This factsheet is for people who have a brain tumour, or who would like information about it.
Brain tumours are an abnormal and uncontrolled growth of cells in the brain. They are usually treated with surgery, radiotherapy or chemotherapy.

How cancer develops
About brain tumours
Symptoms of brain tumours
Causes of brain tumours
Diagnosis of brain tumours
Treatment of brain tumours
Help and support

 

 How cancer develops

The information on the video provided does not constitute advice on diagnosis or the treatment for heart disease and such advice should always be sought from a doctor or another suitably qualified health professional.

About brain tumours

Brain tumours can be either primary or secondary.

  • Primary brain tumours develop from normal cells in your brain.
  • Secondary brain tumours develop when cancer cells from other parts of your body, such as your lung or breast, spread to your brain.

This factsheet will focus on primary brain tumours.

Primary brain tumours are rare; around 4,500 people are diagnosed each year in the UK. Brain tumours can occur at any age but are more common in older people. About 300 children are diagnosed with a brain tumour each year. Cancerous brain tumours are the second most common type of childhood cancer after leukaemia.

Types of primary brain tumour

There are many different types of primary brain tumour and most grow within your brain (intrinsic). They are generally named after the type of brain cell that they develop from. Most intrinsic primary brain tumours are gliomas.

Gliomas grow from glial cells, which support the nerve cells in your brain. The most common types of gliomas are astrocytomas (which grow from astrocytes) and oligodendrogliomas (which grow from oligodendrocytes).

Some tumours grow outside your brain (extrinsic), often from the lining tissues (meninges), and are most frequently called meningiomas. These are usually benign (non-cancerous).

Brain tumours are also given a grade that reflects how fast they are growing and whether they can spread into surrounding tissues (malignant). The grades vary from one to four, with one being the most benign and four the most malignant. Your doctor may refer to a grade one or two tumour as ‘low-grade’ and a grade three or four tumour as ‘high-grade’.

Symptoms of brain tumours

The exact symptoms you have will depend on many factors, including the size of the tumour and its position in your brain. Some brain tumours do not cause any symptoms and may only be discovered by chance.

The most common symptoms of brain tumours are headaches and seizures (fits). If you have a headache, it may be worse at night and early in the morning, but wears off as the day goes on. You may also feel sick or vomit and have blurred vision. These symptoms can be caused by increased pressure in your skull from the tumour. Although headaches are one of the most common symptoms, it's important to realise that headaches are common and most aren't caused by brain tumours.

If your brain tumour causes you to have seizures, you may become unable to speak and have moments of unconsciousness.

Alternatively, you may have weakness on one side of your body, difficulties with speaking, reading and writing, problems with hearing or sense of smell and changes in your personality, memory or mental ability.  This may be because your brain tumour has grown into, and is pressing down upon, important areas of your brain.

These symptoms aren't always due to brain tumours but if you have them, you should visit your GP.

Causes of brain tumours

The exact reasons why you may develop a brain tumour aren’t fully understood at present. Most brain tumours are thought to develop from unusual and random changes (sporadic mutations) in your brain cells, but what causes these changes isn’t known.
There are a number of factors that slightly increase your risk of developing a brain tumour, including:

  • your age – the older you are, the more likely you are to get a brain tumour
  • having an inherited disease – for example, neurofibromatosis (a condition that affects the development and growth of nerve cells)
  • being exposed to radiation – for example, if you have radiotherapy applied to your head as treatment for another cancer
  • having a weakened immune system – for instance, if you have HIV/AIDS, or if you take medicines that suppress your immune system

Currently, there is no evidence to show that mobile phones can cause brain tumours.

Diagnosis of brain tumours

Your GP will ask you about your symptoms and examine you. He or she may carry out tests to assess your reflexes, co-ordination, muscle strength, memory and vision.

Your GP may initially refer you to a neurologist (a doctor specialising in conditions that affect the nervous system) or to a neurosurgeon (a surgeon who operates on the brain and spinal cord).

Your doctor may refer you to have one or more of the tests listed below.

