Quick answer
What is brain tumour?
A brain tumour is a growth of cells in the brain — primary (starts in brain) or secondary (spread from cancer elsewhere). Symptoms depend on location — persistent headache worse in morning, seizures new in adulthood, personality change, weakness on one side, vision or speech problems, or balance difficulties. Most headaches are not brain tumours — but new neurological symptoms need urgent GP assessment and MRI. Treatment may include surgery, radiotherapy, chemotherapy, or steroids to reduce swelling. See a GP urgently for new seizures, progressive neurological symptoms, or persistent morning headache with vomiting.
Brain tumour — primary and secondary
Brain tumours include primary CNS tumours (start in brain/spine) and secondary metastases (spread from other cancers).
~12,000 CNS tumours/year UK — benign often outnumber malignant in incidence
Symptom patterns by location
| Location | Symptoms |
|---|---|
| Frontal lobe | Personality change, apathy, weakness |
| Temporal | Seizures, memory, speech |
| Parietal | Sensory loss, neglect |
| Occipital | Visual field loss |
| Cerebellum | Ataxia, coordination, nausea |
| Brainstem | Cranial nerves, balance, swallow |
| Pituitary | Visual field defect, endocrine |
Raised intracranial pressure:
- Headache worse supine
- Morning vomiting
- Papilloedema on fundoscopy
Red flags vs common headache
Brain tumour headache myth:
- Most headaches are tension or migraine
- But progressive pattern + neuro signs = scan
Urgent MRI triggers (NICE):
- New adult seizure
- Focal neurology
- Progressive cognitive change
- Suspicious headache pattern + abnormal examination
Common tumour types
Benign/slow:
- Meningioma — dural based
- Acoustic neuroma (vestibular schwannoma)
- Pituitary adenoma
Malignant primary:
- Glioblastoma (GBM)
- Anaplastic astrocytoma
- Primary CNS lymphoma — immunocompromised
Metastases:
- Lung, breast, melanoma, renal — often multiple
Treatment pathway
Multidisciplinary tumour board
Surgery:
- Awake craniotomy — eloquent areas
- Debulking vs biopsy-only if deep/inoperable
Radiotherapy:
- External beam, stereotactic radiosurgery (Gamma Knife)
Systemic:
- Temozolomide — glioma
- Treat primary cancer — metastases
Dexamethasone — symptom relief — not long-term without plan
Anticonvulsants if seizures
Living with brain tumour
Driving — notify DVLA — seizure and tumour rules
Cognitive rehab
Brain Tumour Charity support
Advance care planning — realistic goals
New seizure age 45 — MRI before assuming stress — treatable cause may exist.
Common questions
- What are the symptoms of a brain tumour?
- Depends on location and size — headache (often worse lying down, morning vomiting), seizures, focal weakness, speech or vision change, personality change, memory problems, balance and coordination difficulty, hearing loss one side (acoustic neuroma), endocrine symptoms (pituitary tumours). Symptoms usually progressive over weeks to months — not sudden unless bleed into tumour.
- Are all brain tumours cancer?
- No — meningiomas, pituitary adenomas, acoustic neuromas often benign (grade I) — grow slowly, may not need immediate treatment. Gliomas grade II–IV are malignant — glioblastoma (grade IV) most aggressive. Metastases are always malignant — spread from elsewhere.
- How is a brain tumour diagnosed?
- MRI brain with contrast — gold standard. CT if MRI unavailable urgently. Biopsy at surgery or stereotactic biopsy for tissue diagnosis and grading. Lumbar puncture rarely — only if suspected CNS lymphoma or infection with specialist guidance. No screening test for general population.
- How are brain tumours treated?
- Surgery — maximal safe resection where possible. Radiotherapy — whole brain for multiple metastases, focused (SRS) for single metastasis, standard for glioma. Chemotherapy — temozolomide with radiotherapy for glioblastoma. Steroids (dexamethasone) reduce oedema and symptoms short term. Immunotherapy for some metastases (melanoma).
- What is the outlook for brain tumours?
- Varies enormously — benign meningioma — cure with surgery. Low-grade glioma — years to decades. Glioblastoma — median survival ~12–18 months with standard treatment — improving with trials. Brain metastases — treatable, sometimes long survival with targeted systemic therapy depending on primary cancer.