Brain cancer: Symptoms, causes and treatments

Brain cancer can be a scary diagnosis. Read our guide to help with understanding tumor symptoms and types and treatment options for brain cancer. 

By Adesh Tandon, MD, Neurosurgery, Nuvance Health, now part of Northwell Health 

A brain cancer diagnosis can turn life upside down. In those first moments, you may feel shocked, confused and have a flood of questions — Why me? What does this mean for my future? How will I get through this? It’s normal to want reassurance and clear answers. Beyond the medical terms and treatment plans, people need guidance, support and hope. 

This guide is designed to help you understand brain cancer causes, symptoms, diagnosis and treatment options. You will also find guidance about clinical trials and coping with a brain cancer diagnosis.  

Learn more about neurosurgery at the Nuvance Health Neuroscience Institute, now part of Northwell Health. 

What causes brain cancer? 

Primary brain cancer develops when abnormal cells grow uncontrollably in the brain. While most tumors develop for no specific reason, here are some of the risk factors for brain cancer: 

Age

Brain tumors can occur at any age but are more common in children and adults older than 65. 

Radiation exposure

While it can be lifesaving at the time to treat cancer, ionizing radiation to the head and neck could increase the risk of future brain cancer. The good news is radiation therapy continues to get more precise to avoid healthy tissue. 

Family history

Inherited cancer syndromes that cause brain cancer are rare. These syndromes include: 

• Neurofibromatosis type 1 (NF1) 
• Neurofibromatosis type 2 (NF2) 
• Li-Fraumeni syndrome 
• Tuberous sclerosis 
• Turcot syndrome 
• Von Hippel-Lindau syndrome 

A weakened immune system

Conditions or medications that suppress immunity may cause abnormal cell growth in the brain. 

Metastatic cancer

Primary cancer from other parts of the body can spread to the brain, like breast cancer, lung cancer and melanoma. 

What are the types of brain cancer? 

There are many types of primary brain cancer categorized by the type of cell involved and where the tumor begins. Low-grade brain tumors grow slowly, and high-grade brain tumors grow quickly. 

Gliomas are the most common type of brain tumor. These originate in the glial cells. There are several types of gliomas: 

• Glioblastomas (GBM) are the most aggressive glioma. They grow rapidly and infiltrate healthy brain tissue, making complete removal challenging. 

• Astrocytomas can be slow- or fast-growing. They originate in astrocytes, a type of glial cell. Slow-growing astrocytomas can be benign (non-cancerous) while fast-growing tumors are malignant. 

• Oligodendrogliomas originate from myelin cells and grow slower than other gliomas. 

• Ependymomas grow from the ventricles in the brain, blocking cerebral spinal fluid and causing hydrocephalus as a symptom. Ependymomas vary from low-grade to high-grade, aggressive tumors. 

Related content: Hydrocephalus: symptoms, causes and treatments 

• Meningiomas develop in the meninges, or membranes surrounding the brain and spinal cord. These tumors are usually slow-growing and benign (not cancer), but some can grow quickly and become cancerous. 

• Medulloblastomas are most common in kids and young adults. These are fast-growing tumors found mostly in the cerebellum (the lower back part of the brain). 

• Metastatic cancer is more common than primary brain cancer. The most common cancers that spread to the brain are breast, lung and skin cancer. 

What are the symptoms of brain cancer? 

Brain cancer symptoms depend on the size and location of the tumor because different parts of the brain control different functions. Some symptoms could include: 

• Headaches: Persistent or worsening headaches that feel worse when there is natural increased pressure in the brain, like in the morning after sleeping or when coughing or sneezing. 

• Seizures: New seizures in adulthood could be a warning sign of a brain tumor. Tumors in the brain can disrupt the electrical activity in the brain. 

Find a video about seizure first aid here. 

• Cognitive and personality changes: Tumors, especially in the frontal lobe, can affect normal brain function and cause trouble with memory, concentration or mood regulation. 

• Balance and coordination issues: Tumors in the cerebellum affect walking, fine motor control and coordination. 