  • A CT scan – this uses X-rays to make a three-dimensional image of your brain.
  • A MRI scan – this uses magnets and radiowaves to produce images of the inside of your body.
  • An electroencephalogram (EEG) – this is a painless test that records the electrical activity of the brain. It is used to diagnose epilepsy.

If your doctor suspects you have a brain tumour, you will be referred to a hospital that specialises in treating brain conditions. You may need to have a biopsy (where a small sample of tissue is removed) to find out the type and grade of your tumour. This is usually done under local anaesthesia (often with some sedation) but is sometimes carried out under general anaesthesia. Your doctor will use your CT and MRI scans to accurately find the position of the tumour. The biopsy will then be sent to a laboratory for testing. Your treatment will be planned according to the type and grade of brain tumour you have.

Treatment of brain tumours

The treatment you receive will depend on the type of brain tumour you have, as well as its size and grade, and its position in your brain.
If your tumour is slow-growing and not causing many symptoms, you may not need any treatment. Your condition will be monitored closely with routine check-ups and scans. This is often called active monitoring or watchful waiting.
Surgery, radiotherapy or chemotherapy are the main treatment options for brain tumours and may be used alone or in combination.

Surgery

Your surgeon may advise you to have a procedure known as a craniotomy to remove the tumour. You will usually be given a general anaesthetic, which means you will be asleep during the operation. However, it’s possible that you may need to be awake for the procedure if your surgeon has to assess your brain function during the operation. This is important for removing tumours from areas of your brain that control vital functions such as movement, feeling and speech.

Your surgeon will cut your scalp and the area of skull over the tumour. He or she will then remove as much of the tumour as possible and replace the piece of skull and scalp. It might not be possible to remove the whole tumour, particularly if it’s high-grade. If this happens, you will usually need to have further treatment such as radiotherapy and/or chemotherapy to control the remaining tumour.

During the operation, your surgeon may also put some small tabs (wafers) that release chemotherapy into the affected area of your brain to kill any remaining tumour cells, but this isn’t suitable for everyone.
Your surgeon will talk to you about any potential risks and follow-up treatment before the operation.

Radiotherapy

Radiotherapy uses X-rays to treat cancer. A beam of radiation is targeted at your tumour to destroy cancer cells with minimal damage to the surrounding healthy tissue.

Radiotherapy is usually used either after surgery to kill any tumour cells that were not removed, or as an alternative to surgery. It is a painless procedure and is usually given as a series of daily treatments over two to six weeks.

Radiosurgery (also known as gamma knife treatment) is a very highly focused type of radiotherapy. It's usually given as a single treatment and is more often used for extrinsic brain tumours such as meningiomas and neuromas. Speak to your surgeon for more information.

Chemotherapy

Chemotherapy uses medicines to destroy cancer cells. It is usually given as tablets or by injection. Only a few chemotherapy medicines are effective at treating brain tumours – the most commonly used are temozolomide or a combination of three drugs called procarbazine lomustine/CCNU vincristine (PCV).
 

Temozolomide chemotherapy is now frequently used in combination with radiotherapy to treat malignant brain tumours called glioblastomas. This treatment may also be used if your tumour comes back (recurs).

Medicines

You may be given medicines to help control any symptoms you have either before or after surgery, or during or after radiotherapy. Steroids help to reduce the swelling caused by your brain tumour. Anticonvulsants help to prevent fits.
 

Newer medicines known as biological therapies have become available that appear to be highly promising for the treatment of malignant primary brain tumours. They may be particularly helpful for people whose brain tumours come back (recur), but won’t be suitable for everyone. Speak to your doctor for more information.

Help and support

Being diagnosed with cancer can be distressing for you and your family. Dealing with the emotional aspects, as well as the physical symptoms, is an important part of treatment. Specialist cancer doctors and nurses are experts in providing the support you need, and may visit you at home. If you have more advanced cancer, further support is available to you in hospices or at home – this is called palliative care.

 

been suggested by health professionals, website feedback and requests via email.

