What is a primary brain tumour?
A primary brain tumour is a tumour that starts in the brain. The brain controls how we think, feel, learn and move. It also controls other important things in the body, such as breathing and heart rate. The brain is protected by the skull.
We have separate information about tumours that start somewhere else in the body and spread to the brain. These are called secondary brain tumours or brain metastases.
Brain tumours can also affect children. The Children’s Cancer and Leukaemia Group has more information on caring for children with cancer, including brain tumours. The The Brain Tumour Charity also has information about brain tumours in children.
Related pages
Types of brain tumour
There are many different types of brain tumour. More than half of primary brain tumours are gliomas. These tumours are made up of cells that look similar to cells called glial cells. Glial cells are the supporting cells in the brain and spinal cord. The most common type of glioma is an astrocytoma. We have more information about gliomas and other types of brain tumour.
Booklets and resources
Symptoms of a brain tumour
Symptoms of a brain tumour depend on where the tumour is in the brain and how slowly or quickly it grows. Symptoms may develop suddenly, or slowly over months or even years.
A brain tumour can cause headaches but it is unusual for this to be the only symptom. Other symptoms can include feeling sick, having seizures, problems with mobility, speech and vision and changes in personality and behaviour.
Other conditions may cause similar symptoms. But if you have any symptoms, it is important to get them checked by your GP.
We have more information about the signs and symptoms of brain tumours.
Causes of a brain tumour
In almost all cases, experts do not know what causes a primary brain tumour. There are some things that may increase your risk of developing a brain tumour. These are called risk factors.
It is important to remember that having a risk factor does not mean you will get a brain tumour. Only a small number of people develop a brain tumour because of one of these risk factors.
We have more information about the possible different risk factors of a brain tumour.
Diagnosing brain tumours
Many people are diagnosed with a brain tumour when they go to hospital after having a seizure (fit) or other sudden symptoms. Other people go to see their GP about symptoms.
If your GP thinks you may have a brain tumour, they will arrange for you to have a brain scan. Or they may refer you directly to a neurologist. This is a doctor who specialises in brain disorders.
You may have already had a CT scan of your brain. A CT scan can show some changes, such as bleeding or swelling in the brain. But you will usually need to also have a brain MRI scan. Having an MRI scan is very important. This is because MRI scans can give much more detailed information about brain tumours. This information helps guide the doctors when planning your treatment.
You may need to have more than 1 type of MRI. If you have had an MRI scan without the injection of dye (contrast), you will usually need to have another MRI with dye. The dye helps to show the tumour in more detail.
They can help to find out more about the position of the tumour and how close it is to normal brain structures. They may also be used to find out more about the type and the activity of the tumour. Some MRI scans provide detailed images of blood vessels in the brain or show how different parts of the brain are working.
If you are not able to have an MRI scan, for example if you have a pacemaker that cannot go into an MRI scanner, you doctor will discuss this with you.
You may also have some other tests and scans.
At the hospital, you will also have a neurological examination. This is a check of your nervous system.
Tests and scans for brain tumours include:
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Brain CT scan
A CT scan makes a three-dimensional (3D) picture of the brain. The test only takes a few minutes and is painless. You may have an injection of a dye into a vein in your arm. This is called contrast. It helps show certain areas of the brain more clearly.
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Brain MRI scan
An MRI (magnetic resonance imaging) scan uses magnetism to make a detailed picture of the brain. It can also be used to check your spine. It takes about 30 to 60 minutes and does not use any radiation.
During the scan, you need to lie very still on a bed inside a cylinder (tube). It is painless, but lying still for that long can be uncomfortable. The scan is also noisy, but you will be given earplugs or headphones.
Some people worry about feeling claustrophobic (fearful of small spaces) in the scanner. If you are worried about this, make sure you tell the staff in the scanning department. They can help you to feel as comfortable as possible and suggest ways to manage your anxiety. This may include listening to music, or using relaxation techniques. If needed, you may be able to have a sedative tablet to help you relax. Ask your GP or doctor if they can prescribe this before you have the scan.
Specialised types of MRI may be used to look at:- blood vessels (MR angiography)
- chemical activity (MR spectroscopy)
- blood volume (MR perfusion)
- fibre tracts (MR diffusion or tractography)
- specific functional areas (fMRI or functional MRI in the brain).
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PET or PET CT scan
You might have a PET scan which uses low-dose radiation to check the activity of cells in different parts of the body. It is sometimes given together with a CT or MRI scan. In this case, it is called a PET-CT or PET-MRI. It can give more detailed information about cancer or abnormal areas seen on x-rays, CT scans or MRI scans. PET scans are not suitable for everyone. Your doctor or specialist nurse can tell you whether they might be helpful for you.
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SPECT
This test is similar to a PET scan. It looks at blood flow through the brain. It also looks at how certain brain tissues are working. You are given an injection of a radioactive substance, usually in your arm. This substance travels in the blood to the brain. The PET scan then takes pictures (scans) of the brain.
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Brain biopsy
A biopsy is an operation when a surgeon removes a small part of the tumour to find out what type of brain tumour it is. You may have a biopsy done on its own before having treatment. Or if you are having surgery to remove tumour, the biopsy will be taken then. We have more information about having a brain biopsy.
