or its supporting tissues that can damage the brain or threaten its function.
Some types of tumour can occur around the edge of the brain and press on certain parts of it, whilst others can be more diffuse, spreading out and growing in amongst healthy brain tissue.
Brain tumours are divided into four classifications – grades 1 and 2 are low-grade, grades 3 and 4 are classed as high-grade. High-grade or malignant brain tumours are aggressive and can spread quickly in the brain, and are usually a serious threat to life. Low-grade or benign brain tumours are slower-growing and not usually immediately life threatening, but can still have a potentially dangerous impact on a person’s well-being.
What causes a brain tumour? The direct cause of a brain tumour is still not clear, so more investment in research is urgently needed. There are over 120 different types of brain tumour.
Find out more about the causes of a brain tumour.
What is the prognosis of a brain tumour?
The prognosis – impact on well-being and threat to life – is mainly dependent on the type of tumour, location in the brain, tumour size at time of diagnosis, growth and how much can be removed or successfully treated. Factors including patient age and general health also have a bearing, as well as some recognised genetic factors.
What’s the difference between primary and secondary brain tumours? Approximately 16,000 people are diagnosed with a brain tumour in the UK every year and there are estimated to be over 60,000 people living with a brain tumour.
The most common types of cancer that can spread to the brain are lung, breast, and melanoma (a type of skin cancer) with other cancers able to as well.
What is a low-grade brain tumour? A low-grade tumour is normally classified as a grade 1 or grade 2 brain tumour, according to the World Health Organisation (WHO) classification guidelines.
Grade 1 tumours tend to occur in children and young adults but are usually well treated and carry a good prognosis. Some grade 1 tumours may just need surgery, not radiotherapy or chemotherapy. They may re-grow at a slow rate, and further treatment may be possible to reduce their size again. Regular monitoring and careful management are likely to be recommended by the patient’s clinical team.
Grade 2 tumours carry the risk that they will eventually transform into higher-grade tumours. Some tumours initially classified as grade 2 tumours may harbour altered genes that make them behave like high-grade tumours, hence they may need an early biopsy or surgery.
A low-grade brain tumour is slow-growing, compared to a high-grade tumour. It may not come back if it is completely removed by surgery, but recurrence and transformation to a higher grade often occurs. The position of the tumour in the brain will determine if surgery is possible or not.
Low and high-grade brain tumours rarely spread outside the central nervous system, but can grow into the brain or spread at a distance within the brain tissue to form other areas of growth.
What is a high-grade brain tumour? These brain tumours are classified as grade 3 or grade 4. They are fast-growing, aggressive in behaviour and life-threatening.
A high-grade brain tumour usually comes back after treatment, even if it appears to have been completely eradicated the first time. This is because of its invasive nature; the ability to spread its tumour-forming cells to other parts of the brain or spinal cord.
How are brain tumours graded or classified? Pathological classification of a person’s brain tumour enables a clinician to determine the best course of action in treating a patient’s tumour after diagnosis.
The World Health Organisation (WHO) issues updates to the global guidelines for the classification of brain tumours every few years. Current WHO guidelines were last updated in 2016 to include DNA (genetic) profiling of brain tumours as well as the traditional histology – the examination of tumour cells under the microscope.
Tissue samples are required for classification and are obtained by a neurosurgeon performing a biopsy or removal (resection) of the tumour. Samples are sent to pathology labs for careful scientific classification of the tumour.
What is a calcified brain tumour? What is a brain tumour cyst? And what is brain tumour necrosis? A calcified brain tumour is one in which calcium has built up. A range of different types of brain tumour can show different patterns and extent of calcification.
Calcification happens when tumours are no longer able to regulate the movement of calcium in and out of their cells. This may be due to damage to the blood vessels, resulting in a localised haemorrhage (uncontrolled blood flow) within the tumour that kills some of the cells. Calcium flow is disrupted even further and calcium builds up around the dead cells, so calcification tends to indicate that portions of the tumour have died (brain tumour necrosis) and are no longer actively growing.
A necrotic brain tumour means that some cells within the tumour have died, for example in the centre of a glioblastoma multiforme (GBM) brain tumour.
A brain tumour cyst is a sac or bubble that can form in or near a brain tumour. It may contain some tumour cells, brain or spinal cells, blood, and cerebrospinal fluid (a transport for molecules and waste products between cells and the blood, a lubricant and a shock absorber for the brain and spine).
Cysts can cause similar symptoms to a brain tumour because they place pressure on the surrounding brain, but they are not cancerous in themselves. Cysts are typically removed via surgery to remove and/or drain the cyst.
What are the symptoms of a brain tumour? The symptoms of a brain tumour will depend upon which part of the brain is affected. The most common symptoms are caused by an increase in pressure in the skull (intracranial pressure) caused by the growth of a tumour in the brain.
Are headaches caused by a brain tumour? Headaches are one of the main symptoms of a brain tumour, but of course there can be many reasons for having a headache. Headaches caused by a brain tumour tend to:
Eye symptoms of a brain tumour Please remember that are many reasons why people display these eye and vision-related symptoms, but if any of these symptoms have come on suddenly they may be caused by a blood clot or infections such as meningitis or encephalitis, so it is worth seeking medical advice as a matter of urgency.
It is always worth seeing both your GP and an optometrist (optician) to investigate such symptoms. If your doctor suspects the presence of a brain tumour, they will immediately refer you for a scan at a hospital in order to be sure whether or not one is present.
How can an eye test detect a brain tumour? A regular, routine eye test can sometimes detect eye problems that indicate the presence of a brain tumour before any symptoms become obvious.
An eye test is particularly good at identifying any swelling of the optic disc (a condition called papilloedema) and can also identify when there is pressure on the optic nerve. Both of these conditions can be caused by intracranial hypertension (IH), which means a build-up of pressure around the brain, indicating that something is interfering with the normal circulation of cerebral spinal fluid (CSF), or sometimes that there is direct pressure on the optic nerve if a tumour is present in this area.
Symptoms such as unusual dilation of the pupil in one or both eyes, and the colour of the optic nerve, can also indicate that further investigations are required. A test that checks your visual fields may also be useful to include within your eye examination.
What are the other symptoms of a brain tumour? Other common symptoms, which may initially come and go, include one or more of the following:
Brain tumours that affect the pituitary gland Because the pituitary gland has such varied functions, tumours in this area can be difficult to diagnose. Symptoms are often due to changes in the levels of the hormones that the gland produces and there is a range of reasons why those hormone levels may fluctuate, hence delaying the diagnosis of a tumour.
Symptoms caused by hormonal fluctuations include:
Professional medical advice should be sought to check the cause of these symptoms as soon as possible, although they are also more commonly symptomatic of other illnesses or diseases.
However, if no definite alternative cause for your symptoms can be found and if you suspect something is really wrong, and if you’re experiencing a combination of these symptoms together or in succession, then insist that you or your family member gets referred to a neurologist (a brain and nervous system specialist) and for an MRI scan. Early detection and treatment may avoid acute complications later on.
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