Can mobile phones cause brain tumours?
Can my brain tumour come back after treatment?
After I have been treated, what will happen at my check-up appointments?
If I have a brain tumour, can I drive?

Can mobile phones cause brain tumours?

No, there is currently no evidence to show that mobile phones can cause brain tumours.

Explanation

Mobile phones give out and receive radiowaves. These radiowaves can heat up your body. There are guidelines in place to make sure that none of the mobile phones that are sold in the UK expose anyone to harmful levels of radiowaves. Research has shown that exposure to radiowaves below these guideline levels won't cause you to develop any health problems.

However, because mobile phones are a fairly recent invention, researchers can't be absolutely sure that they don't cause any health problems if they are used over a long period of time. For this reason, it's recommended that you try to keep any calls on your mobile phone as short as possible to minimise the amount of radiowaves that you're exposed to. Children under the age of 16 should only use mobile phones if it's essential. This is because their brains and nervous systems are still developing, so exposure to radiowaves could potentially have a greater effect on them.

Further information

Sources

  • Schu J, Bohler E, Berg G, et al. Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany). Am J Epidemiol 2006; 163(6):512-20. doi:10.1093/aje/kwj068
  • Mobile phones and health. Department of Health. www.dh.gov.uk, published 6 October 2006

Can my brain tumour come back after treatment?

Brain tumours can be treated successfully, but it’s possible that they can come back (recur). This most importantly depends on the type and grade of your tumour as well as how much of it has been removed with surgery. You may need to have regular check-ups after you have finished treatment, even if the tumour was benign (non-cancerous) and didn’t spread into other tissues.

Explanation

Both malignant (cancerous) and benign (non-cancerous) tumours can come back after they have been treated. If this happens, they are known as recurrent tumours. When brain tumours come back, they usually grow in the same area of your brain as the first tumour. They can also develop in a different area of your brain or sometimes in your spinal cord.

If your brain tumour comes back after treatment, your doctor will look at all the possible options. This will depend on what kind of treatment you had for your first tumour.

You might be able to have surgery to remove the recurrent tumour. This will depend on a number of factors including the type and size of the tumour, how quickly it's growing, whether it has spread within your brain or to your spinal cord, and also on your general health.

It's usually possible for you to have chemotherapy if your tumour has come back. Even if you have had this treatment before, your doctor may be able to try again, perhaps using a different drug the second time round.

If you had radiotherapy to treat the first tumour, then you may not be able to have it again. This is because radiation can cause damage to the healthy tissues in your brain. If the brain tumour is in the same area as the first one you probably won't be given radiotherapy as it could cause too much damage to the healthy parts of your brain. However, if the tumour has come back in a different part of your brain, then it may be possible for you to have more radiotherapy.

If you have already tried all treatment options and your doctors are unable to get rid of the tumour, then you can be given treatment to help control your symptoms. You may be given steroids, which will help to relieve your symptoms by reducing the swelling inside your head and painkillers to help with your headaches. You may also be given anticonvulsant medicines to control or prevent fits, as they sometimes occur in people with advanced brain tumours.

Further information

Sources

After I have been treated, what will happen at my check-up appointments?

You will need to have regular check-ups after you have been treated. Your doctor may ask you to have a number of different tests, including scans, but this will depend on your condition and what treatment you received.

Explanation

The type of doctor you have your check-ups with will depend on what kind of treatment you had. This may be with your oncologist (cancer specialist), surgeon or another specialist.

When you go for your check-up, your doctor may examine you and ask whether you have had any symptoms. You may also need to have a CT or MRI scan, but this is usually only necessary if your doctor thinks the tumour may be coming back (recurring). If your brain tumour does come back then you may get similar symptoms to the ones you had with the first tumour. However, these symptoms don't always mean that the brain tumour has come back and could be for many other reasons. You should always tell you doctor about any new symptoms as soon as possible.

If your treatment has been successful, as time goes by you may need to have check-ups less regularly.

