Brain Tumours

Brain tumours are created when cells in your brain grow in an abnormal and uncontrolled way. Brain tumours can be malignant, which means they’re cancerous, or benign (not cancerous).

You can get a brain tumour at any age but they’re more common after you reach 50. Children can also get brain tumours.

If brain tumours develop from normal cells in your brain, they’re called primary brain tumours. If the cancer spreads from another part of your body, it’s called a secondary brain tumour. And, this spread of cancer is called metastasis. We’ll focus on primary brain tumours here.

Types of Brain Tumour

There are different types of brain tumour that are usually named after the type of brain cell they develop from. They can also be named after the area of the brain where they’re growing. We describe the most common types below.

Gliomas

These are the most common type of brain tumour. They grow from glial cells, which support the nerve cells in your brain. The most common types of glioma are:

  • astrocytomas and glioblastomas
  • oligodendrogliomas
  • ependymomas
  • Meningiomas

About one in five brain tumours in adults is a meningioma. These tumours start in the layers of tissue that cover your brain (the meninges) and are more often benign.

Pituitary Tumours

About one in 10 brain tumours develops in the pituitary gland – a gland in your body that produces natural chemicals called hormones. These are called adenomas and are usually benign.

Medulloblastomas

Medulloblastoma usually develops in the cerebellum, which is at the back of your brain. It rarely affects adults but is the most common brain tumour in children.

Symptoms of Brain Tumours

The exact symptoms you’ll have will depend on the size of the tumour and where it is in your brain.

Symptoms you can get as a result of increased pressure on your brain from the tumour include:

  • headaches – these are often worse at night and early in the morning but may wear off as the day goes on
  • feeling sick or vomiting
  • blurred vision
  • If you are experiencing the symptoms for a while, see a doctor.

Diagnosis of Brain Tumours

Your doctor will ask you about your symptoms and examine you. They’ll do some tests to assess your reflexes, co-ordination, muscle strength, memory and vision too.

You might need to have some more tests to confirm if you have a brain tumour, and to find out what type you have.

  • Blood tests – these assess your general health and check for specific chemical markers in your blood.
  • Magnetic resonance imaging (MRI) scan – this uses magnets and radio waves to produce images of the inside of your brain.
  • Computerised tomography (CT) scan – this uses X-rays to make a three-dimensional image of your brain.
  • Electroencephalogram (EEG) – this uses electrodes that are attached to your scalp to record your brain activity to look for anything unusual.

Brain Tumour Grading

You may need to have a biopsy to find out the type and grade of your tumour. Your doctor will use your CT and MRI scans to accurately find the position of the tumour and remove a small sample of tissue. They’ll send this to a laboratory to be tested. They might do this as part of an operation to treat a brain tumour.

This sample will be graded from one to four, based on how fast your tumour is likely to be growing. Grade one is a low-grade, slow-growing tumour that’s the least likely to spread and four is malignant and the most likely to spread. Doctors can also test the genetic information of your tumour, which may guide them in deciding which treatment is best for you.

Treatment of Brain Tumours

Different brain tumours develop in different ways. Your treatment will vary depending on which type you have, how advanced it is, and where it is in your brain. Your doctor will discuss what your treatment options are and give you advice and information.

Observation

If your tumour is slow-growing and you don’t have many symptoms, you might not need any treatment straight away. Your healthcare team will monitor you closely and you’ll have routine check-ups and scans.

Surgery

The aim of surgery is to remove as much of the tumour as possible. For some types of brain tumour this can cure them. And for others, it can slow down the growth of tumours and help to ease your symptoms.

You may be able to have open surgery, which is called a craniotomy, or keyhole surgery. This will depend on the type of brain tumour you have, as well as its size and position. If you have a pituitary tumour, your surgeon may be able to remove it through your nose, which is called transsphenoidal surgery.

You’ll usually be given a general anaesthetic during these operations, which means you’ll be asleep. But you might need to be awake for the procedure if your surgeon needs to check how your brain is working during the operation. This is important if your surgeon is removing tumours from areas of your brain that control functions such as movement, feeling and speech.

Non-surgical treatment

Radiotherapy

Radiotherapy uses a targeted beam of radiation to destroy your tumour while aiming to minimise any damage to your surrounding healthy tissue. You usually have radiotherapy after surgery to kill any remaining tumour cells, but sometimes you can have it as an alternative to surgery.

You may have radiotherapy everyday over two to six weeks, or as a single very highly focused treatment called radiosurgery. Another name for this type of radiotherapy is stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT), which you might hear called cyberknife or gamma knife treatment.

Chemotherapy

Chemotherapy uses medicines to destroy cancer cells. Only a few chemotherapy medicines work for brain tumours. The ones that are most commonly used are temozolomide, or a combination of, or just one of, the medicines procarbazine, lomustine and vincristine.

You might have chemotherapy on its own or in combination with other treatments. Temozolomide tablets are often used alongside radiotherapy to treat brain tumours called glioblastomas. You might also have this treatment if your tumour comes back after having other types of chemotherapy.

When your surgeon removes your tumour, they might put small implants called wafers into the affected area of your brain. These will release chemotherapy medicines to kill any remaining cancer cells.

Steroids

Steroids are hormones (chemicals) that your body makes to help reduce swelling. Synthetic (man-made) steroids can help to reduce swelling from your brain tumour, surgery or radiotherapy.

Call +65 64712674 for an appointment to see our brain specialist today.