Ask a neurosurgeon - your questions about brain tumours answered

Brain tumours are a mass or growth of abnormal cells in the brain, and they either be benign or malignant, they vary in size and grow at different rates. Mr Edward McKintosh, an expert neurosurgeon, answers some of the most commonly asked questions about brain tumours.

What are the early signs and symptoms of a brain tumour?

If the tumour causes pressure inside the head then patients get headaches. The problem with this is that all of us sometimes get headaches. The kind of headaches caused by brain tumours increase with time, generally over a period of weeks (unlike headaches associated with flu etc., which go away after a few days). They may be worse in the morning, when people have been lying down and may be associated with vomiting or poor vision.

A large number of tumours present with a seizure and for this reason all patients who have a seizure should have an MRI scan. Fortunately, most patients with seizures don’t have tumours.

Less commonly tumours cause weakness of an arm or leg, or problems with speech. This type of presentation is fairly rare, however.

Increasingly, tumours are being found ‘incidentally’ when scans are done following trauma or for other reasons.

What is the outlook if you have a brain tumour?

This very much depends on the type of tumour. Some tumours are small, benign and don’t need treatment. Some tumours do need surgery but don’t return if they are all taken out. Other tumours cannot be entirely removed and continue to grow. The most aggressive tumours can prove fatal within a few months, but this is certainly not the case for all brain tumours.

Are there different types of brain tumour?

There are a considerable number of different brain tumours but they are generally divided into tumours which originate within the brain itself (gliomas). Most gliomas cannot be entirely removed and will eventually progress and – often over several years – prove fatal. Tumours formed from the lining covering the brain (meningiomas) generally grow slowly and can often be completely removed, after which they generally do not return. Neither gliomas nor meningiomas spread to the rest of the body.

Metastatic tumours which spread from cancer elsewhere in the body (such as lung cancer, melanoma, thyroid cancer or breast cancer) can also spread to the brain. These tumours can often be removed surgically and a decision of whether to do so or not depends to a large extent on whether the tumour has spread to other sites within the body and how well the patient is as a whole.

How can brain tumours be treated?

If it is possible to remove a brain tumour then surgery is generally the best option for the majority of tumours. Small tumours (less than 3cm) can often be treated with focussed radiotherapy instead. Tumours which are too large or in too dangerous a location to remove may instead have a small piece taken in a biopsy operation. Once this confirms what kind of tumour it is, they can often be treated with chemotherapy and radiotherapy. These can slow down the rate of growth of the tumour considerably, but do not generally cure it.

Do all brain tumours need surgery?

No, benign tumours which are small, slow growing and occur in older patients may not need any treatment as they may grow so slowly that they never cause any problems.

If you would like to find out more, make an appointment with a specialist.