Condition and Treatments

Conditions

There are many different types of tumour that can arise in the brain and neurological system. These can be primary brain tumours (starting within the brain) or secondary tumours (spread from a tumour elsewhere in the body, also known as a metastases).

There are over 100 different types of brain tumour and they are usually named after the cell they develop from. Here are a few of the most common primary brain tumours:

Fast growing and aggressive, these are the most common type of cancerous (malignant) brain tumour in adults.

  • Astrocytoma, IDH mutant
  • Oligodendroglioma, IDH mutant

Grow from the layers of tissue that cover the brain and spinal cord (meninges). These are usually not cancerous (benign).

Grow from the pituitary gland that lies in a hollow just behind the eyes. The pituitary gland is a small pea-sized gland responsible for producing and secreting hormones. Pituitary tumours are an abnormal growth in the gland, most pituitary tumours are non-cancerous (benign). They can affect the function of the gland resulting in over or under-active production of certain hormones. They are usually slow growing but when large enough can press on the structures of the eye causing visual impairment which may sometimes be permanent.

Also known as vestibular schwannomas. These are non-cancerous (benign) brain tumours that start in the nerve that connects the brain to the ear.

They do not spread to other parts of the body and usually grow very slowly over several years, often with no symptoms to report. When symptoms do occur you may get hearing loss, buzzing in one or both ears and dizziness amongst other things.

Patients are seen in clinic by the specialist to discuss potential treatment options which may include: 

Treatment

Radiotherapy

Radiotherapy is the treatment of cancerous tumours using x-rays to kill the cells but may also be used to treat some benign brain tumours. It can be used on its own for neuro-oncological tumours but it may also be given alongside chemotherapy treatments in some patients.

Radiotherapy is given as an outpatient with the treatment schedule varying in the number of treatments given to patients, this can be 30 treatments, 15 treatments or in some case 10 treatments. Each patient is assessed and a treatment plan agreed for the individual patient.

See the links below for further information on Radiotherapy:

The oncologist always discusses the appropriate schedule including the planning process prior to the delivery of treatment. The neuro-oncology nurse specialist is also available to discuss the treatment and possible side effects.

Radiotherapy itself is painless. However, there are some side-effects associated with it which could include fatigue, skin reactions, headaches, hair loss, dizziness and nausea. The side-effects usually gradually disappear after completion of treatment.

If you develop any side-effects, you should seek advice from your oncologist or nurse specialist. 

For more information about Brain Tumours and Radiotherapy visit the links below:

Surgery

The aim of surgery primarily is to determine a diagnosis, this may also help with any further treatment decisions that may be required. Surgery may also help with some symptom relief but this is not always the case. Surgery will be discussed by the surgeon with each patient and the options explained to them, these may include:

Biopsy

This is where a small piece of the tumour is removed to help with diagnosis (usually performed as a day case).

Debulking/partial resection

This is to remove as much of the tumour as safely possible. It is not always possible to remove all the tumour with surgery and some patients may need additional treatment depending on histology results, to treat remaining tumour. 

  • Craniotomy – This is performed under a general anaesthetic. A piece of skull is removed over the tumour to make an opening. Specialist microscopes are then used by the surgeons to carefully remove as much tumour as possible without taking any of the healthy areas of the brain. After the surgeon has removed part or most of the tumour the piece of skull is replaced.
  • Endonasal – This is where a thin tube with a camera on the end is passed up the nose through to the tumour, this is often used in pituitary tumours. As the part of the skull is not removed, recovery is often much quicker than a craniotomy.
  • Supraorbital – This is performed through an incision in the eyebrow and is thought to be minimally invasive surgery. This is not an option for all tumours and will depend on the location of the tumour. This procedure allows access to the frontal regions of the brain.

Chemotherapy

The aim of chemotherapy is to try to:  

  • shrink the cancer
  • keep the disease under control
  • help to manage symptoms

View more information about the chemotherapy service at Leeds Cancer Centre.

Chemotherapy can be given either by an intravenous infusion, in tablet form or a combination of both and is generally given in courses. This will vary depending on the treatment you receive and the response to treatment. You will usually receive all your chemotherapy treatments as an outpatient. Detailed information will be given to you once your regime has been decided.

Detailed information is provided about the specific side-effects and how to manage them before starting treatment with the most common side-effects being:

  • fatigue
  • a drop in blood counts
  • nausea
  • hair loss (only with some chemotherapy drugs).

The most common chemotherapy drugs used for the treatment of neurological cancers include:

For more information view Macmillan Cancer Support – Chemotherapy for a Brain Tumour

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