Brain Tumor: Symptoms, Types & Treatment

A brain tumor is a type of central nervous system (CNS) tumor caused by the growth of abnormal cells in the brain. It can be benign or malignant, meaning cancerous.

The first warning signs of a brain tumor can include severe headache, blurred vision, paralysis, poor balance, or even seizures. These symptoms depend on the tumor’s location, size, and type.

The exact causes of brain tumors are not fully understood, but they are associated with genetic changes in cell DNA that cause cells to grow and divide abnormally. Brain tumors can begin in the brain itself, or they can result from cancers that spread (metastasize) to the brain from other parts of the body, such as the lungs, breasts, kidneys, or skin (melanoma).

Treatment for brain tumors is usually managed by a multidisciplinary care team, which may include a medical oncologist, neurologist, neurosurgeon, and radiation oncologist. Treatment may involve surgery to remove the tumor, radiation therapy, chemotherapy, targeted therapy, or a combination of these, depending on the tumor type, size, grade, and location.

Symptoms of a brain tumor

Symptoms that may indicate a brain tumor can include:

• Headaches or changes in your usual headache pattern
• Headaches that gradually worsen or become more frequent
• Memory problems or difficulty concentrating
• Changes in mood or behavior
• Nausea and vomiting without an obvious cause
• Blurred, cloudy, or otherwise changed vision
• Reduced hearing or a decreased sense of smell
• Feeling excessively tired or unusually sleepy
• Loss of appetite and/or unexplained weight loss

Changes in balance or motor coordination, confusion, weakness on one side of the body, or seizures may also occur.

Other possible brain tumor symptoms include tremors, difficulty moving part of the body or one side of the body, difficulty walking, speaking, or swallowing, slurred speech, and abnormal eye movements.

According to the National Cancer Institute, symptoms of adult central nervous system tumors can depend on where the tumor forms, its size, how quickly it grows, and the part of the brain or spinal cord affected.

Symptoms of brain metastasis

The symptoms of brain metastasis are the same as those of a tumor that starts in the brain.

Confirming a diagnosis

A brain tumor is usually diagnosed by a neurologist or oncologist based on your symptoms, when they began, your medical history, and a neurological exam that checks balance, reflexes, muscle strength, movement, vision, and hearing.

To confirm the diagnosis, the doctor typically orders imaging tests such as a brain MRI, CT scan, or PET-CT to determine the tumor’s location, size, and number.

A biopsy may also be performed, often during surgery to remove the tumor, to identify the tumor type and help guide the most appropriate treatment.

Main types

There are several types of brain tumors, classified according to their origin and location. Because the list is extensive, some of the most common types include:

• Meningioma: characterized by a tumor in the meninges, which are the membranes that surround and protect the brain and spinal cord. It is usually benign, but it can become malignant.

• Glioblastoma: a type of brain tumor that affects glial cells, which help support neuron function, and is usually highly malignant.

• Astrocytoma: this type of primary tumor affects astrocytes, which are star-shaped cells that support and nourish neurons. Its severity varies according to size and characteristics, such as the degree of malignancy.

• Medulloblastoma: the most common malignant brain tumor in children. It develops in the cerebellum, a brain structure responsible for balance and posture, and usually tends to respond well to treatment.

• Pituitary adenoma: a type of benign tumor that affects the pituitary gland, which is located inside the brain in the sella turcica of the sphenoid bone. This gland controls the production of hormones such as prolactin, cortisol, and growth hormone, affecting the entire body.

• Acoustic neuroma or schwannoma: a type of benign tumor that develops in the nerves that run from the ear to the brain and control hearing and balance.

• Ependymoma: a type of brain tumor that develops from ependymal cells, which line the neural tube, or the tissue that covers the nervous system.

A brain tumor can also be classified as primary, when abnormal cells start in the nervous system itself, or secondary, when abnormal tumor cells in the brain come from cancer in another organ, such as the lungs, kidneys, intestine, breast, or melanoma. These are called metastases.

Treatment options

Treatment for a brain tumor depends on the tumor’s size, type, grade, and location, as well as whether it has spread to other parts of the central nervous system.

According to the National Cancer Institute, care for adult central nervous system tumors may include surgery, radiation therapy, chemotherapy, targeted therapy, surveillance, and supportive care. The oncologist may recommend one or more of the following options:

1. Surgery

Surgery is usually the first treatment for a brain tumor. It aims to remove the tumor along with some surrounding tissue, and in some cases it can completely cure low-grade tumors. However, not all tumors can be safely removed with surgery.

During surgery, the doctor also takes a small sample of the brain tumor (a biopsy) to be analyzed in a laboratory. The results help determine the exact tumor type so the oncologist can recommend the most appropriate treatment.

2. Radiation therapy

Radiation therapy is used to treat brain tumors by applying high-energy external beam radiation directly to the tumor site. This is called conventional radiation therapy.

The goal is to destroy cancer cells, reducing or stopping tumor growth, or eliminating the brain tumor.

This type of treatment is usually recommended after surgery to remove the tumor. It may be done together with chemotherapy, depending on each case.

In some cases, brachytherapy may be recommended. This is a type of radiation therapy done with a radioactive implant placed in the brain, which gradually releases radiation.

Treatment length varies for each type of tumor, and the radiation oncologist determines the number of sessions and the radiation dose.

3. Chemotherapy

Chemotherapy is a type of treatment that involves giving medications directly into a vein through a catheter, or as oral chemotherapy pills, to destroy the tumor cells causing the brain tumor.

The most commonly used chemotherapy drugs include carmustine, temozolomide, lomustine, procarbazine, vincristine, etoposide, cisplatin, carboplatin, and irinotecan. These medicines are prescribed by an oncologist based on established treatment protocols for each specific type of brain tumor.

Chemotherapy works by interfering with the multiplication of cancer cells, which divide quickly. However, it can also affect healthy cells, causing side effects such as hair loss, fatigue, reduced immunity, anemia, or diarrhea.

The doses of these chemotherapy drugs and the number of sessions are determined by the oncologist. Treatments are generally given at intervals so healthy cells can recover.

4. Targeted therapy

Targeted therapy uses medications that act directly on genes and proteins in brain tumor cells, preventing growth and helping destroy this type of tumor.

For this type of therapy to be used, specific exams and tests are needed to identify these genes and proteins in tumor cells. Not all tumor types have medications available for this kind of treatment.

Bevacizumab is another example of therapy, called anti-angiogenic therapy, used for certain types of brain tumors. The dose depends on the tumor’s size and severity.

5. Supportive therapy

Supportive therapy involves using medications to ease symptoms caused by the brain tumor. For example, corticosteroids can reduce brain swelling, relieve headaches, and lower the risk of complications such as increased intracranial pressure.

Anticonvulsants may also be recommended to prevent seizures in people with a brain tumor.

In addition, pain relievers may be recommended to manage pain, and medications for anxiety or depression may be prescribed, as this type of tumor can also lead to emotional changes.

Is a brain tumor curable?

A brain tumor can sometimes be cured, depending mainly on the tumor type and how aggressive it is. Benign tumors have a higher chance of cure because they usually grow slowly and do not invade surrounding brain tissue.

For malignant (cancerous) tumors, the chance of cure depends on how fast the tumor grows, how easily it spreads within the brain, and how well it responds to treatment.

Possible complications

A brain tumor can affect important structures of the nervous system and may cause changes in concentration, memory, speech, vision, and even body movement.

These changes can lead to complications such as difficulty communicating, vision problems, and hemiplegia, which is when one side of the body has no movement.

In addition, brain tumor treatment, especially surgery, can cause side effects such as limited body movement.