Top 10 Symptoms of A Brain Tumor You Shouldn't Ignore

What is a Brain Tumor?

A brain tumor is a growth of abnormal cells in the brain, usually in the form of a mass. This mass can either be a primary tumor, or a secondary tumor. A tumor is considered "primary" when this abnormal division of cells starts in the brain itself. A "secondary" tumor, or metastatic tumor, exists when cancer cells from a different part of the body spread to the brain and further divide. Adding to this description, a tumor can either be benign or malignant. A benign tumor is non-cancerous, localized to one area, and will not progress to spreading to the rest of the body. A malignant tumor is considered cancerous, will grow rapidly, invade nearby tissues, and spread to distant organs. 

Due to the intricacies of the brain and the nervous system, brain tumors often tend to have a range of symptoms. These symptoms can vary based on the location and size of the tumor, as well as the specific type of cell that undergoes abnormal division. A large tumor has the ability to press on different structures around it and create symptoms that are, at times, unrelated to the brain and the nervous system. Whether the tumor is benign or malignant will also dictate how aggressive and serious the symptoms are.  

As symptoms caused by brain tumors can be nonspecific, we will discuss some of the most common symptoms below. Brain tumors are sometimes found on imaging when a patient is being evaluated for common medical conditions. If you are experiencing concerning symptoms, consulting a healthcare provider is essential for a thorough evaluation and timely medical care.

What Are Usually the First Symptoms of a Brain Tumor?

As mentioned, presenting symptoms of a brain tumor can vary significantly due to different factors. The best way to figure out what to expect from the tumor is to have your healthcare provider conduct a biopsy. When the cancer cells are tested in the laboratory, brain tumors are assigned a grade from 1 to 4. Symptoms vary depending on the grade of the tumor. Grade I and grade II brain tumors are relatively slow-growing and cause subtle symptoms that get worse over a period of months to years. Grade III and grade IV brain tumors are fast-growing and cause sudden symptoms that quickly get worse over a period of days to weeks.

Common brain tumor symptoms include:

• Headaches that are unexplained and often worse when waking up in the morning

• Persistent nausea and vomiting

• Fatigue

• Drowsiness

• Dizziness or vertigo (a sensation that the world is spinning)

• Vision difficulties, such as blurry vision, double vision, or loss of peripheral (side) vision

• Hearing problems

• Difficulty speaking, thinking, or finding words

• Numbness or paralysis (loss of sensation or movement) in an arm or leg

• Balance problems causing recurrent falls

• Confusion

• Memory difficulties

• Problems following simple instructions

• Personality changes

• Seizures or convulsions, without a history of seizures

• Excessive hunger and weight gain

Brain Tumor Symptoms By Location 

Different parts of the brain control certain functions in the body. As a result, brain tumors in different parts of the brain can cause different symptoms. For example, the cerebellum at the back of the brain controls balance and movement, so a brain tumor located in this part of the brain may cause problems with walking and coordination. A pineal gland tumor that secretes a hormone called melatonin may make you feel drowsy. Brain tumors in other parts of the nervous system may cause different symptoms. 

The following symptoms can occur with brain tumors located in different parts of the brain (the four lobes of the cerebrum and brain-stem):

Symptoms Due to Increased Pressure

In addition to the location-based symptoms listed above, brain tumors can also cause other symptoms due to increased pressure on nearby healthy cells. As brain tumors grow, they take up space and increase pressure inside the skull. Symptoms like headache occur due to this increased intracranial pressure. 

A brain tumor can also cause fluid to accumulate in the brain by preventing normal circulation of cerebrospinal fluid in the spaces within the brain. This fluid buildup can press against certain structures and cause symptoms. Similarly, some brain tumors cause bleeding, which can build up in specific areas, leading to increased intracranial pressure. 

Brain tumor symptoms due to increased pressure include:

• Persistent, severe headache

• Nausea

• Vomiting

• Vision changes, sometimes rapidly worsening

• Abnormal eye movements

• Changes in mental status ranging from drowsiness to coma

• Seizures, often without a history of seizures

Benign and Malignant Tumors

Benign brain tumors are noncancerous and slow-growing. They often cause subtle symptoms that may not be noticeable. These brain tumor symptoms tend to get worse over many months or years. They are less likely to come back after treatment.

Malignant brain tumors have abnormal cells that are cancerous. They often cause symptoms that develop suddenly and get worse quickly over a few days to weeks. Malignant cancers are more likely to recur after treatment.

