what you will find on this page
Before we look at the different types of brain tumours, it’s helpful to understand some of the key terms you might hear.
When we say “brain tumours,” we mean tumours that start in the brain, spinal cord, or in the thin protective layers that cover them (the meninges). We also sometimes mean cancers that have spread to the brain or spine from somewhere else in the body, these are called secondary or metastatic brain tumours.
UNDERSTANDING BRAIN TUMOURS
2% Ependymoma
9% Oligodendroglioma
9% Astrocytoma
29% Meningioma
49% Glioblastoma
Two of the most common types are:
Glioblastoma (GBM) - a malignant (cancerous) tumour that grows quickly and is difficult to treat
Meningioma - usually benign (non-cancerous) and slower-growing
There are more than 140 different types of primary brain tumour, including oligodendrogliomas, astrocytomas and ependymomas. GBM and meningioma are the ones doctors see most often, but symptoms and treatment can vary widely depending on the specific type and location of the tumour.
eg from the lungs or breast
Spreads to the brain
SECONDARY (metastatic)
eg glioma
Starts in the brain
PRIMARY
Primary tumours begin in the brain or spinal cord.
Secondary tumours, also called metastases, happen when cancer spreads from another part of the body, such as the lungs or breasts, to the brain or spinal cord.
This site mainly focuses on primary brain tumours, but we include some specific information on secondary tumours. Primary tumours can be benign (non-cancerous) or malignant (cancerous). Unlike in other parts of the body, the difference isn’t always clear-cut - both can cause serious problems depending on their location and size. Even a benign brain tumour can be harmful if it’s in a sensitive area or grows large enough to press on important structures.
Primary vs Secondary Tumours
Meningiomas start in the lining of the brain and spinal cord. Most (around 93%) are benign and grow slowly. Many never cause symptoms, and in some cases, especially for older patients with small tumours, the best approach is to monitor them rather than operate.
If a meningioma is large or causing symptoms, surgery can often cure it. In some cases, radiotherapy may also be used if surgery isn’t possible or if the tumour comes back.
Glioblastomas are aggressive, fast-growing malignant tumours that start in the brain’s supporting cells. The exact cause isn’t known, and they usually appear at random.
These tumours invade nearby healthy brain tissue and are very difficult to treat. Even after surgery, it’s almost impossible to remove every cancer cell, as some spread beyond what can be seen on a scan. Because of this, treatment often combines surgery with radiotherapy and chemotherapy to help control the disease.
Language and word finding
Categorising objects
Hearing loss
Memory loss
Seizures
Unidentified smells
TEMPORAL LOBE
Facial weakness
Balance and co-ordination
Double vision
Communication
Swallowing
Blood pressure/heartbeat
BRAIN STEM
Loss of sleep, appetite and memory
Vomiting
Lack of dexterity (using your hands)
Walking/movement co-ordination and balance
Eye flickers
CEREBELLUM
Memory loss, language aphasia and hearing impairment
Seizures involving hallucinations involving vision
Loss of vision on one side
OCCIPITAL LOBE
Recognising people or objects
Movement co-ordination
Balance
Spacial awareness
Word finding
Writing
Reading
Numbness on the opposite side
Understanding information from your 5 senses
PARIETAL LOBE
Communication skills
Controlling emotions and behaviour
Making decisions, solving problems, planning and organising
Loss of smell
Lack of inhibition
Understanding social situations
Weakness on the opposite side
Lack of concentration
Mood
FRONTAL LOBE
FRONTAL LOBE
PARIETAL LOBE
TEMPORAL LOBE
OCCIPITAL LOBE
CEREBELLUM
BRAIN STEM
For example:
- A tumour in one area might cause headaches
- In another, it could affect speech, movement or vision
Both GBMs and meningiomas:
- Require CT and MRI scans to diagnose properly
- May need surgery and/or radiotherapy
- Can cause similar symptoms if they are in the same location
Even benign tumours can cause significant problems if they press on important areas of the brain. This is because the brain is delicate and highly organised - even a small growth in the “wrong” place can have a big impact.
