Malignant brain tumour (brain cancer)

 A malignant brain tumour is a type of cancer that starts in the brain or spreads into the brain from another area of the body. 

 What is a malignant brain tumour (brain cancer)? 

• A malignant brain tumour is a type of cancer that starts in the brain or spreads into the brain from another area of the body.
• It's different to a benign brain tumour, which is not cancerous and usually grows more slowly.
• How serious a malignant brain tumour is depends on how big it is, if it has spread and your general health.

 Symptoms of a malignant brain tumour (brain cancer) 

Main symptoms of a malignant brain tumour (brain cancer)

The symptoms of a malignant brain tumour (brain cancer) can vary depending on the type of tumour, where it is in the brain, what's causing it and how quickly it's growing.

Common symptoms may include:

• new headaches, or headaches that are getting worse – these usually happen with other symptoms
• feeling sick (nausea) or being sick (vomiting) when moving suddenly – this usually happens with other symptoms
• fits (seizures)
• eye problems that are getting worse, such as blurred vision, seeing dots and lines or flashes of light, or not being able to see out of the corners of your eyes
• being very sleepy or fainting (losing consciousness)
• changes to behaviour or personality, such as problems with thinking and concentration

 See a GP if: 

• you have headaches that keep coming back, make you feel sick, or do not go away when you take painkillers
• you feel sick often or it does not get better after a few days

 Call 112 or go to A&E if someone: 

• has a headache that came on suddenly and is extremely painful
• has a fit (seizure) for the first time, it lasts longer than usual for them, or it lasts longer than 5 minutes if you do not know how long their seizures usually last
• is seriously injured during a fit (seizure)
• faints (loses consciousness) and does not wake up or they're finding it difficult to breathe

 Important 

Some of these symptoms are very common and can be caused by other conditions.

Having the symptoms does not definitely mean you have a brain tumour, but it's important to get checked.

If your symptoms are caused by cancer, finding it early may mean it's easier to treat.

What happens at your GP appointment

The doctor will ask you more about your symptoms, such as when they happen and if anything makes them better or worse.

They'll also ask about your general health and medical history.

Depending on your symptoms, they may want to examine you or offer some tests to see if your symptoms could be caused by another condition.

Referral to a specialist

You may get an urgent referral for more tests or to see a specialist in hospital if the GP thinks you have symptoms which could be cancer.

This does not definitely mean you have cancer.

 Causes of a malignant brain tumour (brain cancer) 

Who is more likely to get a malignant brain tumour (brain cancer)

It's not always clear what causes a malignant brain tumour (brain cancer).

Anyone can get it, but you may be more at risk if you:

• are over 85 years old
• are very overweight or living with obesity
• have a close relative who has had a brain tumour
• have a genetic condition that increases the risk of brain tumours, such as neurofibromatosis type 1, neurofibromatosis type 2 or tuberous sclerosis

Many cancers are also linked to lifestyle.

How to lower your risk of a malignant brain tumour (brain cancer)

You cannot always prevent a malignant brain tumour (brain cancer), but there are things you can do to lower your chance of getting it.

 Do 

• eat a healthy, balanced diet including at least 5 portions of fruit and vegetables a day
• try to lose weight if you're overweight
• try to quit smoking
• try to cut down on alcohol – avoid drinking more than 14 units a week

It's important to get any symptoms of a malignant brain tumour checked by a GP.

 Tests and next steps for a malignant brain tumour (brain cancer) 

Main tests for a malignant brain tumour (brain cancer)

If the GP or specialist thinks you might have a brain tumour, they'll probably refer you for further tests at the hospital.

This is usually a scan of your brain to see if you have a tumour, such as:

• an MRI scan
• a CT scan
• a PET scan
• an X-ray

Getting your results

You may get some results on the day that you have tests, or after a few days.

You can call the hospital or your GP if you're worried and they may be able to update you if your results are ready.

If you're told you have a brain tumour

Being told you have a malignant brain tumour can feel overwhelming. You may be feeling anxious about what will happen.

You'll be helped through your diagnosis and treatment by a team of specialists.

This team will include a clinical nurse specialist who will be your main point of contact during and after your treatment. You can ask them any questions you may have.

Next steps

If you've been told you have a malignant brain tumour, you'll usually need more tests.

This will help your specialist team decide what treatment you need.

You may need:

• more scans of your brain
• blood tests
• a lumbar puncture to test the fluid around your brain and spinal cord
• a small sample of cells to be taken from the brain tumour (a biopsy)

You may not have all these tests.

The results of these tests can show how far the cancer has spread, and if the cancer has been caused by certain changes in your genes.

 Treatment for a malignant brain tumour (brain cancer) 

Main treatments for a malignant brain tumour (brain cancer)

A malignant brain tumour (brain cancer) is often treatable. But it can be difficult to treat.

The treatment you have will depend on:

• the size and type of tumour you have
• where it is
• if it has spread
• your general health

It may include surgery, chemotherapy, radiotherapy, and medicines to help with the symptoms.

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan that is best for you
• help you manage the side effects of treatment

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you're worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Surgery is the main treatment for most types of malignant brain tumours.

Surgery may be used to:

• remove the tumour, or part of it
• take a sample of the tumour for testing (a biopsy)
• drain any build up of fluid on your brain (hydrocephalus) to help improve symptoms

You may not need surgery immediately if you have a very slow growing tumour that is not causing any symptoms.

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

You may have radiotherapy for a malignant brain tumour:

• as the main treatment if the cancer is large or has spread
• after surgery, to help stop the cancer coming back

Radiotherapy for a malignant brain tumour is usually given from outside the body, where a machine is used to carefully aim beams of radiation at the cancer.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for a malignant brain tumour:

• after surgery, to help stop the cancer coming back
• if your brain tumour comes back

Sometimes chemotherapy is given with radiotherapy (chemoradiotherapy).

Targeted medicines

Targeted medicines kill cancer cells.

Targeted medicines are sometimes used to treat certain types of brain tumours in children and young people over 1 year old.

Medicines to help with symptoms

As well as other treatments to reduce the size of the tumour, you might be offered medicines to:

• help control seizures (fits)
• reduce swelling inside your brain
• control any pain

What happens if you've been told your cancer cannot be cured

If you have advanced brain cancer, it might be very hard to treat. It may not be possible to cure the cancer.

If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

Finding out the cancer cannot be cured can be very hard news to take in.

You'll be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They'll work with you to help manage your symptoms and make you feel more comfortable.

The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.