• Nausea or vomiting: Brain tumors can cause intracranial pressure and in turn nausea or vomiting. 

• Vision or hearing changes: Tumors near the optic or auditory pathways in the brain can cause blurred or double vision, loss of hearing or ringing in the ears. 

• Weakness or numbness: Pressure on the motor or sensory areas in the brain can cause symptoms in the arms, legs or face. 

Symptoms may come on gradually or suddenly depending on the growth rate of the tumor and location in the brain.  

Having these symptoms doesn’t necessarily mean you have a brain tumor because they are also signs of other common conditions, like sleep deprivation or dehydration. However, persistent new headaches, seizures and cognitive changes should prompt you to see a doctor. 

Most people can start by seeing a primary care provider for an exam. Your primary care provider may initiate brain imaging and connect you with a neurologist or neurosurgeon for further evaluation.  

Find a neurosurgeon near me. 

If your symptoms are acute or very worrisome, like you had a seizure, go to the emergency department for immediate care and assessment. 

How is brain cancer diagnosed? 

Diagnosing a brain tumor involves multiple steps to ensure accuracy and guide treatment, including: 

• A neurological exam to evaluate your reflexes, vision, balance, muscle strength and cognitive function. 

• Brain imaging to see inside your brain. CT scans may be used first in urgent settings. MRI provides high-detail images of brain structures and tumors. PET scans may also be used to detect changes in brain activity. In some cases, advanced MRIs may also be used to evaluate brain function. 

• A biopsy of the tumor or surgical resection will confirm the tumor type and grade, guiding treatment planning. Imaging can provide clues about the type of tumor, like irregular borders could suggest cancer. But analyzing tissue is the only way to definitively know if it is cancer. 

How treatable is brain cancer? 

The success of brain cancer treatment depends on multiple factors: 

• Tumor type and grade: Low-grade tumors often respond well to treatment, while high-grade gliomas are more aggressive and may be more difficult to treat. 

• Location: Tumors near essential brain structures, like the brain stem, may limit surgical options. 

• Patient health and age: Younger, healthier patients may tolerate intensive therapy better. 

Modern multidisciplinary care — combining neurosurgery, medical oncology and radiation therapy — can improve outcomes, especially when treatment starts early. 

What are treatments for brain cancer? 

Treatment for primary brain cancer often requires a combination approach. Neurosurgeons, radiation oncologists and medical oncologists collaborate to create a plan tailored to each person. Supportive treatments like physical therapy, occupational and speech therapy to manage side effects and medications to reduce swelling or seizures also play an important role. 

Here are some treatments you may have depending on the type, size and location of brain cancer: 

Brain cancer surgery 

Neurosurgeons aim to remove as much of the tumor as possible without harming essential brain functions. The technique your neurosurgeon performs depends on the size, location and type of tumor you have. 

A craniotomy is the most common type of surgery for brain cancer. During a craniotomy, a neurosurgeon removes a piece of bone from the skull to access the brain and the tumor. There are different techniques to reach the tumor depending on where it is located.  

An awake craniotomy may be recommended if the tumor is near essential functions in the brain and your neurosurgical team needs to test brain function during the surgery, like your sight, speech and cognitive abilities. Medications will ensure you don’t feel any pain. 

Neurosurgeons at Nuvance Health offer fluorescence-guided surgery for glioblastomas. The fluorescence technology lights up the tumor tissue and differentiates it from healthy tissue. Neurosurgeons can stay in the safe resection zone while removing as much of the cancer as possible. 

Learn more about fluorescence-guided surgery for glioblastoma. 

Radiation therapy for brain cancer 

Radiation therapy may be recommended after surgery to destroy the remaining cancer cells. Sometimes radiation may be the main treatment if surgery is not an option.  

External beam radiation therapy (EBRT) involves precisely targeting beams at the cancer cells. There are several different types of EBRT including stereotactic radiosurgery (SRS) and intensity-modulated radiation therapy (IMRT). 

Brachytherapy, or internal radiation, is another type of radiation therapy for brain cancer. A radiation oncologist or neurosurgeon places radioactive seeds in or near the tumor. Brachytherapy can help target the cancer cells and less healthy tissue because the radiation from the seeds travels a very short distance. The seeds don’t need to be removed because they are about the size of a grain of rice and lose their radioactivity over time. 