Unexplained mood swings, confusion, or forgetfulness
Feeling unsteady or clumsy, difficulty walking
Often affecting one side of the body
Trouble finding the right words, slurred speech, or changes in how you speak
What you might notice
Personality or memory changes
Balance or coordination issues
Weakness or numbness
Speech problems
Symptom
Blurred or double vision, or losing part of your field of vision
Often happens without other signs of illness, like food poisoning
Fits or convulsions, even if you’ve never had them before
New or different headaches that don’t go away, are worse in the morning or change over time
What you might notice
Changes to vision
Feeling sick or vomiting
Seizures
Headaches
Symptom
DRUG
Targetable mutation
FUSIONS
EPIGENETIC CHANGES
CHROMOSOMAL ABNORMALITIES
POINT MUTATION
GERMLINE
SOMATIC
Methylation assay
Better chemo response
Glioblastoma
MGMT
FISH
Favourable
Oligodendroglio
1p/19q
FISH or sequencing
Aggressive
Glioblastoma
EGFR
DNA sequencing
Favourable
Gliomas
IDH
Diagnostic / test method
Effect on behaviour / prognosis
Tumour type
GENE
- Point mutations - small changes in a single gene that can alter how a cell works
- Chromosomal abnormalities - missing or extra sections of DNA that may affect many genes
- Epigenetic changes - changes that switch genes on or off without altering the DNA code itself
- Fusions - when parts of two different genes join together to form a new one
- Somatic vs germline mutations - somatic changes happen only in tumour cells, while germline ones are inherited and present in all cells
Some of the most common changes in brain tumours are:
- IDH mutations - often found in lower-grade gliomas and linked to better outcomes
- EGFR mutations - more common in GBM and linked to faster growth
- 1p/19q codeletion - common in oligodendrogliomas and used as part of diagnosis
- MGMT methylation - affects how well chemotherapy works, especially with temozolomide
These genetic changes can sometimes stay the same over time, but tumours may also develop new ones as they grow. Tests for these changes usually require a tissue sample from surgery or a biopsy, and results can play an important role in guiding treatment decisions.
In this section, we explain some key details about GBM - including how it’s classified, the main treatment options, and supportive care.
The information here offers a general guide. Every patient’s situation is different, and treatment can vary greatly from person to person. This is not a substitute for a detailed discussion with an experienced medical team who can give advice tailored to you.
A CT scan of the head is usually carried out straight away. An MRI scan with contrast can give more detailed information, but not everyone can have an MRI - for example, if they have metal fragments in their body or if lying in the scanner causes severe claustrophobia.
However, not all GBMs look typical at first. Around 1 in 5 may appear more like lower-grade tumours (grade 2 or 3) when first seen on imaging.
In the past, GBM was diagnosed based only on how the tumour looked under a microscope. The latest WHO classification now also uses genetic testing as part of the diagnosis.
A GBM is defined as an IDH-wildtype (unmutated) grade 4 astrocytoma. Around 5% of GBMs are IDH-mutant, and these tend to have a better outlook. These are now classified separately as grade 4 astrocytoma, IDH-mutant.
One challenge is that much of the research used to guide treatment historically included both IDH-wildtype and some IDH-mutant tumours, which can sometimes make interpretation confusing.
Pathologists diagnose GBM using a combination of features - such as necrosis (dead tissue), increased blood vessel growth, and specific tests (including IDH testing and NGS-based genetic analysis).
[2021 WHO Classification
AFTER
Diagnosis based on:
Histology plus molecular genetic features
Key addition:
IDH-wildtype = called Glioblastoma
IDH-mutant = NOT Glioblastoma, now classified as Astrocytoma
Why it matters:
More precise diagnosis
Better treatment planning and prognosis
Diagnosis based on:
Histology
(tumour appearance under the microscope)
Example:
Glioblastoma = high grade tumour with necrosis and microvascular proliferation
Genetic Markers:
Not always considered
[pre 2021 WHO Classification
BEFORE
- Relieve symptoms - for example, if the tumour is pressing on important parts of the brain
- Improve survival - removing as much tumour as possible can help patients live longer
- Provide a diagnosis - tissue from the surgery is examined to confirm the type of tumour
Like all surgeries, there are risks. The potential benefits need to be balanced against possible side effects.
