What to look for: Brain tumour symptoms

About 300 people are diagnosed with a brain tumour every year — high profile examples include singers Russell Watson and Sheryl Crow, who both survived.

There are around 130 different types of brain tumour. Only around half are cancerous, while the rest are benign — although these can still be life-threatening, because of the damage they can do to the brain.

Primary brain tumours, which arise from the brain, are very rare, and secondary tumours which have spread to the brain from cancers in other parts of the body, are more common — up to 40% of all cancers eventually spread to the brain.

Brain tumours can be difficult to detect and symptoms can vary widely, depending on where in the brain they are, but Dr Kevin O’Neill, a consultant neurosurgeon, says the most common signs are headaches and seizures.

“But of course, headaches and seizures are reasonably common, and most people with headaches don’t have a brain tumour,” he stresses. “The worrying pattern of headaches is typically worse in the morning, perhaps waking you from sleep, and getting worse over time. What’s key is that they’re often different from your ‘usual’ headache – most people have had enough headaches to know what theirs feels like.”

Headaches related to brain tumours are usually linked to increasing mass and pressure from the tumour, and are often worse in positions like lying down, where gravity adds to the problem.

Raised pressure can also lead to nausea and vomiting or progressive neurological problems as the tumour affects the surrounding brain. These may include clumsiness, visual disturbance or weakness on one side of the body, often similar to stroke symptoms.

Other signs may include changes in senses, including an impaired sense of smell and hearing, problems with speech, writing or drawing, and difficulty with averting the eyes upwards.

According to Dr O’Neill, the prognosis for brain tumours is extremely variable, as some may be very slow growing and never cause a problem, while others are very aggressive and have a poor prognosis even with maximum treatment, which includes neurosurgery, radiotherapy and chemotherapy.

The high-profile British patient five-year-old Ashya King had to be taken to a Czech clinic to get proton therapy. However, Dr Matt Williams, a consultant clinical oncologist, says while there are some rare tumours where proton therapy may be beneficial, for the most common types of tumour, it doesn’t appear to be advantageous.

“Proton therapy is just another type of radiotherapy, and carries many of the same benefits and risks. Those where it offers an advantage are the tumours where we know we want to give a big dose, but where we’re limited by a delicate structure next to the tumour. Those where it isn’t as useful are where the tumour is mixed in with the normal tissue, so we’d find it harder to give a higher dose,” he explains.

“The other issue is that the gap between what you can achieve with conventional radiotherapy and proton therapy has narrowed over the last few years, as the technology for conventional radiotherapy has improved.”


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