It's not possible for doctors to predict precisely when or if your brain tumour will come back. You will therefore need to have regular check-ups after you have finished treatment, even if the tumour was benign (non-cancerous) and didn’t spread into other tissues.

Further information

  • Brain & Spine Foundation

            0808 808 1000
            www.brainandspine.org.uk

Sources

 

If I have a brain tumour, can I drive?

As soon as you have been diagnosed with a brain tumour, you will need to stop driving and contact the Driver and Vehicle Licensing Agency (DVLA). They will let you know when it's safe for you to start driving again.

Explanation

If you have a brain tumour, then you're required by law to let the DVLA know because there is a risk of having epilepsy with a brain tumour and it could therefore affect your vision and your ability to drive. You won't be allowed to drive until the medical department at the DVLA confirm that you're fit to drive safely again. This is for your safety and for the safety of other road users. The DVLA may need to contact your doctor to help them decide for how long it will be unsafe for you to drive. Once this time has passed you should be able to drive again after passing a medical assessment, which will test your sight and how well you can control a vehicle.

Further information

  • Directgov

      0300 790 6806
      www.direct.gov.uk

Sources

  • Brain tumour – A guide for patients and carers. Brain & Spine Foundation. www.brainandspine.org.uk, accessed 8 September 2010
  • Medical rules for all drivers. Directgov. www.direct.gov.uk, accessed 8 September 2010

Related topics

Cancer – a general overview
Chemotherapy
CT scan
Gamma knife treatment
Lumbar puncture
MRI scan
Radiotherapy
 
This information was published by Bupa’s Health Information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is interned for general information only and does not replace the need for personal advice from a qualified health professional.
 
Publication date: November 2010
 

Brain tumours factsheet

 
Visit the brain tumours health factsheet for more information.

 

 

 
 
 
 
 
 
 

Related topics

 
Cancer – a general overview
Chemotherapy
CT scan
Gamma knife treatment
MRI scan
Radiotherapy

Further information

Sources

  • Brain tumours. Macmillan Cancer. www.macmillan.org.uk, published 1 December 2009
  • Cassidy J, Bissett D, Spence RAJ, et al. Oxford handbook of oncology. 2nd ed. Oxford: Oxford University Press, 2006:436–43
  • Brain tumours. Cancer Research UK. www.cancerhelp.org.uk, published September 2010
  • Neoplasms, Brain. eMedicine. http://emedicine.medscape.com, published 26 August 2009
  • Brain tumour – suspected. Clinical Knowledge Summaries. www.cks.nhs.uk, published July 2005
  • The INTERPHONE Study Group. Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE international case–control study. Int J Epidemiol 2010; 39(3):675-94. doi:10.1093/ije/dyq079
  • Chemotherapy wafer implants (Gliadel wafers). Cancer Research UK. www.cancerhelp.org.uk, published July 2010
  • Joint Formulary Committee, British National Formulary. 60th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2010
  • Vredenburgh JJ, Desjardins A, Herndon JE, et al. Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 2007; 25:4722-9. doi:10.1200/JCO.2007.12.2440
  • Schu J, Bohler E, Berg G, et al. Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany). Am J Epidemiol 2006; 163(6):512-20. doi:10.1093/aje/kwj068
  • Mobile phones and health. Department of Health. www.dh.gov.uk, published 6 October 2006
  • Brain Tumour FAQ. National Brain Tumour Foundation. www.braintumor.org, accessed 8 September 2010
  • Brain tumour – A guide for patients and carers. Brain & Spine Foundation. www.brainandspine.org.uk, accessed 8 September 2010
  • Medical rules for all drivers. Directgov. www.direct.gov.uk, accessed 8 September 2010

 
This information was published by Bupa’s Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice form a qualified health professional.
 
Publication date: November 2010

Related articles

This factsheet is for people who are having a breast lump removed, or who would like information about it. There are several different types of breast lump. Most of them aren...
Published by Bupa's Health Information Team, June 2011. This factsheet is for women who would like information about being breast aware. Breast awareness means knowing how your...