Cancer of the Brain and Brain Tumours

brain cancer

The main parts of the brain include:

The cerebrum. This is divided into the right hemisphere (right side) which controls the left side of the body, and the left hemisphere which controls the right side of the body. Each hemisphere is divided into various sub-sections, the main divisions being the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The cerebrum is also where you think and store your memory.

The cerebellum. This lies behind and below the cerebrum. One of its main functions is to help control balance and co-ordination.

The brain stem. This helps to control basic bodily functions such as the heartbeat, breathing and blood pressure. Nerves from the cerebrum also pass through the brain stem to the spinal cord.

The meninges. These are thin layers of tissue which separate the skull from the brain. The outer layer next to the skull is called the dura. The next layer is called the arachnoid. Under the arachnoid tissue is the cerebrospinal fluid (CSF) which bathes the brain and spinal cord.

Primary malignant brain tumours

A primary malignant brain tumour is a cancer which arises from a cell within the brain. The cells of the tumour grow into and damage normal brain tissue. Also they can increase the pressure inside the skull. However, unlike most other types of malignant tumours, primary brain tumours rarely spread (metastasise) to other parts of the body.

There are various types of primary malignant brain tumour. The different types develop from different types of cell in the brain.

Secondary malignant brain tumours

A secondary malignant brain tumour means that a cancer which started in another part of the body has spread to the brain. The most common types that do this are cancers of the breast, lung, colon, kidney and skin (melanoma).

Different types of brain tumour

  • Meningioma:Meningiomas are usually benign. They grow from cells in the meninges (the tissues that surround the brain).
  • Medulloblastoma: These are high-grade malignant tumours that grow in the cerebellum. They are uncommon in adults, but are one of the two most common brain tumours in children.
  • Astrocytomas (originating from astrocyte cells.)
  • Glioblastoma multiforme. This is a high-grade tumour which tends to grow quite quickly. It is the most common type of primary malignant brain tumour in adults.
  • Oligodendrogliomas (originating from oligodendrocytes).
  • Ependymoma (originating from ependymal cells).
  • Primitive neuroectodermal tumours (PNETs)
  • Pituitary tumours
  • Acoustic neuroma (schwannoma)

What causes brain tumours?

The cause of most benign brain tumours and primary malignant brain tumours is not known.Genetic factors may be a risk for some people. For example, people with the hereditary diseases called neurofibromatosis type 1 and tuberous sclerosis have a higher than average risk of developing a glioma. When people with these diseases develop a glioma, it tends to occur in childhood or early adult life. However these cases are only a small proportion of all glioma tumours.

How common are brain tumours?

Benign brain tumours and malignant primary brain tumours are uncommon. The most common types in adults are benign meningioma and a glioma called glioblastoma multiforme. Some types are very rare.Brain tumours can occur at any age. Some types (such as medulloblastoma) are more common in children, and some are more common in adults.

What are the symptoms of a brain tumour?

Early symptoms may include headaches and feeling sick. These are due to increased pressure within the skull (raised intracranial pressure). These symptoms may come and go at first and tend to be worse in the morning. Coughing, sneezing and stooping may make the headaches worse. Epileptic seizures (convulsions) sometimes occur. Increasing drowsiness may occur as the tumour enlarges.

Symptoms due to the location in the brain

As a tumour grows it can damage the nearby brain tissue. The functions of the different parts of the body are controlled by different parts of the brain.

  • Weakness of muscles in an arm, leg, part of the face, or eyes.
  • Problems with balance, co-ordination, vision, hearing, speech, communication or swallowing.
  • Loss of smell.
  • Dizziness or unsteadiness.
  • Numbness or weakness in a part of the body.
  • Confusion.
  • Personality changes.

Symptoms related to hormonal changes are noticed if you have a pituitary tumour.

How are brain tumours diagnosed and assessed?

  • A detailed clinical examination by a neurologist or neurosurgeon is the first step.
  • An MRI scan or CT scan of the head are the common tests done to confirm or rule out the presence of a brain tumour. If a tumour is identified, further more detailed scans and tests may be done. For example, a PET scan or an angiogram are sometimes done to get more information about the tumour.
  • A biopsy may be needed to be sure of the type of tumour. To obtain a biopsy from a brain tumour you need to have a small operation, usually done under anaesthetic. A small hole is bored in the skull to allow a fine needle through to obtain a small sample of tissue.
  • Blood tests and other tests on other parts of the body may be done if the tumour is thought to be a secondary tumour.
  • What are the treatments for brain tumours?
  • The main treatments used for brain tumours are surgery, chemotherapy, radiotherapy and medication to control symptoms such as seizures. The treatment or combination of treatments advised in each case depends on various factors.


Surgery is often the main treatment for benign brain tumours and primary malignant tumours. The aim of surgery is to remove the tumour (or even some of the tumour) whilst doing as little damage as possible to the normal brain tissue.


Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on cancerous tissue. This kills cancer cells or stops cancer cells from multiplying.
Radiotherapy is sometimes used instead of surgery when an operation is not possible for a malignant brain tumour. Sometimes it is used in addition to surgery if it is not possible to remove all the tumour with surgery or to kill cancerous cells which may be left behind following surgery.


Chemotherapy is a treatment which uses anti-cancer medicines to kill cancer cells, or to stop them from multiplying.

Medication to control symptoms

If you have seizures caused by the tumour then anticonvulsant medication will usually control the seizures. Painkillers may be needed to ease any headaches. Steroid medication is also commonly used to reduce inflammation around a brain tumour.

What is the outlook?

It is difficult to give an overall outlook. Every case is different. For example, if you have a benign meningioma which is in a suitable place for surgery, the outlook is excellent. For primary malignant brain tumours, the outlook will vary, depending on the type, grade and location in the brain. The outlook is often poor if you have a secondary malignant brain tumour.

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