The growth of abnormal cells in the brain is called a brain tumour. A brain tumour can develop in any part of the brain or skull, including the base of the skull, protective lining of the brain (meninges), brain stem, pituitary gland, and other areas of the brain.
Brain tumour remains uncommon in Malaysia, with 1.6% of new cancer cases attributed by the brain and central nervous system in 2020. Nevertheless, brain tumours are dangerous because they can compress on healthy parts of the brain or spread to other parts of the brain or spine.
Not all brain tumours are cancerous. Low grade brain tumours or Grade 1 and 2 are non-cancerous (benign) brain tumours with relatively slower growth rate. High grade brain tumours or Grade 3 and 4 are cancerous (malignant) brain tumours and tend to grow faster and spreads into nearby normal parts of the brain.
There are two types of brain tumour. A primary brain tumour is a tumour that originates in the brain. Secondary brain tumours or metastatic brain tumours are cancerous tumours that develop in other parts of the body and gradually spread to the brain.
Cancers that commonly spread to the brain include colon cancer, breast cancer, and lung cancer.
There are several risk factors that can increase your chances of developing a brain tumour.
- Age: Brain tumours can affect individuals of any age, including children, but they are typically more prevalent in older people (85 to 89 years old).
- Radiation: In rare instances, brain tumours are due to exposure to radiotherapy, X-rays, or CT scans of the head.
- Genetic condition or family history: Genetic conditions such as Neurofibromatosis and Turner syndrome can increase the risk of developing brain tumours.
The most common symptoms of a brain tumour include:
- Headaches, especially if you did not have them prior to this, and steadily becomes more frequent and severe over a period of weeks or months
- Seizures, observed as jerking or twitching of hands, arms, or legs, or in some cases, the whole body
- Confusion and memory loss
- Numbness, weakness, and paralysis in one part of the body
- Unexplained nausea and vomiting
- Personality and behaviour changes
- Fatigue or tiredness
- Loss of balance and dizziness
- Difficulties with speech
- Changes in vision, including blurred vision, tunnel vision or floating shapes
- Problems with hearing
Different parts of the brain are responsible for various functions. The following are some of the common symptoms seen in different parts of the brain. The symptoms of a brain tumour will vary depending on the type, grade, size, and location of the tumour.
Responsible for your personality and movement control
- Weakness on one side of the body
- Difficulty walking
- Speech and sight problems
- Loss of smell
- Changes in behaviour and personality
Stores memories and processes sounds.
- Hearing difficulty
- Short-term memory loss
- Hearing voices in your head
- Speech difficulties
Aids in object recognition and information storage.
- Speech difficulties
- Difficulty understanding
- Difficulty writing or reading
- Loss of sensation in one part of the body
Responsible for processing what you see.
- Changes in vision
- Difficulty in identifying object sizes and colours
Controls posture and balance of the body.
- Coordination and balance problems
- Uncontrolled eye movements
Produces hormones for body function.
- High blood sugar (diabetes mellitus)
- High blood pressure (hypertension)
- Weight gain
- Mood changes
- Milk leakage from the breast when you are not breastfeeding
Plays an important role in regulating body functions such as breathing.
- Double vision
- Difficulty speaking and swallowing
- Difficulty walking and unsteadiness
The spinal cord extends from the brain to the lower part of the back, and a tumour in the spinal cord can affect different parts of the body.
- Loss of bowel and bladder control
- Numbness or weakness
Responsible for the production of the hormone melatonin.
- Double vision
- Difficulty in walking
Diagnosis is made based on various investigations. Your doctor would first question your general health and conduct a neurological exam to check your hearing, vision, balance, coordination, and reflexes. Blood tests may be requested.
In addition, your doctor may request the tests below to aid in the diagnosis.
- Magnetic resonance imaging (MRI) is done to have a detailed view of the brain, including the tumour’s size and exact position in detail.
- Computed Tomography (CT) scan is offered as an alternative to MRI.
- Biopsy reveals the nature of cancer (malignant or benign). Samples may be extracted during surgery to remove the tumour, or a stereotactic biopsy may be performed by creating a small hole in the skull for removal of tissues using a needle.
- Spinal tap (lumbar puncture) removes cerebrospinal fluid (CSF) from around the spine to detect cancer cells when the tumour cells are suspected to have invaded the meninges.
Learn more about the different types of screening and diagnostic procedures performed to diagnose brain tumour.
The treatment for a brain tumour depends on location and size of tumour, grade and type of tumour, and your overall health.
Prior to treatment, discuss with your doctor the objectives outlined in the treatment plan. Additionally, you should consult your doctor about the potential adverse effects of the treatment plan and options for palliative care.
- Surgery is one of the main treatments for brain tumours. It is performed to remove the entire tumour or to limit the growth of the tumour by removing a part of the tumour.
- Chemotherapy is a cancer treatment that employs potent cancer-killing medications. Chemotherapy can be given before surgery to shrink tumour size and after surgery to destroy the remaining cancer cells and to reduce the rate of spread of cancer.
- Radiotherapy destroys cancer cells with high-energy x-rays. It is usually used for the tumour and the surrounding area of healthy brain tissue, the whole brain, or the spinal cord.
- Gamma Knife Radiosurgery is a form of radiation therapy that uses 192 precise laser beams of radiation to target a tumour. It also acts as an alternative therapy to chemotherapy, surgery, or other forms of radiation therapy. It is used to treat brain tumours that have metastasised to the brain and for both benign and malignant brain tumours.
- Palliative care will be considered in situations where treatment is not recommended, or cancer cannot be treated completely. The goal is to maximise the quality of life by minimising signs and symptoms of cancer.
Learn more about the different types of treatment technologies to treat brain tumour
There are no known effective measures to prevent brain tumours as of now. Nonetheless, the risk of developing brain tumour can be reduced by avoiding smoking and excessive radiation exposure.
There are no screening tests available for tumours of the brain and spinal cord at this time. However, if your first-degree biological relative (sibling or parent) was diagnosed with brain tumour, genetic counselling may be recommended to find inherited syndromes related to brain tumours.
Meanwhile, if you were diagnosed with inherited syndromes that may put you at higher risk for brain tumour, your doctor may recommend frequent physical exams and other tests to find tumours early for timely treatment.
Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.