Brain tumours

This information isn't only about cancerous brain tumours. Brain tumours can be either malignant (cancerous) or benign (non-cancerous), and this information is about both types.

Brain tumours can be primary or secondary. A primary tumour is a tumour that starts in the brain. A secondary brain tumour is a tumour that has spread to the brain from somewhere else in the body.

Primary brain tumours

Primary brain tumours are tumours that start in the brain and have not spread there from somewhere else in the body.

Benign brain tumours remain in the part of the brain where they started, and don't spread into and destroy other areas of the brain. They don't spread to other parts of the body.

If a benign brain tumour can be removed successfully it shouldn't cause any further problems. However, sometimes it's difficult to remove the tumour because of its position within the brain, or because the surrounding brain tissue could be damaged by surgery. Some benign tumours will regrow slowly and, if this happens, treatment with radiotherapy or furthersurgery may be needed.

Malignant primary brain tumours are most likely to cause problems by spreading into the normal brain tissue around them, causing pressure and damage to the surrounding areas of the brain. These tumours rarely spread outside the brain to other parts of the body.

Symptoms of brain tumours

A brain tumour may cause symptoms because the space it takes up in the skull puts pressure on the brain, or because it is disturbing the function of the part of the brain it's growing in.

Symptoms due to increased pressure in the skull

The brain is contained within the skull and has a fixed amount of space. If a tumour grows in the brain it will often cause an increase in pressure within the skull, which can cause symptoms to develop. An increase of pressure in the skull is called raised intracranial pressure (ICP). The most common symptoms of raised pressure within the brain are headaches, feeling sick (nausea) and being sick (vomiting).

Of course, many other things can cause headaches or feelings of sickness, but if you have either of these for over a week with no sign of getting better, it's important that you see your GP to get them checked out.

  • Headaches - A pressure headache is usually dull and constant, and occasionally throbbing. Severe headaches are uncommon. A headache may get worse when you cough, sneeze, bend down or do any hard physical work. All of these tend to raise pressure in the brain. Headaches may be worse at night and may wake you.
  • Feeling sick (nausea) and vomiting - If the raised pressure makes you sick, it may be worse in the morning than during the day. It may also get worse if you suddenly change position, for example from sitting or lying to standing.
  • Seizures - Seizures (fits) are another common symptom of brain tumours. Some people may experience muscle spasms, which could be twitching or jerking of an arm or leg, or sometimes the whole body. Occasionally they can cause moments of unconsciousness.

A seizure can be a frightening experience. If you have one you should seek medical help so that the cause can be diagnosed and treated. It's important to remember that a seizure can be caused by medical conditions other than a brain tumour.

  • Drowsiness - Another possible symptom is drowsiness. This can happen as the pressure in the skull increases. You may find that you sleep more or that you drop off during the day when you wouldn't normally.

As well as the symptoms described here, raised intracranial pressure can also cause changes to your sight, such as blurred vision, 'floating objects' and tunnel vision. It may also make you confused or affect your balance.

Symptoms connected with the tumour's position

Some symptoms may be caused by tumours in particular parts of the brain. Sometimes a headache can feel worse on the same side of the head as the tumour. In general, each area of the brain controls different functions. A tumour in a particular part of the brain may prevent that area of the brain from working normally.

Some of these symptoms are listed below, grouped under the different parts of the brain. They are included as a guide. An exact diagnosis can only be made by a doctor and confirmed by tests.

The diagram showing the lobes and functions of the brain show some of the different functions of each area of the brain.

  • Frontal lobe − changes in personality and intellect; uncoordinated walking or weakness of one side of the body; loss of smell; occasional speech difficulties.
  • Parietal lobe − difficulty speaking or understanding words; problems with writing, reading or doing simple calculations; difficulty coordinating certain movements, and finding your way around; numbness or weakness on one side of the body.
  • Temporal lobe − seizures, which may cause strange sensations: a feeling of fear or intense familiarity (déjà vu), strange smells or blackouts; speech difficulties; memory problems.
  • Occipital lobe − loss of vision to one eye, which the person may not notice at first and may sometimes be discovered during routine eye tests.
  • Cerebellum − lack of coordination; slurred speech (dysarthia); unsteadiness; flickering involuntary movement of the eyes (nystagmus); vomiting and neck stiffness.
  • Brain stem − unsteadiness and an uncoordinated walk; facial weakness, a one-sided smile or drooping eyelid; double vision; difficulty speaking and swallowing; vomiting or headache just after waking (this is rare). Symptoms may appear gradually.
  • Meninges - headaches, sickness and problems with sight and movement.
  • Pituitary gland - the pituitary gland produces lots of different hormones so a tumour in the gland can cause a variety of symptoms including: irregular periods; infertility; weight gain; lethargy; high blood pressure; diabetes; mood swings; and enlarged hands and feet. A tumour in the pituitary gland can also cause pressure on the nerves to the eyes, causing tunnel vision.

All the above symptoms may be caused by conditions other than a brain tumour. If you have any of the symptoms described it's important to see your GP.

Personality changes

Sometimes brain tumours may cause changes in personality or behaviour. This usually happens when the tumour is in the brain's cerebral hemispheres. This situation can be very unsettling for the person and their family. Sometimes a referral to a psychologist for assessment and support can help.

Driving

As brain tumours can cause changes in the way the brain works, it may be dangerous to drive. In the UK, there are laws that restrict some people with brain tumours from driving for a while. The restrictions vary with the type of tumour you have, and the type of driving licence you hold.

You'll not usually be allowed to drive for at least a year after the condition has been diagnosed and, in some circumstances, you may not be allowed to drive again. With some types of benign tumours you may be able to drive again once you have recovered from your treatment.

It's your legal responsibility, not your doctor's, to tell theDrivers and Vehicle Licensing Authority (DVLA)| about your illness. The DVLA will advise you of any restrictions on your right to drive. You can speak to the DVLA on 0300 790 6806 (car and motorcycle licence holders) or 0300 790 6807 (bus, coach and lorry driver licence holders). You should also inform your vehicle insurance company.

*Information provided by Macmillan cancer support

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