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BRAIN CANCER FACTSHEET
Understanding the brain
The main parts of the brain include:
The cerebrum. This is divided into the right hemisphere (right side) which controls the left side of the body,
and the left hemisphere which controls the right side of the body. Each hemisphere is divided into various sub
sections, the main divisions being the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The
cerebrum is also where you 'think' and store your memory.
The cerebellum.
This lies behind and below the cerebrum. One of it's main functions is to help control balance and co-ordination.
The brain stem.
This helps to control basic bodily functions such as the heartbeat, breathing, blood pressure, etc. Nerves from the cerebrum also pass through the
brain stem to the spinal cord.
The meninges.
These are thin layers of tissue which separate the skull from the brain. The outer layer next to the skull is called the dura. The next layer is called
the arachnoid. Under the arachnoid tissue is the cerebrospinal fluid (CSF) which bathes the brain and spinal cord.
The pituitary gland.
This releases various hormones into the bloodstream.
The main type of cell in the brain is called a neurone. There are millions of neurones in the brain. Neurones have long thin nerve fibres which
enable them to send messages to other parts of the brain, and down the spinal cord to all parts of the body. The brain also contains cells called
glial cells. These provide support, nourishment and protection for neurones. There are various types of glial cells including astrocytes,
oligodendrocytes and ependymal cells.
Source: www.patient.co.uk
What is brain cancer?
A brain tumour is any intracranial mass created by an abnormal and uncontrolled growth of cells either normally found in the brain itself (neurons,
glial cells - astrocytes, oligodendrocytes, ependymal cells, lymphatic tissue, blood vessels), in the cranial nerves (myelin producing cells Schwann
cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic
tumours).
Source: www.wikipedia.org
Types of brain tumours
There are nearly 100 different types of brain tumours. They are generally named after the type of cell they developed from. Most brain tumours
develop from the cells that support the nerve cells of the brain. These are called glial cells. A tumour of glial cells is called a glioma.
Brain tumours can also be named after the area they are growing in. A tumour of the pituitary gland is called a pituitary adenoma. A tumour
developed from the covering of the brain (the meninges) is called a meningioma. Tumours growing from the nerves entering the brain are called
neuromas. An acoustic neuroma is a tumour growing on the nerve that controls hearing.
Grade - benign or malignant?
Brain tumours are put into groups according to how fast they are likely to grow. There are 4 groups called grades 1 – 4. The cells are examined
under a microscope. The more normal they look, the more slowly the brain tumour is likely to develop and the lower the grade. The more abnormal
the cells look, the more quickly the brain tumour is likely to grow and the higher the grade. Low grade gliomas (grade 1 and grade 2) are the
slowest growing brain tumours.
You may have been told you have a benign tumour or a malignant tumour. As a rule of thumb, low grade tumours are regarded as benign and high
grade as malignant. By benign, we generally mean:
• The tumour is relatively slow growing
• It is less likely to come back if it is completely removed
• It is not likely to spread to other parts of the brain or spinal cord
• It may just need surgery and not radiotherapy or chemotherapy as well
By malignant, we generally mean:
• The tumour is relatively fast growing
• It is likely to come back after surgery, even if completely removed
• It may spread to other parts of the brain or spinal cord
• It cannot just be treated with surgery and will need radiotherapy or chemotherapy to try to stop it from
coming back
With other types of cancer, these black and white explanations of benign and malignant work well. But with brain tumours, there are a lot of grey
areas. Some low grade astrocytomas can spread to other parts of the brain or spinal cord. Radiotherapy and chemotherapy are sometimes used
to treat 'benign' tumours. Even a slow growing tumour can cause serious symptoms and be life threatening if in a crucial part of the brain.
Source: www.cancerhelp.org.uk
People with concerns about their own health should contact their GP or cancer team
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BRAIN CANCER FACTSHEET
What causes brain tumours?
The cause of most benign brain tumours and primary malignant brain tumours is not known. Genetic factors may be a 'risk factor' in some cases perhaps in about 5% of cases. For example, people with the hereditary diseases called neurofibromatosis type 1, Turcot syndrome, Li-Fraumeni
cancer syndrome, and tuberous sclerosis have a higher than average risk of developing a glioma. In most of these cases, the glioma occurs in
childhood or early adult life and do not account for most cases of glioma. Most cases of glioma occur in older adults where genetic factors are not
thought to be involved.