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Biomarker testing (molecular markers)
Most types of brain tumours are tested for gene changes. These are called molecular marker tests or biomarker tests.
Molecular markers describe markers, proteins, or changes in the genetic structure of a tumour. The samples are tested for changes in the genes in the tumour cells. We have more information about biomarker testing. -
Blood tests
A blood test cannot diagnose a brain tumour. But some types of tumours release certain hormones or chemicals into the blood. If the tumour is affecting your pituitary gland or pineal gland, you may have blood tests to check for this.
You will also have blood tests to check your general health. This may include checking your:- liver and kidney function
- blood cell levels, for example whether you have a low number of red blood cells (anaemia).
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Chest x-ray
Some people may have a chest x-ray to check their lungs and their general health.
Waiting for test results can be a difficult time. You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Grading of brain tumours
The grade of a tumour describes how abnormal the cells look under a microscope. Your doctor will use the information about the grade along with results of molecular markers (biomarkers). This can help them to understand how quickly a tumour may grow, and how best to treat it.
Low-grade tumours usually grow slowly and may not cause symptoms for a long time.
High-grade tumours grow faster than low-grade tumours.
We have more information about how brain tumours are graded.
Treatment for a brain tumour
Treatments used for brain tumours include surgery, radiotherapy and chemotherapy. You may have a combination of treatments.
Your treatment depends on:
- the size and position of the tumour
- the type and grade of the tumour
- any biomarkers you have
- the symptoms you have.
If the tumour is slow-growing (low grade) and with few or no symptoms, your doctor may suggest active monitoring or surveillance. This is sometimes called watch and wait. This is when you have regular scans to check for any growth or changes. Doctors will monitor your scans and symptoms carefully and start treatment if needed. This means you have active monitoring instead of having treatment straight away.
Some people may need to start treatment quickly, for example if the tumour is growing more quickly and is high-grade.
If you need treatment, you may be offered surgery to try to remove all or as much of the tumour as possible. If it is not possible to remove all of the tumour, removing part of the tumour can still be helpful.
Sometimes radiotherapy or chemotherapy may be offered after surgery.
Radiotherapy can be given in different ways. Sometimes it is given as single high dose. This is called stereotactic radiosurgery (SRS). SRS may be used to treat secondary brain tumours (brain metastasis) or small primary brain tumours.
When surgery is not possible, the main treatment is usually radiotherapy. This could be with or without chemotherapy. Some people may have chemotherapy alone as their main treatment.
You may also need help managing your symptoms during your treatment and for a while afterwards. You may need drugs called anti-convulsants to help reduce the risk of seizures. You may also need steroids to reduce swelling around the tumour. Some people may be offered surgery to reduce the pressure inside the skull.
We have more information about brain tumour treatments.
After brain tumour treatment
After your treatment has finished, you usually have regular check-ups and scans. How often you have these depends on your situation. This includes the type of tumour, the grade, if there were any gene changes and the treatment that you had. Your doctor or nurse can tell you more about this.
These appointments are a good time to talk to your doctor or specialist nurse about any worries or problems you have. If you notice any new symptoms between check-ups, do not wait for your next appointment. Contact your doctor or specialist nurse for advice.
Coping with changes
As you recover from treatment, you may have to adjust to some changes. These may be caused by the treatment you have had or the tumour.
Help with your recovery
Your healthcare team includes professionals who can help you during and after your treatment. You may meet them when you are in hospital, in a clinic, or in your own home. Your doctor or nurse may refer you to a neurological rehabilitation (neuro-rehab) service. This service may be able to refer you to a physiotherapist, speech and language therapist, or occupational therapist, and offer emotional support.
We have more information about what support is available. We also have information about things you can do.
How diagnosis affects your right to drive
Following diagnosis and treatment for a brain tumour, most people will not be allowed to drive for a period of time. If you drive, it is important to discuss with your doctor how your diagnosis and treatment for a brain tumour affects your right to drive.
If you have a driving licence, you must tell the licencing agency (DVLA or DVA) that you have been diagnosed with a brain tumour. We have more information about how a brain tumour may affect your right to drive.
Getting support
Being diagnosed with a brain tumour may cause a range of different emotions. There is no right or wrong way to feel. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
- Call the Macmillan Support Line for free on 0808 808 00 00.
- Chat to our specialists online.
- Visit our brain cancer forum to talk with people who have been affected by brain tumours, share your experience, and ask an expert your questions.
You may also want to get support from a brain tumour charity, such as:
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our primary brain tumour information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
EANO-ESMO Clinical Practice Guidelines for prophylaxis, diagnosis, treatment and follow-up: Neurological and vascular complications of primary and secondary brain tumours. 2021. Available from www.eano.eu/publications/eano-guidelines/eano-esmo-clinical-practice-guidelines-for-prophylaxis-diagnosis-treatment-and-follow-up-neurological-and-vascular-complications-of-primary-and-secondary-brain-tumours [accessed August 2024].
NICE Guideline NG99. Brain tumours (primary) and brain metastases in over 16s. 2018 (updated 2021). Available from: www.nice.org.uk/guidance/ng99 [accessed August 2024].
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