Chemotherapy, targeted therapy and immunotherapy for brain cancer 

Medical oncology is systemic treatment for cancer, meaning it affects your entire body. There are three main types of medical oncology: chemotherapy, immunology or targeted therapies may be recommended in conjunction with surgery and radiation for brain cancer. 

Temozolomide is a common type of chemotherapy for primary brain cancer, particularly to treat glioblastomas. 

Targeted therapies may be recommended if the tumor has a certain genetic makeup. Just like its name, these therapies target specific genetic markers that make the tumor grow. 

Immunotherapy may be used to treat cancer that has spread to the brain. Immunotherapy boosts your immune system to help it attack cancer cells. 

While brain cancer may not be curable, these treatments aim to help extend your life as long as possible. 

Can you survive brain cancer? 

Survival from brain cancer varies widely. Your care team is the best source for understanding your situation. Trusted sources like the American Cancer Society also provide data on survival rates. 

Generally, low-grade brain tumors, like slow-growing gliomas, are treatable with surgery and careful monitoring.  

Aggressive tumors, like glioblastoma, require early intervention from neurosurgery and oncology experts. While a cure is challenging, treatment can help to extend and maintain your quality of life as much as possible. 

Data and doctors can guide you, but remember, no one can 100% predict the future. Keep reading to find ways to deal with a brain cancer diagnosis and keep living as well as possible. 

Are clinical trials for brain cancer worth it? 

If you tried all available treatment options or have aggressive cancer that is difficult to treat, you could consider enrolling in a clinical trial. Clinical trials test new treatments. Depending on the phase of the trial, they may test dosage safety (phase 1), effectiveness and side effects (phase 2) or how it compares to the standard of care (phase 3).  

Clinical trials can offer hope to people who have exhausted other options as they test new treatments. Participants can also contribute to medical progress. 

Whether or not to enroll in a clinical trial is a deeply personal decision and depends on your treatment goals and how you want to live your life.  

Discuss eligibility and potential benefits or risks with your neurosurgeon or oncologist to see if a clinical trial is right for you. 

How to deal with brain cancer? 

Brain cancer can be daunting and overwhelming, and everyone will have a unique experience. Generally, the following coping strategies may be helpful. 

Find a multispecialty care team you trust 

Find a neuro-oncology team you have confidence in and trust. They should listen to you and your needs, offer you the latest options and help you feel comfortable. 

Your care team may also include mental health, social work and rehabilitation specialists. 

Mental health and social work providers can help with coping techniques personalized for you. Social workers can also help you navigate daily living logistics like childcare, financial support, grocery delivery, transportation to treatments and more. 

Physical therapy, occupational therapy and speech therapy can help manage your symptoms and recover from treatments so you can maintain your independence as much as possible. 

Learn more about supportive care. 

Surround yourself with a support system 

Have a family member or friend accompany you to appointments. It can help to have a second pair of ears and emotional support. 

Try to spend as much time as possible making memories with the people you love and doing things that bring you joy. 

Your support system may also include people with similar experience. You can find support groups through organizations like the American Brain Tumor Association or on social media. 

Stay focused on your goals 

Goals can give you something to look forward to and offer you hope. Goals can be as simple as looking forward to an upcoming holiday or your favorite season. Or maybe you take a trip or write a book about your life. Whatever gives you purpose and makes you smile may help make a serious illness more manageable. 

Complete your advanced directive for healthcare 

Some people find comfort in taking control of their future by completing an advanced directive. An advanced directive is a legal healthcare document that details your wishes for future medical care. An advanced directive can help you feel in control and alleviate stress on you and your family to make important medical decisions in the event you cannot make them yourself. 

The bottom line: Brain cancer is a complex condition, but early diagnosis, personalized care and modern treatments offer hope. Knowing your tumor type, understanding all treatment options, considering clinical trials and preparing yourself and family for the future can make a meaningful difference in outcomes and quality of life.