Brain Tumours

About Brain Tumours

Cancers that start in any part of the brain or related structures are called as primary brain tumours. Cancers that have spread to the brain from somewhere else in the body are called secondary brain tumours or brain metastasis. There were 2,60,000 new cases reported in 2018 globally.

Symptoms of brain tumours differ depending  upon the position of the tumour in the brain. Common symptoms include headaches, sickness, poor balance & coordination, drowsiness, changes in your vision and fits or seizures.

Brain tumour treatment depends on the type of tumour, where it is located and the patient general health. It also depends on whether or not the cancer has spread.

Types of Brain Tumours:

  1. Gliomas: These are brain tumours starting in the glial cells. Gliomas can be low (slow-growing) or high grade (fast-growing). Doctors use the grade & position of the tumour to decide the treatment plan. There are 3 main types of gliomas and sometimes the tumour can have a mix of more than one of these types. These include:
    • Astrocytoma: They are the most common type of glioma and can occur in most parts of the brain and occasionally in the spinal cord. They originate in particular glial cells, star-shaped brain cells in the cerebrum. They usually do not spread outside the brain and does not usually affect other organs.
    • Ependymona:  This is a type of tumour that can from in the brain or spinal cord. It starts in the ependymal cells. These cells line the fluid areas of the brain (ventricles) and the spinal cord. This tumour can occur at any age but is most common in young children.
    • Oligodendroglioma: This type of glioma brain tumour occurs primarily in adults but is also found in children. About 3% of all brain tumours are oligodendrogliomas. These develop from cells called oligodendrocytes.
  2. Vestibular Schwannomas: These are also called as acoustic neuromas. It is a non cancerous (benign) tumour on the main nerve leading from the inner ear to the brain. Hence this can cause hearing loss and imbalance. It is a very rare type of tumour.
  3. Craniopharyngiomas: These are very rare benign broom tumours. These tumours usually grow near the base of the brain, just above the pituitary gland. They are often diagnosed in children, teenagers and young adults. They do not usually spread, but they occur close to important structures and can cause problems if they grow.
  4. Haemangioblastomas: These start from cells lining the blood vessels in the brain. They are often slow growing and are usually limited to one part of the brain. They are also usually difficult to treat. They represent 2% of brain tumours.
  5. Lymphoma: This is a cancer that begins in the infection fighting cells of the immune system, called as lymphocytes. They can start in the brain or spinal cord. There are two main types of lymphoma – Non-Hodgkin and Hodgkin. Lymphoma is treatable and outlook can vary depending on the type and stage of illness.
  6. Meningiomas: These tumours start in the membranes (meninges) covering the brain and spinal cord. These tumours usually grow slowing and 90% of them are benign (non cancerous). About 25% of brain tumours are meningiomas. They are more common in older people and women.
  7. Pituitary Tumours: Most tumours develop from the gland tissue and are called adenomas. They are nearly always benign, so they grow slowly and tend not to spread. Some pituitary tumours may affect hormone levels. These are called secreting hormones. These tumours can cause quiet unusual symptoms because they make too much of one pituitary hormone.
  8. Primitive Neuro Ectodermal Tumours (PNET): These are primary central nervous system tumours and are usually benign Doctors use this term to group these tumours together because the tumour cells look similar under a microscope.
  9. Spinal Cord Tumours: About 20% of central nervous system tumours are in the spinal cord. They can be low (slow-growing) or high grade (fast-growing) tumours. There are different types of brain tumours that can develop in the spinal cord. Meningiomas and Neurofibromas are the most common types in adults; whereas Astrocytoma and Ependymomas are most common in children.

Once brain tumour has been diagnosed, doctors will determine the stage of cancer and whether or not it is metastatic; based on which doctors would be able to devise a treatment plan. Treatments include surgery, radiotherapy, chemotherapy, targeted therapy, proton beam therapy and steroids.

screening

No major professional organisations currently recommend any routine screening of the general public for brain tumours.

our experts

Dr Rajan Shah

Director & Head of Department - Neurosurgery & Neurosciences

Dr David Peterson

Consultant Neurosurgeon

COMPARE PRICING FOR - Brain Tumours

treatment

Treatment for Brain tumours include:

Surgery: This is the main treatment for most brain tumours. Our skull is made up of bone, hence there is a fixed amount of space for the brain to take up. If there it is a growing tumour, it takes up space and increases the pressure inside your head. The increased pressure causes some of the symptoms of brain tumours. Surgery may be recommended to:

    • remove the whole tumour
    • remove part of the tumour (this is called subtotal resection or debulking)
    • take a biopsy
    • drain any build-up  of fluid on your brain (hydrocephalus)

Even if your surgeon doesn’t think they can completely remove the brain tumour, they are still likely to try and remove as much as possible. This can help to slow down the progression of the tumour and relieve your symptoms.

You may not need surgery straight away if you have a very slow growing tumour (low grade) that isn’t causing symptoms. Your doctor will monitor you with regular scans.

Chemotherapy: This is given by administrating drugs intravenously (IV), intra-arterially (IA) or via intra – peritoneal (IP) injections to destroy cancer cells. This treatment can last up to many weeks. Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy tumour cells. You may have it:

    • after surgery ti lower the chances of the tumour coming back
    • if your brain tumour comes back

You usually have chemotherapy on its own or with radiotherapy.

Some chemotherapy drugs can’t cross the blood brain barrier. This is a natural filter between the blood and the brain which protects the brain from harmful substances. You might have some chemotherapy drugs administered into the fluid surrounding the brain and spinal cord. This is called as intrathecal chemotherapy.

Radiotherapy: This is the use of his energy x-rays to destroy tumour cells. You may have radiotherapy on its own, or after surgery. It is usually given to:

    • the tumour and the surrounding area of healthy brain tissue
    • the whole brain
    • the spinal cord

You usually have a type of radiotherapy called external beam radiotherapy. For a small brain tumour, you may have stereostatic or radiosurgery. It targets his doses of radiation to a small area.

Targeted Therapy: This is performed by administrating a number of drugs to the patient which will target certain components of the cancer cells.

Proton Beam Therapy: This is a type of radiation therapy. It uses protons rather than x-rays to treat cancer. Proton beam therapy has had promising results with reduced side effects compared to radiation.

Steroids: Certain steroids like Dexamethasone, Prednisolone, Methylprednisolone have an important role in the treatment of brain tumours.

Treatments are often used in combination with each other, particularly is the cancer is advanced and surgery is being performed. Chemotherapy may often be used before surgery to shrink the tumour or after surgery to destroy any cancer cells that could not be removed during surgery.

You may experience vomiting, nausea, hair loss, fatigue & body pain during treatment. Please do not hesitate to discuss this further with your doctor, for more information on the management of any symptoms.

 

recovery

Recovery would depend upon treatment of choice.

  • Most patients require a post – surgical recovery period of up to 4- 6 weeks. Speak to your surgeon to understand the amount of recovery you would need following your treatment.
  • Appropriate rest is also important during this period.
  • If there is pain and discomfort then please speak to your doctor for its management.

length of stay

Hospital Stay:     3-7 days for surgery

Total Stay:           Depending upon treatment the length of stay can wary from 2 weeks to a few months

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