Radiotherapy to the brain is thought to increase the risk of a brain tumour. But again, this would only account for a small minority of cases.
Secondary ('metastatic') brain tumours arise from various cancers of the body. These have various causes.
Source: www.patient.co.uk
What are the symptoms of a brain tumour?
General symptoms
Common early symptoms are headaches and feeling sick. These are due to increased pressure within the skull (raised intracranial pressure).
These symptoms may come and go at first, and tend to be worse in the morning. Coughing, sneezing and stooping may make the headaches
worse. Epileptic seizures (convulsions) sometimes occur. But note: most people who have epilepsy do not have a brain tumour. Increasing
drowsiness may occur as the tumour enlarges.
Symptoms due to the location in the brain
As a tumour grows it can damage the nearby brain tissue. The functions of the different parts of the body are controlled by different parts of the
brain. Therefore, the symptoms vary from case to case depending on which part of the brain is affected, and on the size of the affected area. For
example, one or more of the following may develop. These symptoms tend to develop gradually.
• Weakness of muscles in an arm, leg, part of the face, or eyes.
• Problems with balance, co-ordination, vision, hearing, speech, communication, or swallowing.
• Loss of smell.
• Dizziness or unsteadiness.
• Numbness in a part of the body.
• Confusion.
• Personality changes.
• Symptoms related to hormone changes if you have a pituitary tumour.
Source: www.cancerbackup.org.uk
Source: www.patient.co.uk
How are brain tumours diagnosed and assessed?
A doctor will examine you if a brain tumour is suspected from the symptoms. This will include checking on the functions of the brain and nerves
(movements, reflexes, vision, etc).
An MRI scan or CT scan of the head are the common tests done to confirm or rule out the presence of a brain tumour. If a tumour is identified,
further more detailed scans and tests may be done. For example, a PET scan or an angiogram is sometimes done to get more information about
the tumour.
A biopsy may be needed to be sure of the type of tumour. A biopsy is when a small sample of tissue is removed from a part of the body. The
sample is then examined under the microscope to look for abnormal cells. To obtain a biopsy from a brain tumour you need to have a small
operation usually done under anaesthetic. A small hole is bored in the skull to allow a fine needle through to obtain a small sample of tissue. By
examining the cells obtained by the biopsy, the exact type of tumour can be identified, and if it is malignant, to determine what grade it is.
Blood tests and other tests on other parts of the body may be done if the tumour is thought to be a secondary tumour. For example, it is quite
common for a lung cancer to spread to the brain. Therefore, a chest x-ray may be done if this is suspected.
Various hormone tests may be done if a pituitary tumour is suspected.
WELSH CANCER INTELLIGENCE AND SURVEILLANCE UNIT
Source: www.patient.co.uk
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BRAIN CANCER FACTSHEET
What are the treatments for brain tumours?
The main treatments used for brain tumours are surgery, chemotherapy, radiotherapy, and medication to control symptoms such as seizures. The
treatment or combination of treatments advised in each case depends on various factors such as:
• The type of brain tumour, and the grade of the tumour if it is malignant.
• The exact site of the tumour.
• Your general health.
Surgery
Surgery is often the main treatment for benign brain tumours and primary malignant tumours. The aim of surgery is to remove the tumour whilst
doing as little damage to the normal brain tissue. Your specialist will advise on whether surgery is a possible option.
Radiotherapy
Radiotherapy is a treatment which uses high energy beams of radiation which are focused on cancerous tissue. This kills cancer cells, or stops
cancer cells from multiplying. Radiotherapy is sometimes used instead of surgery when an operation is not possible for a malignant brain tumour.
Sometimes it is used in addition to surgery if it is not possible to remove all the tumour with surgery, or to kill cancerous cells which may be left
behind following surgery.
Chemotherapy
Chemotherapy is a treatment which uses anti-cancer drugs to kill cancer cells, or to stop them from multiplying. It may be used in addition to other
treatments such as surgery or radiotherapy, again, depending on various factors such as the type of tumour.
