Brain tumor in adults

Symptoms can vary depending on which particular structures in the brain are being disrupted, and how big the tumor has grown, and which structures it is pressing on. This is known as a space-occupying lesion and can have causes other than a tumor.

Commonly people suffer headaches, but this can have all manner of causes. Nausea and vomiting can be common, especially first thing in the morning. Anyone who has a seizure should be checked out immediately – a brain tumor is one of a number of causes.

Progressive weakness on one side of the body and changes to your balance or coordination can occur. Problems with speech – either articulating or understanding it – may be a symptom and should be assessed.

Changes to your vision are quite common with a brain tumor, but your optician should be your first stop, as it’s much more common to need glasses (or stronger glasses) than have a brain tumor.

Mental and behavioral changes may be subtle, but it’s significant if family, friends, and work colleagues notice any changes.

The cause is largely unknown, but there are certain things that increase your risk. They’re more common as you get older. There’s a genetic component to it, so having a family history increases the risk as well as some neurological conditions like neurofibromatosis or Tuberous Sclerosis. Exposure to any radiation from airplanes, CT scans, radiotherapy, or repeated X-rays of the head, all increase your risk.

Brain tumors are often the first thing people worry about with headaches – it seems to rank high in the public’s awareness and causes a great deal of alarm. It’s worth considering that headaches are very common, and brain tumors are comparatively rare. So, when to worry? If you start getting frequent headaches when you didn’t previously suffer, or they feel very different in nature to your usual, or they are very severe, these are all reasons to seek an urgent doctor’s appointment to discuss.

A first seizure needs thorough investigation, and you should avoid driving until you’ve been given the all-clear. Any unusual symptoms affecting your vision, speech, balance, coordination, or strength need to be checked out. Similarly, discussing any changes to your behavior or memory would be best.

Your doctor will ask for detail about your symptoms and examine you – they will check the nerves in your head (cranial nerves) and the peripheral nerves to your arms and legs.

They may refer you for further investigations, such as a scan of your head, or they may refer you to a neurologist, a specialist that deals with the brain and spinal cord, or a neurosurgeon, a surgeon that operates on the brain and spinal cord. They will refer you urgently if they are concerned about a brain tumor.

Treatment for brain tumors varies depending on several factors, such as whether the tumor is benign or malignant, the type of cancerous cells, the location and impact of the tumor, other health conditions, and your overall fitness. Surgery may be offered as a definitive treatment to cut out the abnormal cells, and chemotherapy or radiotherapy would have the same aim.

Your team may consider that reducing the size of the tumor - “de-bulking” - will best relieve symptoms, especially if complete surgical removal is too risky to attempt. De-bulking usually refers to surgery, but oral steroids may be used to reduce inflammation and, therefore size, which may ease symptoms.

Radiotherapy treatment involves using high energy X-rays to destroy tumor cells, usually in a form called external beam radiotherapy. With a small brain tumor this may be targeted as a very high dose to one small area of the brain, called stereotactic radiotherapy.

Chemotherapy treatment uses anti-cancer drugs to destroy any cancer cells in the brain. This can be given on its own, or in addition with radiotherapy and you may be offered this after surgery to help prevent a tumor from returning, or if your brain tumor comes back.

Depending on the symptoms, you may also require medications to manage them, such as anti-sickness medication for nausea and vomiting, painkillers for headaches, and anti-seizure medication if you suffer seizures.

It’s tough to contemplate, but sometimes your treatment team considers the best course to be “watch and wait,” where they scan you regularly and keep an eye on any changes to the tumor size, surrounding brain structures, and any symptoms you develop.