What is brain tumour?

A brain or spinal cord tumour occurs when abnormal cells grow and form a mass or a lump. The tumour may be benign (not cancerous) or malignant (cancerous), but both types can be serious and may need urgent treatment.

A brain tumour may be a primary or a secondary cancer. Cancer that first develops in the brain is called a primary brain cancer. It may spread to other parts of the nervous system, but rarely spreads to other parts of the body.

Sometimes cancer starts in another part of the body and then travels through the bloodstream to the brain. This is known as secondary cancer or metastasis.

Types of brain tumours

There are more than 40 types of primary brain and spinal cord tumours. These are classified based on the type of cell and how the cells are likely to behave.

Benign and malignant tumours

Tumours are often classified as benign (not cancer, slow-growing and unlikely to spread) or malignant (cancer, faster-growing with potential to spread).

Benign tumours

Benign brain tumours usually grow slowly and are unlikely to spread. A benign tumour may grow and affect how the brain works. This can be life-threatening and may need urgent treatment. Sometimes a benign tumour can change over time and become malignant.

Malignant tumours

A malignant brain tumour may be called brain cancer. Some malignant brain tumours grow slowly, while others grow rapidly. They are considered life-threatening because they may grow larger, spread within the brain or to the spinal cord, or come back after treatment. 

How common are brain tumours?

Around 421 Queenslanders are diagnosed with malignant brain tumours every year and it can affect people at any age. Benign brain and spinal cord tumours are more common than malignant tumours.

Risk factors

The causes of most brain and spinal cord tumours are unknown, but factors known to increase the risk include:

• Family history – While it is rare for brain tumours to run in families, a fault in the genes, usually passed down from either the mother or father, can increase the risk of developing a brain tumour. For example, some people have a genetic condition called neurofibromatosis which can lead to tumours of the brain and spinal cord.
• Radiation Therapy – People who have had radiation therapy to the head, particularly to treat childhood leukaemia may have a slightly higher risk of developing a brain tumour.
• Chemical exposure – A chemical called vinyl chloride, some pesticides, and working in rubber manufacturing and petroleum refining have been linked with brain tumours.

Symptoms

Symptoms depend on where the tumour is in the brain and how slowly or quickly the tumour is growing. It can develop suddenly or gradually over time.

Many symptoms are likely to be caused by other medical conditions, but see your doctor about any new, persistent or worsening symptoms.

General symptoms – Brain tumours can increase pressure inside the skull (known as intracranial pressure). Pressure can build up because the tumour is taking up too much space is causing brain swelling or is blocking the flow of the cerebrospinal fluid around the brain.

Intercranial pressure can lead to symptoms such as:

• Headaches – often worse when you wake up
• Nausea and vomiting – often worse in the morning or after changing position (e.g. moving from sitting to standing)
• Confusion and irritability
• Blurred or double vision
• Seizures (fits) – might have some jerking or twitching of your hands, arms or legs, or can affect the whole body
• Drowsiness
• Weakness in parts of the body
• Poor coordination
• Loss of consciousness
• Difficulty speaking for finding the right words.

Other symptoms depend on where the tumour is located in the brain or spinal cord. See Understanding Brain Tumours booklet for more information.

Diagnosis

Many people diagnosed with a brain or spinal cord tumour first go to see their general practitioner (GP) because they are feeling unwell. Occasionally a brain tumour will be found during a scan for something unrelated, such as a head injury or an optometry appointment. Some people have sudden symptoms (such as loss of consciousness, a severe headache or a seizure) and go straight to the hospital’s emergency department.

The doctor will ask you about your symptoms and medical history, and will do a physical examination. You may then have one or more of these scans/tests:

• Physical examination – your doctor will assess your nervous system to check how different parts of the brain and body are working, including your speech, hearing, vision and movement
• MRI scan
• CT scan
• Blood tests.

Further tests include:

• MRS scan – looks for changes in the chemical make-up of the brain
• MR tractography – helps show the message pathways within the brain
• MR perfusion scan – shows the amount of blood flowing to various parts of the brain
• SPECT or SPET scan – takes three-dimensional pictures showing blood flow in the brain
• PET scan
• Lumbar puncture (spinal tap) – uses a needle to collect cerebrospinal fluid from the spinal column
• Surgical biopsy – tissue is removed and is examined by a pathologist
• Genetic tests – special tests on cells from the tumour to look for gene changes.

Some tests may be repeated during or after treatment to check how well the treatment is working. Waiting for the test results can be a stressful time. It may help to talk to a friend or family member, a healthcare professional, or call Cancer Council on 13 11 20.

Treatment

For benign tumour, surgery may be the only treatment needed. For a malignant brain, treatment can include surgery, radiation therapy and chemotherapy, which may be used alone or together. Medicines, such as steroids or anticonvulsants (anti-seizure medication), may be given to reduce symptoms. You may be able to access new or modified treatments through a clinical trial.

The treatment you are offered for a brain or spinal cord tumour will depend on:

• The type, size, grade, location and genetic make-up of the tumour
• Your age, medical history and general state of health
• The types of symptoms you have
• The aim of treatment – whether to remove as much of the tumour as possible; to slow its growth; or to relieve symptoms by shrinking the tumour and reducing swelling.

For more information on the treatment of brain and spinal cord tumours please refer to the Understanding Brain Tumours booklet.

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease.

Both low-grade and high-grade tumours can affect how the brain works and be life-threatening, but the prognosis may be better if the tumour is low-grade, or if the surgeon is able to remove the entire tumour.

Some brain or spinal cord tumours, particularly gliomas, can come back. They may also (transform) into a higher grade tumour. In this case, treatments such as surgery, radiation therapy or chemotherapy may be used to control the growth of the tumour for as long as possible, relieve symptoms, and maintain quality of life.

Support for Queenslanders

Whether you have been diagnosed with a brain tumour, or have a family member or friend who is affected by cancer, there are times when you may need support. Our professional services and support programs are here to help you.

Find out more about:

• Phone support
• Email support
• Cancer counselling
• Practical and financial support
• Support groups
• Information sessions

You don’t have to face cancer alone – we’re here to help.

Resources

For more information on brain tumours please see these resources.

If you are a patient, family or friend and would like to order a copy of the Understanding Brain Tumours booklet, please call Cancer Council 13 11 20

Visit our community resources page for information session videos on brain tumours.