Some people may not be well enough after surgery to continue with further treatments like radiotherapy or chemotherapy, so doctors take overall health into account when planning surgery.
- Younger, healthier patients may have treatment for six weeks
- Older patients or those who are less well, may have a three-week course
If needed, radiotherapy can be combined with chemotherapy.
For patients who are very unwell, shorter courses - such as one or two weeks, sometimes with a gap between treatments - may be offered.
To have radiotherapy, the tumour needs to be a certain size, and the patient must be able to lie flat and follow instructions during treatment.
- Given alongside radiotherapy
- Used on its own if the patient cannot have radiotherapy
When combined with radiotherapy, temozolomide is taken daily (seven days a week) during the radiotherapy course. After that, it’s usually given as a five-day course every month for the next several months.
If the tumour starts to grow again, other treatments may be considered - such as lomustine or a combination of lomustine, procarbazine and vincristine (known as PCV). Other drugs sometimes used include carboplatin and etoposide, and in certain situations, there is some experience with irinotecan and bevacizumab.
Looking after your general health is also important. Eating well, keeping hydrated, and getting enough rest can make a real difference to how you feel during treatment.
Depending on your needs, your medical team may recommend additional support, such as:
- Physiotherapy - to help with mobility and strength
- Speech and language therapy - to support speech, communication or swallowing difficulties
- Occupational therapy - to make day-to-day activities easier and safer
These supportive measures can be tailored to your situation and are often an important part of your overall care.
Many people are not well enough to have all of these treatments, which can lead to a shorter survival time.
For patients who have no treatment, or only surgery or a biopsy, survival is often much shorter - on average 2–3 months.
While these statistics can be difficult to hear, every person’s situation is unique. Your outcome may be different depending on factors like your age, general health, the tumour’s location, and how it responds to treatment.
- Glioblastoma (GBM) is more common in men, around 3 men are diagnosed for every 2 women.
- Meningiomas are more common in women.
- Some brain tumours are linked to rare genetic syndromes, although this is unusual.
- A small number develop after previous treatment, such as radiotherapy. For example, children who had brain radiotherapy for leukaemia may have a slightly higher risk of a brain tumour later in life, but this is rare.
What we do know is that brain tumours are not linked to common cancer risk factors like smoking or diet but for most people, we simply can’t pinpoint the exact cause.
For many people, the first signs of a brain tumour come out of nowhere, such as a seizure or symptoms that feel like a stroke. In 2020, around 45% of patients with primary brain tumours in England were diagnosed through an emergency route (including A&E and emergency GP referrals). This is significantly higher than the rate for all cancers, which was 22.5%.of primary brain tumours are diagnosed during an emergency.
The brain can often adapt as a tumour grows, so symptoms may be mild or unnoticed for a while. But eventually, the pressure or disruption caused by the tumour becomes too much, and more obvious symptoms can appear suddenly. Seizures are a common example of this.
When people look back after their diagnosis, they often realise they’d had small, subtle symptoms for some time, things they didn’t connect to a brain tumour. Once symptoms do appear, they may take a while to improve and often don’t fully get better until the tumour is treated.
For faster-growing, aggressive tumours, doctors think they’ve often been developing for around six months or less. On the other hand, slow-growing benign tumours can be present for many years before they’re found, sometimes only being discovered by chance during a scan for something else.
It depends on the type of brain tumour and where it’s located.
Some tumours, like certain meningiomas, can be cured if they’re in an area where surgeons can safely remove them. But if the tumour is in a difficult or sensitive part of the brain, removing it completely may not be possible.
For more aggressive tumours, doctors usually don’t talk about a cure, but there are treatments that can help people live longer, sometimes for many years. New treatments and clinical trials are also becoming available all the time.
When doctors talk about prognosis (how long someone might live with a tumour), they use averages based on other patients. These figures can be more accurate for common tumours but for rarer ones, the data is less certain. And even with good data, no one can predict exactly what will happen for an individual.
A few rare inherited conditions can make brain tumours more likely, but these are extremely uncommon. For most people, there’s nothing they did or didn’t do that caused their tumour.
