Understanding Brain Tumours
A brain tumour is an abnormal growth of cells in the
brain. It can be malignant or benign. Malignant tumours
are cancers. Benign tumours are relatively slow-growing.
There are over 150 types of brain tumours classified
by the World Health Organisation. Brain tumours can
differ in terms of the cells they originate from, how
quickly they are likely to grow and spread, and the part
of the brain they affect. Knowing your tumour's type can
therefore help you understand your condition.
Types of Adult Brain Tumours
Brain tumours can generally be divided into two
categories: benign and malignant. While the former
is more common, some "benign" brain tumuors can
be aggressive due to their location and symptoms.
Meningiomas are the most common benign brain
tumours occurring more on the surface of the brain.
Sometimes they can be found in the skull base, on the
underside of the brain as well.
On the other hand, malignant brain tumours can be
classified as primary or metastatic. Among primary
brain cancers, glioblastoma multiforme (GBM) is the
most common type and has the worst prognosis.
Metastatic malignant brain tumours can metastasise
from cancers in lung, breast, colon or other organs.
There can be solitary or multiple lesions at the time of
presentation. The primary tumour may be asymptomatic
and can only be identified by investigations.
The symptoms of brain tumours are extremely diverse,
depending on the location, volume and growth rate
of the tumour. For example, brain tumour in the
right frontal lobe can affect the patient's mood and
personality, leading to headache and seizures; brain
tumour at the left temporal lobe may cause speech
problem, memory loss, or even auditory hallucination
or delusion; if a brain tumour is in the parietal lobe, the
patient may suffer from hemiplegia.
There are twelve pairs of cranial nerves in the human
brain, each of which is responsible for different senses.
If the brain tumour affects the first pair of cranial nerves,
the sense of smell will be affected; if the second pair is
damaged, the patient will have visual problem. A former
patient was unaware of weakened sense of smell.
She did not seek medical attention until losing weight
due to loss of appetite. She was finally diagnosed with
Since symptoms from brain tumour can be very
diversified, doctors need to be highly vigilant. Doctors
will arrange for patients to undergo MRI scans or
computed tomography scans for more detailed
work-up. For some small brain tumours, such as
pituitary tumours or acoustic neuromas, a routine MRI
scan may not be enough. Doctors may need to order
MRI scans of specific areas with appropriate protocols
to obtain necessary detailed information.
Interdisciplinary Personalised Treatment - HKSH Brain Tumour Programme
Although there are various international guidelines and clinical formulations available for many types of brain tumours,
being able to tailor make a personalised plan for the patient is the key to treatment success.
The treatment plan of the brain tumour is determined by
the tumour type and patient-specific factors. In simple
- For benign asymtomatic tumours that are small
in size, clinical observation and regular MRI
examinations are recommended;
- If there is a malignant tumour or a benign tumour
with symptoms, it is suggested for the team to
conduct multidisciplinary meeting. Tissues may be
extracted for pathological and molecular analysis
to guide treatment, or surgical operation may be
required for gross total excision, or to remove the
largest extent of tumour under safe conditions to
- Adjunct therapy such as stereotactic radiosurgery,
chemotherapy, radiotherapy, targeted therapy or
immunotherapy can be arranged accordingly.
Our team values patient engagement and empowerment
during treatment and recovery. Doctors would put
together a personalised plan of care that is tailored
made to the best outcome.
1. Louis et al. (2016). The 2016 World Health Organization
Classification of Tumors of the Central Nervous System:
a summary. Acta Neuropathologica (2016) 131:803–820
2. Wong et al. (2021). Overview of the clinical features and
diagnosis of brain tumors in adults. https://www.uptodate.com/
3. Louis et al. (2020). Central Nervous System Cancers, Version
3.2020, NCCN Clinical Practice Guidelines in Oncology. Journal
of the National Comprehensive Cancer Network: JNCCN , 2020