Medication to control symptoms
If you have seizures caused by the tumour then anticonvulsant medication will usually control the seizures. Painkillers may be needed to ease
headaches. Steroid medication is also commonly used to reduce inflammation around a brain tumour. This reduces the pressure inside the skull
which helps to ease headaches, nausea and other 'pressure' symptoms.
You should have a full discussion with a specialist who knows your case. They will be able to give the pros and cons, likely success rate, possible
side-effects, and other details about the possible treatment options for your type of brain tumour.
You should also discuss with your specialist the aims of treatment.
For example:
• In some cases, treatment aims for a cure. If a benign tumour can be removed by surgery then a
cure is likely. The chance of a cure for malignant tumours varies, depending on the type of tumour,
grade, and other factors such as the location in the brain. (Note: when dealing with malignant tumours,
doctors tend to use the word 'remission' rather than the word 'cured'. Remission means there is no
evidence of cancer following treatment. If you are 'in remission', you may be cured. However, in some
cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
• In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it may be
possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free
of symptoms for some time.
• In some cases, treatment aims to ease symptoms ('palliative treatment'). For example, if a cancer is advanced
then you may require painkillers or other treatments to help keep you free of pain or other symptoms. Some
treatments may be used to reduce the size of a cancer which may ease symptoms such as pain.
Source: www.patient.co.uk
What is the prognosis (outlook)?
It is difficult to give an overall outlook. Every case is different. For example, if you have a benign meningioma which is in a suitable place for
surgery, the outlook is excellent. For primary malignant brain tumours, the outlook is variable, depending on the type, grade, and location in the
brain. The outlook is usually poor if you have a secondary malignant brain tumour.
The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very
general. The specialist who knows your case can give more accurate information about your particular outlook, and how well your type and stage of
cancer is likely to respond to treatment.
Source: www.patient.co.uk
WELSH CANCER INTELLIGENCE AND SURVEILLANCE UNIT
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BRAIN CANCER FACTSHEET
* Please note the following information is for Wales only *
Summary
There were around 265 registrations of brain cancers per annum in 1992-2006. The change in EASR for incidence, though not significant for either
sex, has decreased for males by almost 1% and for females by 0.4% over the period. The cumulative risk 0-74 years was 0.8% in males, and
0.5% in females.
Males
146
1.9%
14th
56.6
0.5%
0.8%
-0.9%
-0.2%
3.7%
94
64.8%
Average registrations per annum (1992-2006)
Relative Frequency
Rank
Mean age at diagnosis (years)
Cumulative Rate (0-64 years)
Cumulative Rate (0-74 years)
Percentage Annual Change in EASR (incidence)
Percentage Annual Change in EASR (mortality)
Percentage Death Certificate Only
Average deaths per annum (1992-2006)