Almost never. Brain tumours can sometimes spread within the brain or to the spine but it’s very unusual for them to spread anywhere else in the body.
One exception is medulloblastoma, a rare type of brain tumour. In about 1 in 20 cases (5%), it can spread outside the brain or spine.
A second opinion means asking another specialist for their view on your diagnosis or treatment. In brain tumours, this can be a bit more complex because care often involves a whole team of experts.
The doctor giving the second opinion will usually look at all your test results, including scan images and lab reports, before giving their thoughts on your options.
Different specialists focus on different parts of treatment. If you want to discuss surgery, you should speak to a neurosurgeon. If you want to explore radiotherapy or chemotherapy in detail, you’ll need to speak to an oncologist.
You might consider a second opinion if:
- You have a very rare tumour
- Your current treatment isn’t working as hoped
- You’re interested in clinical trials
- You’ve been diagnosed with a very aggressive tumour
It’s worth remembering that seeking another opinion can take time and energy, and it may not always change your treatment plan.
Sometimes, after getting a second opinion, you might decide you’d prefer to continue your treatment with a different specialist or at another centre. This is usually fine, but it should be discussed and agreed in advance with the new team.
It’s also important to let your current specialist know. Moving care can take some organising, especially with treatments like chemotherapy that follow a set schedule.
Even if you change where your main treatment happens, you may still need your local team for things like blood tests, urgent care, or steroid prescriptions. Being open with all your teams helps make sure your care runs smoothly.
- NHS (state-funded) - Usually free, but it can take longer to arrange.
- Private - Often quicker, but you’ll need to pay. Private specialists may also suggest treatments that aren’t available on the NHS and could be expensive.
- Overseas - These can be very costly and difficult to organise. Experts abroad might recommend treatments not available in your home country.
Patients family
Access to a website like this would have been a breath of fresh air during the chaos and confusion that followed my husband’s diagnosis. Having clear, specialist-led information in one place would have helped us better understand what was happening, what options existed and how to navigate decisions with more confidence. At a time when everything felt overwhelming, clarity and compassion in how information was presented would have made a real difference. I’m really glad that this website now exists for others facing a similar situation.
Patients family
Tackling a GBM diagnosis is extraordinarily overwhelming, the stats bulldoze you & researching treatment options online is sole destroying. Having one consolidated place to connect with other patients, understand additional treatment options & potential trials & follow others journeys is incredibly comforting and very much needed. Thank you. It’s a tough journey and we only get through it by all sharing our discoveries to make each others experiences that little bit easier.
Thank you for putting the time aside for this website. Being a caregiver to a 10momths in GBM patient I can honestly say that this website will benefit future patients enormously.
Patient
When everything changed, I didn’t want medical jargon or endless links. I just wanted clear, honest information I could actually understand.
Having it all in one place helped. Finding the information together was a huge relief. We could stop Googling and start getting a clearer picture of what was going on.
I could come back when I was ready. Some days I read a lot. Some days I couldn’t read anything at all. Knowing I could come back without pressure really helped.
Knowing more made things feel less chaotic. Understanding my options didn’t fix everything, but it helped things feel a little less out of control.
This was about more than treatment. This affected my whole life - not just my health. Seeing emotional and practical support included made me feel like that was understood. I didn’t feel like I was doing this alone. It felt like someone had already done the hard work of pulling this all together for me - and that meant a lot!
This website is an independent resource, developed by the Horizons in Neuro-Oncology (HINO) team in the UK. Initial development was supported by Dr Matt Williams and Lillie Pakzad-Shahabi, with grant funding from Novocure to support ongoing work.
HINO maintains editorial independence. While the team collaborates with a range of healthcare organisations and receives grant support from Novocure, all content is created and reviewed by the HINO team and reflects their combined clinical expertise, professional experience, and lived experience as patients and caregivers.
While content is based on UK clinical practice, much of the information may be relevant to international readers. It is provided for general guidance and should not replace medical advice from your own healthcare team.
Please use this information to support discussions with your local oncology team, or see our advice on obtaining a second opinion.
