Brain tumours
When normal cells grow old or become damaged, they die and new cells take their place. Sometimes, however, this process goes wrong and new cells form when the body doesn’t need them, or old or damaged cells don’t die as they ought to. In this case, the build up of extra cells can form a mass of tissue – a tumour.
Brain tumours may be ‘primary’ (ie: they start in the brain) or ‘secondary’ – also known as ‘metastatic’ – which means they started in another part of the body but have moved to the brain.
Tumours can be either benign or malignant, but metastases are always malignant.
Malignant brain tumours
Malignant brain tumours – also sometimes referred to as ‘brain cancer’ — contain cancer cells and are more serious. They may grow rapidly and invade healthy brain tissue, and cancer cells can also break away from a malignant brain tumour and spread to other parts of the brain or to the spinal cord, though not usually to other parts of the body. Treatment for malignant tumours usually involves a combination of surgery, chemotherapy and radiotherapy.
‘Intrinsic’ tumours – those that arise inside the substance of the brain itself, such as gliomas – may be either benign or malignant, except metastases, which are always malignant.
Treatment for brain tumours
Treatment for brain tumours usually starts with detailed scans such as CT and MRI, possible drug treatment to shrink the tumour, and surgery to reduce or remove the tumour. Malignant tumours may not always be cured by surgery. A subset of tumours – those which are malignant or those which can’t be removed completely due to their location – may require chemotherapy and radiotherapy.
Benign brain tumours
When a tumour is benign, this means it does not contain malignant cells, which grow aggressively and destroy the normal tissue around it as it grows. Benign tumours can also grow aggressively but this is rare, and they do not destroy the normal tissue around them but rather grow and simply occupy space by displacing normal tissue as it grows. They can usually be removed and they don’t usually grow back. They can cause problems in the brain due to their size or their position, by putting pressure on sensitive areas or causing increased pressure in the head. Some tumours are small and cause no symptoms. In this case, your neurosurgeon may not operate but may instead adopt a wait-and-see approach. However, if you do eventually need an operation, most benign tumours respond well to surgery and you probably won’t need chemotherapy or radiotherapy afterwards.
Most ‘extrinsic’ brain tumours – those that occur around or underneath the brain, such as meningiomas or pituitary tumours – are benign.
Symptoms of a brain tumour
Some brain tumours are found incidentally, while the patient is undergoing treatment or scans for something else. Some may be found as a result of symptoms, which can be very diverse, from headaches, to loss of vision, a stroke or a fit.Prognosis for brain tumours
The vast majority of benign brain tumours are curable and the patient returns to a normal life. But even with difficult intrinsic brain tumours, such as metastases, unpleasant symptoms can be relieved or removed in most instances.
Dr Nash will always see patients urgently, and treat them quickly and effectively along with other experts that form part of a multidisciplinary team.
All brain tumours that have been removed (‘excised’) are sent for analysis to see if there is any genetic activity, and if so, patients are offered the opportunity to have other members of their family tested for susceptibility to similar cancers. However, it should be stressed that this may only be relevant in a very small group of patients.