Mortality:Incidence Ratio (1992-2006)
Females
119
1.6%
17th
56.9
0.4%
0.5%
-0.4%
+0.4%
4.3%
70
59.2%
*
**
Significant at 5% level
Significant at 1% level
Number of incident cases and age-specific rates, 1992-2006
350
40
30
Number of Cases
250
25
200
20
150
15
100
10
50
Age Specific Rates per 100,000 population
35
300
5
0
0
Under 5
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Age Group
Males Cases
Females Cases
Males ASR
Females ASR
Prevalence Statistics (at 31st December 2006) in Wales
Males
Up to 1 year
>1 to 5 years
>5 to 10 years
>10 to 20 years
Total up to 20 years
Number
Rate per 100,000
% prev in pop
% in each time interval
93
184
221
297
795
6.44
12.74
15.30
20.56
55.03
0.01
0.01
0.02
0.02
0.06
11.70
23.14
27.80
37.36
100.00
Number
Rate per 100,000
% prev in pop
% in each time interval
82
148
193
247
670
5.39
9.73
12.69
16.24
44.05
0.01
0.01
0.01
0.02
0.04
12.24
22.09
28.81
36.87
100.00
Females
Up to 1 year
>1 to 5 years
>5 to 10 years
>10 to 20 years
Total up to 20 years
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Trends in Incidence 1992-2006
Males
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Total
Crude Rate
EASR
WASR
1992
2
5
1
2
5
3
4
7
10
8
7
18
14
19
24
16
4
3
152
10.92
10.04
7.94
1993
5
6
1
2
2
2
8
3
3
9
6
12
17
14
17
13
7
2
129
9.24
8.46
6.95
1994
3
5
2
2
1
3
6
4
5
12
11
9
17
26
16
18
8
1
149
10.65
9.62
7.67
1995
6
4
4
2
3
5
5
5
4
15
10
9
15
12
19
10
9
2
139
9.93
9.11
7.72
1996
1
5
0
0
1
12
4
5
11
10
10
18
20
18
21
10
9
1
156
11.13
10.16
8.13
1997
2
8
1
3
3
0
3
2
4
8
10
6
17
29
21
13
5
2
137
9.76
8.65
7.06
1998
2
2
1
5
4
1
5
7
6
8
14
10
17
23
23
18
7
5
158
11.23
9.96
7.81
1999
4
1
3
3
7
0
2
8
6
10
14
15
12
26
20
19
6
4
160
11.37
10.18
8.11
2000
5
3
0
0
3
2
9
5
7
8
12
16
27
15
17
14
9
6
158
11.22
10.09
8.00
2001
5
1
2
2
3
1
6
5
9
5
18
11
12
23
19
20
7
5
154
10.93
9.57
7.54
2002
4
3
3
0
1
2
2
4
6
10
9
26
8
16
15
15
12
6
142
10.04
8.66
6.76
2003
1
3
3
1
4
5
2
10
5
7
17
10
11
18
12
8
12
0
129
9.05
8.03
6.58
2004
3
7
2
1
3
3
4
5
3
4
7
16
17
28
15
17
6
5
146
10.18
8.80
7.19
2005
1
4
1
3
3
3
4
8
8
7
11
15
19
15
12
15
13
7
149
10.36
8.86
7.01
2006
4
5
1
4
2
3
5
5
7
6
6
17
10
15
14
13
9
2
128
8.86
7.74
6.52
1992
3
4
1
0
1
5
7
2
3
8
6
6
12
16
17
7
7
4
109
7.34
6.21
5.21
1993
5
3
2
1
1
3
5
6
7
11
10
6
13
16
18
12
5
6
130
8.74
7.59
6.37
1994
5
4
2
0
2
1
4
3
6
6
8
8
14
14
18
10
9
6
120
8.06
6.75
5.64
1995
5
3
2
3
1
2
3
4
7
12
4
13
12
13
12
14
6
5
121
8.13
7.10
6.03
1996
5
4
2
1
2
0
5
2
3
6
7
12
11
17
13
9
10
5
114
7.65
6.50
5.46
1997
2
2
2
0
2
1
5
2
5
6
10
13
10
11
15
15
5
4
110
7.38
6.24
4.94
1998
3
5
3
1
4
3
5
5
6
8
9
11
15
18
14
7
8
0
125
8.38
7.60
6.54
1999
2
10
1
0
1
4
4
5
1
7
10
14
10
19
15
19
6
5
133
8.91
7.44
6.22
2000
1
2
4
3
5
2
5
3
5
4
9
10
6
10
14
18
7
4
112
7.47
6.18
5.14
2001
5
3
2
3
0
5
4
1
5
6
7
9
11
16
6
11
12
5
111
7.39
6.28
5.49
2002
3
3
3
2
3
4
4
4
4
4
11
13
6
14
18
17
8
5
126
8.35
6.92
5.77
2003
4
1
3
0
3
2
2
2
1
4
11
13
14
18
18
13
16
5
130
8.60
6.79
5.47
2004
2
2
3
3
0
2
2
4
6
6
6
6
5
9
12
13
9
5
95
6.26
5.03
4.22
2005
4
3
3
2
5
3
3
7
6
8
5
10
11
13
11
16
7
1
118
7.76
6.74
5.91
2006
1
4
4
3
1
3
3
5
8
10
8
16
14
13
8
11
12
7
131
8.61
7.15
5.99
Females
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
Total
Crude Rate
EASR
WASR
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