Warning Signs of Brain Tumours

Introduction

Brain tumours. This term tends to evoke fear when mentioned. But what are brain tumours and are they curable? How do we know if a headache is not a sign of a brain tumour? The ninth most common cancer in the UK,¹ a brain tumour is an abnormal growth of cells in the brain. They can be of many types (some less severe than others) and yes, early detection is the best way to ensure a good treatment outcome.  The first step is understanding the warning signs of brain tumours for early diagnosis and treatment. So let us learn more about brain tumours and their warning signs.

What is a brain tumour?

Our brain is an organ that is connected to every part of our body. The brain controls all our body movements, from our arms and legs to our internal organs. Our problem-solving abilities, memory, language and behaviours are also due to our brain.  The cells that make up the brain are called neurons, which create electrical and chemical impulses throughout our body to act. Sometimes, abnormal growth occurs in the brain cells, creating a swelling also called a tumour that affects the function of the neurons. The locations of these tumours determine the symptoms they cause. Smaller tumours cause milder symptoms whereas larger tumours create more widespread issues.²

There are over 150 documented types of brain tumours that range in symptoms and severity affecting different areas of the brain. Brain tumours are largely divided into two types, primary tumours and secondary tumours.³

Primary tumours

• They originate from the brain itself. 
• These tumours consist of the neurons themselves. 
• They can be benign or cancerous.

Secondary tumours

• They are tumours that arise from different parts of the body (such as the breast or the lungs) and lodge into the brain and grow there.³

Tumours can also be benign or cancerous:⁴

Benign brain tumours 

• They are slow-growing and have well-defined swellings in the brain. 
• They can grow larger and create pressure in the brain, causing severe symptoms depending on their location. 
• For example, if the tumour is located in the part of the brain responsible for vision, the symptom could be loss of vision. 
• Benign tumours usually have better outcomes compared to cancerous brain tumours.

Cancerous or malignant brain tumours 

• They are more life-threatening, as they are fast-growing, not well defined (making them harder to manage surgically) and cause more severe symptoms (affecting larger areas of the brain if not treated promptly). 
• Malignant brain tumours also tend to spread to various parts of the body and can have worse outcomes. 

Causes and risks

While there is no specific cause of brain tumours, some risk factors are noted in research. Some of them include:⁵

Age

• The risk of brain tumours increases with age (most tumours are found in individuals over the age of 80).
• However, some tumours are more common in children. 

Radiation 

• Rarely, brain tumours are found in individuals who have been exposed to radiotherapy in the past.

Family history of genetic conditions

• While brain tumours are not hereditary, some genetic diseases such as Tuberous sclerosis, Neurofibromatosis type 1 and type 2, and Turner's syndrome are known to increase the risk of developing brain tumours.

Common symptoms of brain tumours

The signs and symptoms of brain tumours depend on the location of the tumour. Different areas of the brain are responsible for different functions of the body. For example, a tumour located in the back of the head can affect the neurons in that area (called the cerebellum). The cerebellum is responsible for our balance and coordination. A tumour located there would cause issues with walking, frequent falls or clumsiness and normal functioning. 

It is important to note that these symptoms indicate a serious diagnosis such as a brain tumour only when you don’t normally show these symptoms. For example, you’re not a clumsy person and generally have good coordination, but notice these changes that are not normal for you.⁶

Brain tumours can affect the normal functioning of the body, causing physical and psychological symptoms. Some of them are:³

Headaches

• Severe, persistent headaches that may be accompanied by a feeling of nausea or vomiting.

Seizures

• Abnormal brain activity causes alarming uncontrolled movements or convulsions and unconsciousness, especially without a previous history of seizures. 

Paralysis

• Weakness and numbness of a body part or limbs.

Cognitive changes

• Difficulty in speaking, problem-solving, decision-making, finding the right words, understanding language or changes in normal mental capacity.

Changes in behaviour or personality 

• Behaving strangely or inappropriately with no history of odd behaviour. 

Memory loss

• Gaps in memory, forgetting people or events, or how you got somewhere and what you did at a particular point in time. 

Vision changes

• Darkening of vision or loss of vision. 

Changes in hearing 

• Ringing in the ears (tinnitus) or reduced hearing especially when accompanied by dizziness and balance problems.

Abnormal movement

• Being abnormally clumsy, walking differently, and uncoordinated movements.

Speech difficulties 

• Slurred speech as well as difficulty understanding words and naming things.

It is important to note that not all these symptoms mean that you have a brain tumour. The diagnosis is done after careful consideration by medical professionals. These symptoms, however, are “red flags” or warning signs, indicating that something serious, that needs immediate medical attention, is happening.

Diagnostic process

The first step is to recognise the warning signs and get medical help. Once you are suspected of having a brain tumour the medical team will perform some tests and scans to ensure the correct diagnosis.

A proper clinical history of your illness supplemented with results from the scan will be important in giving the team an idea of the tumour’s location, causes of the symptoms, and the right treatment to alleviate current symptoms before promptly treating the brain tumour itself.²

Initial medical evaluation

Survey of symptoms and medical history 

• the doctors will ask you questions about your symptoms when they started and the history of your illness.

