Brain tumours (neuro-oncology)
Anyone can be affected by brain tumours. Some children are born with tumours and they can occur at any age in life.
Benign (harmless) brain tumours stay in the part of the brain where they started and don’t spread into other areas.
Primary brain tumours start in the brain and have not spread from somewhere else in the body.
Malignant primary brain tumours are most likely to cause problems by spreading into the normal brain tissue around them and causing pressure and damage to the surrounding areas.
A secondary brain tumour is caused by cancer cells from a cancer elsewhere in the body spreading to the brain.
Patients diagnosed with a brain tumour will be able to discuss their tumour with a consultant.
This section provides details of brain tumour services for adult patients. Please follow the main menu link for information on children’s cancers.
There are many types of brain tumour. They are usually named after the type of brain cell from which they have developed.
These tumours develop from glial cells. The glioma group can be broadly split into the following categories:
- Astrocytomas: The most common brain tumours in adults, which are thought to develop from astrocyte cells.
- Oligodendrogliomas: They develop from oligodendrocyte cells, which produce the ‘insulation’ covering of nerve cells (the myelin sheath).
- Mixed gliomas: They are made up of more than one type of cell.
- Ependymomas: They develop from ependymal cells, which line the ventricles (fluid spaces) of the brain and the central canal of the spinal cord. These tumours can spread to other parts of the brain and spinal cord.
Some gliomas are more serious than others. They are graded on their biological ‘aggressiveness’.
Other types of brain tumour
- Medulloblastomas: These develop in the cerebellum at the back of the brain, but may spread to other parts of the brain. They are rare in adults, but are one of the most common malignant brain tumours in children.
- Metastases: Brain metastases are the most common brain tumours seen clinically in the UK. Approximately one quarter of cancer patients will develop brain metastases. Cancer patients who develop neurological symptoms should consult their oncologist or GP at the earliest opportunity as treatment options may be greater with earlier detection.
- Meningiomas: These develop from the meninges – a layer of cells covering the central nervous system. They usually grow slowly and can occur over the brain or spinal cord. Most are benign (harmless) and will not spread from the area in which they originated.
- Acoustic neuroma (vestibular schwannoma): These develop from the vestibular nerve, which is responsible for balance control. These tumours typically present with hearing loss and tinnitus. They are usually found in adults and are more common in people with the genetic condition neurofibromatosis.
- Pituitary tumours: The pituitary gland produces hormones that control and regulate other hormone producing glands in your body. Most pituitary tumours are benign. They can present with hormone irregularities and / or visual symptoms.
- Lymphoma: A lymphoma is a malignant tumour of the immune system. It can arise within the brain or more commonly from elsewhere in the body.
- Pineal tumours: Tumours in the pineal region of the brain are rare and tend to occur more often in children and young adults. A wide range of tumour types may develop in this region. Blood and cerebrospinal fluid markers may help in the diagnosis.
Other types of tumour exist, but they are rare.
If a brain tumour is suspected, your GP or local hospital will refer you to the Neuro-Oncology Specialist Surgical Unit at the Royal Victoria Hospital or the Northern Ireland Cancer Centre.
The Regional Neuro-Oncology Service diagnoses and treats brain tumours and spinal neurological tumours.
The team will decide on your treatment plan following investigations on your suspected brain or spinal tumour. The decision will be discussed with you or passed on to your GP or local hospital involved in your care.
You will be involved in the final decision on your treatment.
Investigations and diagnosis
At the hospital, the doctor will ask you about your general health and will perform a detailed examination to test your nervous system. This examination may include:
- basic cognitive tests, for example basic arithmetic, memory tests
- eye tests
- hearing tests
- facial movement and sensation
- tongue movement
- power, sensation, coordination and tendon reflexes of arms and legs
You may be sent for further tests depending on your particular situation and symptoms. Further information below:
If additional tests are required, the specialist centre will organise them.
Regional Neuro-Oncology Service
The Regional Neuro-Oncology Service has a multi-disciplinary team (MDT) of professionals who are experts at diagnosing and treating brain and spinal tumours.
Your treatment plan will depend on the type and stage of your cancer. You may have one type of treatment or a combination of two or more treatments.
Further details on treatments below:
- Specialist palliative care
- Stereotactic radiotherapy (available through referral to a hospital outside Northern Ireland)
No medical treatment can be given without patient consent.
If you have agreed to have treatment, you will be asked to sign a form giving your consent.
If you would like a second opinion on any aspect of your diagnosis, contact your neuro-oncologist or neurosurgeon to discuss this further.
We will be happy to provide advice and information on second opinions.
The Neuro-Oncology Service organises follow-up reviews for patients who have received their treatment. These reviews are very important.
Please ensure you are aware of your review plan details. If you have any queries, please contact your neuro-oncology specialist nurse.
At the reviews, consultants will check on your progress and, if necessary, refer you for further investigations.
If you have any problems or notice any new symptoms in between review appointments, contact your GP, local Macmillan or hospice nurse, or neuro-oncologist. You should also contact the neuro-oncology specialist nurse as soon as possible.
If you require additional support or referral to local community services, your GP or district nurse can organise this.
- Types, symptoms, causes and risks of brain tumours
- Macmillan Cancer Support – brain tumours
- Action Cancer
- Brainwaves NI
- Cancer Focus
- Cancer Research UK
- Brain and Spine Foundation
- Brain Tumour Action
- Changing Faces
- Headway – The Brain Injury Assessment
- Epilepsy Action
- Brain Tumour Trust
- Meningioma UK National Helpline
- Pituitary Foundation
- NI Driver and Vehicle Licencing