Tumours inside the skull can arise from the meninges (the coverings around the brain), the blood vessels, the pituitary gland, or the brain substance itself. By far the most common malignant tumour is a secondary tumour; these are most common as complications of lung cancer, but they may come from any organ in the body. After secondary cancer, the most common primary cancer group are called the gliomas, which are tumours of the nerve cells themselves. After this, tumours arising from the meninges are the next most common.
The exact symptoms produced by a tumour depend entirely upon where it is, what it’s pressing on, and what structures it may be invading and destroying. Tumours at the front of the brain can produce a progressive change in personality, or alterations in the emotions, giving either euphoria or irritability. Further back, tumours can produce epilepsy and/or weakness of the limbs on the opposite side of the body.
Tumours in the side part of the brain called the temporal lobe can produce progressive inability to speak, and sometimes hallucinations; and tumours low down at the base of the brain cause a rise in pressure within the brain. This can lead to a condition called hydrocephalus (water on the brain), which causes severe headaches and vomiting, and which, in small children, can cause progressive enlargement of the head. Coordination is often a problem for people who have tumours in this position.
Benign tumours are relatively easy to treat and some malignant tumours respond to treatment, but others are relatively resistant. Surgery is usually the best treatment for benign tumours; malignant primary tumours can be successfully cut out, but the surgeon won’t want to remove too much of the brain tissue, and it may be difficult to remove a malignant tumour completely. Often surgery is used to begin with, then chemotherapy or radiotherapy afterwards. Surgery is seldom used in secondary tumours; these are often multiple, and impossible to remove completely.
The response to treatment depends very much on the exact type of tumour; tumours arising from the same type of tissue in two different patients may have quite different sensitivities to treatment. The response to treatment is very much an individual matter and doctors in the cancer clinics will often try a particular course of treatment, and then adjust the treatment according to the individual response.
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