Physical examination

• the doctor will then examine your brain function by conducting some simple tests to better understand your cognitive function, and check your reflexes, movements, muscle strength and other neurological parameters.²

Imaging

If your physical examination and symptoms are indicative of brain tumours, medical professionals will either conduct a CT or  MRI scan to pinpoint the location of the tumour. This will help locate the tumour and understand whether it can be surgically removed. ²

Biopsy

Sometimes, a biopsy may be done to determine the type of cells in the tumour. This procedure involves the surgeon getting a small number of cells from the tumour (if it is accessible as seen on the scan), and sending it for analysis in the medical lab. This can help understand if the tumour is cancerous or benign, primary or secondary and the severity of the condition.²

Treatment options

The treatment for a brain tumour depends on the following factors:

The type of tumour

• is it cancerous or non-cancerous? Is it primary or secondary? Cancerous tumours may be difficult to remove surgically.

Location in the brain 

• some parts are difficult to reach surgically

The size of the tumour

Your overall health and fitness

• It could be riskier to operate on older and frail individuals.²

The primary treatment for brain tumours is surgery. Some medications are given initially to reduce swelling and pressure (steroids), for the pain (painkillers), nausea and vomiting, seizures and any other specific symptoms. However, directly treating the tumour is the only way to manage the symptoms.

The following are viable therapies for tumour treatment:⁵

Surgical treatment

• The surgeons aim to remove as much of the tumour as possible.
• Usually, benign tumours and smaller cancerous tumours are easier to remove surgically. However, if the tumour’s location is highly risky or the tumour is too widespread, surgery may not be possible.
• This is determined after careful consideration by the surgeons and the medical team with your brain scans. 
• The advancements in neurosurgical techniques have significantly improved surgical outcomes and recovery after surgery.

Radiation therapy

• High-energy radiation beams are used to target the tumour in the brain so that they may destroy the cells. 
• This may be used with surgery and chemotherapy. 
• It also may be used when surgery is not possible to reduce the size of the tumour.

Chemotherapy

• Chemotherapy is another way of killing tumour cells through specific chemotherapy drugs. 
• It is usually used in combination with radiotherapy or surgery.

Treatment outcomes

The outcome of treatment and recovery depends on various factors such as:⁵

• Your age
• The type of tumour
• Location
• The treatment: how was the surgery and were there any complications?
• General health condition 

Generally, people with non-cancerous tumours have a better survival rate than patients with cancerous tumours.⁵

Summary 

• Brain tumours are swellings or masses in the brain caused by an overgrowth of cells. 
• They can be primary (arising from the brain cells themselves) and secondary (arising from other cancers in the body). They can also be cancerous or non-cancerous (benign).
• Cancerous tumours are ill-defined, more widespread and cause symptoms more rapidly than benign tumours 
• Benign tumours are well-defined and have a better outcome than cancerous tumours.
• Some warning signs of brain tumours include:
  • Abnormal headaches, persistent, accompanied by nausea and vomiting.
  • Mental and behavioural changes
  • Paralysis of the body or limbs
  • Changes in vision, hearing, balance and dizziness
  • Other symptoms are based on the location of the tumour in the brain.
• The tumour is diagnosed through your clinical history and symptoms, imaging and a biopsy if needed.
• The primary treatment is surgical removal of the tumour. Radiotherapy and chemotherapy are also used to reduce the size of the tumour and prevent it from occurring again.
• People with non-cancerous tumours tend to have better treatment outcomes.

FAQs

How quickly do brain tumour symptoms progress?

The progression of brain tumour symptoms can vary widely depending on the type, size, and tumour location. Some tumours grow slowly over years and may cause gradually worsening symptoms, while others grow rapidly, leading to a swift onset of severe symptoms.⁵

Can brain tumours be cured?

The possibility of curing a brain tumour depends on various factors, including the type of tumour, its location, size, and whether it has spread. Treatments such as surgery, radiation therapy, and chemotherapy can be very effective in managing and sometimes eliminating the tumour, particularly if caught early.²

Are brain tumours hereditary?

Most brain tumours are not inherited, but some genetic conditions can increase the risk of developing them. Conditions like neurofibromatosis and Turner syndrome are examples where individuals may have a higher predisposition to brain tumours due to their genetic makeup.⁵

Can lifestyle changes reduce the risk of brain tumours?

While the exact causes of brain tumours are not fully understood, maintaining a healthy lifestyle can potentially reduce the risk. Avoiding exposure to harmful chemicals, maintaining a healthy diet, regular exercise, and avoiding smoking can contribute to overall brain health.⁷

What role does imaging play in diagnosing brain tumours?

Imaging techniques such as MRI, CT scans, and PET scans are crucial in diagnosing brain tumours. These imaging methods provide detailed scans of the brain, helping doctors determine the tumour's size, location, and impact on surrounding tissues. They are essential tools in both diagnosis and planning treatment.⁵

How does a brain tumour affect daily life?

Brain tumours can significantly impact daily life, affecting cognitive functions, physical abilities, and emotional well-being. Symptoms like headaches, seizures, and speech difficulties can interfere with routine activities, requiring adjustments and support to manage these challenges effectively.⁷

What support is available for those living with brain tumours?

Support for individuals with brain tumours includes medical treatment, rehabilitation services, psychological support, and support groups. Organisations like The Brain Tumour Charity and Macmillan Cancer Support offer resources and guidance to help patients and their families cope with the diagnosis and treatment.

Can brain tumours recur after treatment?

Yes, brain tumours can recur after treatment. The likelihood of recurrence depends on the tumour type, initial treatment effectiveness, and other individual factors. Regular follow-up appointments and monitoring are essential to detecting and managing any recurrence promptly.¹

What advancements are being made in brain tumour treatment?

Advancements in brain tumour treatment include the development of targeted therapies, immunotherapy, and improved surgical techniques. These innovations aim to increase the effectiveness of treatments while minimising side effects, offering hope for better outcomes in brain tumour management.⁵