What is a Brain Tumour?
Brain tumours are abnormal growths of cells within or around the brain. Your skull is a rigid bone that encloses your brain. Any abnormal growth within such a restricted space can cause problems.
Brain tumours can be classified as benign (non-cancerous) or malignant (cancerous). While benign tumours tend to grow slowly and may not spread, malignant tumours can be aggressive and invade surrounding brain tissue. Both types can cause significant health issues due to the brain's limited space and critical functions.
Brain tumours can further be classified into primary and secondary. Primary tumours originate in the brain. Secondary tumours, also known as metastatic brain tumours, occur when cancer spreads to the brain from other organs such as the breast, kidney or lungs. Secondary tumours are always malignant, as benign tumours don’t spread from one organ to another.
Symptoms of Brain Tumours
Symptoms vary based on the tumour's size, type, and location. Common signs include:
Headaches: Often worse in the morning or when lying down. These headaches can also occur when you’re sleeping or get worse with cough or sneezing.
Seizures: New-onset seizures or changes in existing seizure patterns.
Cognitive or Personality Changes: Memory problems, confusion, or mood swings.
Motor or Sensory Impairments: Weakness, numbness, or difficulty with coordination.
Vision or Speech Difficulties: Blurred vision, double vision, or trouble speaking.
It's important to note that these symptoms can also be caused by other conditions. If you experience persistent or worsening symptoms, consult a healthcare professional promptly.
Causes and Risk Factors
The exact cause of most brain tumours remains unknown. However, certain factors may increase risk:
Age: The risk increases with age, particularly for malignant tumours.
Genetic Factors: Rare, inherited conditions like neurofibromatosis can predispose individuals to the development of neural tumours.
Radiation Exposure: Previous exposure to ionising radiation, especially to the head. You can be exposed to ionising radiation through high-radiation cancer treatments or from environmental exposure to radiation.
Occupational Hazards: Exposure to certain chemicals or electromagnetic fields.
How is a Brain Tumour Diagnosed?
Diagnosing a brain tumour involves several steps:
Neurological Examination: Assessing vision, hearing, balance, coordination, and reflexes. Your doctor will also conduct a test to see if your functions are intact.
Imaging Tests: MRI and CT scans provide detailed images of the brain to identify abnormalities.
Blood tests: Occasionally, some rare tumour types can be diagnosed with blood testing.
Biopsy: A sample of the tumour tissue is examined by a neuropathologist to determine the type and grade. The biopsy will help your doctor determine whether the tumour is benign or malignant and whether it originated in the brain or spread from other organs.
Early and accurate diagnosis is always crucial for effective treatment planning.
Treatment Options for Brain Tumours
Treatment depends on various factors, including tumour type, size, location, and the patient's overall health. Common treatments include:
Surgery: The most common treatment for malignant tumours is surgery, where the tumour is removed as safely as possible, without causing damage to the healthy parts of the brain. For tumours located in an area that makes full removal risky, partial removal of the tumour can be beneficial.
In general, surgical approaches aim to achieve the maximal safe resection, to allow for diagnosis, reduction of mass effect, control of tumour growth and to maximise adjuvant therapeutic potential.
Radiation Therapy: Use of ionising radiation can help control the growth of tumour cells by targeting the rapidly dividing cells characteristic in tumour biology. Mostly, it is used as an adjunct to treatment following maximal resection of tumour bulk to control smaller areas with potential tumour cells. In some indications, it can be used as a primary treatment for brain tumours without surgery.
Chemotherapy: Using drugs to target or slow the growth of cancer cells. The majority of brain tumours do not respond to traditional chemotherapy alone as it typically does not cross into the brain due to the presence of a blood-brain barrier. In recent years, the increased use of targeted or immune therapy that can cross this barrier has greatly improved the efficacy of treatment for selected cancers or primary brain tumours.
A multidisciplinary team typically manages treatment, tailoring approaches to individual needs based on multiple factors such as size, location, function, tumour type and disease genetics.
A Neurosurgeon is typically one of the earliest members of this team due to the challenges encountered by the enclosed space within both the brain and spine, surrounded by the inflexible nature of the cranial and vertebral bones. This requires a carefully considered approach to diagnosis and treatment, where functional outcomes are balanced against the need for maximal benefits of surgical, radiation or chemotherapies.
Conclusion
Brain tumours, while relatively rare, have a significant impact on people and their families. Awareness of symptoms, risk factors, and available treatments is essential. In New Zealand, a robust healthcare system and supportive organisations are in place to assist those affected. Brain Tumour Support NZ provides peer support and advocacy for patients and families. The Cancer Society of New Zealand offers support services, information, and counselling.
Early detection and personalised care can lead to better outcomes and improved quality of life.
If you have concerns about brain health or experience persistent neurological symptoms, consult a healthcare professional promptly. Early intervention can make a meaningful difference.