Types of Brain Tumors

There are more than 120 different types of brain tumors. They are named depending on the part of the brain and spinal cord involved and the type of brain cells or brain tissue that grows uncontrolled. For example:

• Meningioma.

• Craniopharyngiomas.

• Schwannoma.

• Pituitary adenoma.

• Glioma (a common type of tumor of the glial cells in the brain and spinal cord). 

• Glioblastomas.

• Oligodendrogliomas.

• Astrocytomas.

• Ependymomas.

• Choroid plexus tumors.

• Embryonal tumors such as medulloblastoma.

• Germ cell tumors.

• Pineal gland tumors.

• Pituitary gland tumors.

• Nerve tumors.

• Brain tumors that start in the blood vessels, bones, connective tissue, or muscles surrounding the brain.

Primary vs Secondary Brain Tumors

Primary brain tumors are cancers that occur due to uncontrolled growth of brain cells or cells in nearby tissues, such as the meninges (the meninx is the membrane that covers the brain). They can also develop in nerves or glands in the brain (pineal gland and pituitary tumors).

Secondary brain tumors are also called metastatic brain tumors. They occur when cancer cells from some other part of the body spread to the brain. For example, lung, breast, colon, thyroid, kidney, and melanoma (skin) cancer can spread to the brain. Brain metastases are far more common than primary brain tumors.

Signs and symptoms of brain metastases may include:

• Headache

• Nausea and vomiting

• Weakness or numbness on one side of the body

• Vision changes

• Speech problems

• Problems with balance or coordination

• Forgetfulness 

• Confusion with everyday matters

• Seizures

What Are the Red Flags for Brain Tumors?

The first sign and most common symptom of a brain tumor is often headache. About 50% of all people with brain tumors report headaches. The headaches occur due to a growing brain tumor pressing upon surrounding healthy brain tissue. Also, brain tumors can cause swelling, which can cause increased pressure inside the head, which can cause headaches. 

Here are some of the key features of brain tumor headaches:

• Headache symptoms caused by brain tumors can happen at any time of the day but are typically worse in the mornings. 

• The headaches can be severe enough to wake a person from sleep. 

• Brain tumor-related headache pain often gets worse with coughing or straining. 

• The headache may feel like a tension headache or migraine.

• Brain tumors located in the occipital lobe (back of the brain) can cause neck pain. 

• Brain tumors located in the frontal lobe (front of the brain) can cause eye pain or sinus pain. 

Other signs and symptoms of brain tumors that should not be ignored include:

• Seizures or convulsions.

• Vision, speech, or hearing problems.

• Changes in behavior or mental abilities.

• Numbness and weakness on one side of the body.

• Difficulty with balance and coordination.

When to Be Concerned

You should be concerned if you have any severe, persistent, or worsening symptoms. Brain tumor symptoms may resemble other medical conditions or be due to other less serious causes. However, they should be evaluated by a healthcare professional for proper diagnosis and treatment.

Risk factors for brain cancer include:

• Older adults - the risk of brain cancer increases with age, especially after age 50.

• Radiation exposure

• Inherited syndromes such as neurofibromatosis type 1 and type 2, Lynch syndrome, tuberous sclerosis, Li-Fraumeni syndrome, Von Hippel-Lindau syndrome, Cowden syndrome, Turcot syndrome, and Gorlin syndrome.

• Weakened immune system

• Certain viral infections

What Can Be Mistaken for a Brain Tumor?

Some of the conditions that can cause similar symptoms as brain tumors include:

• Subdural hematoma and epidural hematoma (brain bleeds and collection of blood that compresses brain tissue).

• Encephalitis (swelling and inflammation in the brain caused by viral or bacterial infections or autoimmune responses where the immune system attacks healthy brain cells).

• Hemorrhagic stroke or ischemic stroke.

When to See a Doctor

You should see a doctor for any persistent, severe, or worsening symptoms. Signs of brain tumors can be difficult to differentiate from other causes and need to be properly evaluated by a healthcare provider.

As mentioned, brain cancer symptoms vary depending on the type and size of the tumor and the area of the brain where it is located. Low-grade, slow-growing benign brain tumors can cause subtle symptoms that may not be noticeable for many months or even years. On the other hand, high-grade fast-growing malignant brain tumors can cause sudden and severe symptoms. 

How Do They Check For Brain Tumors?

Healthcare providers can make a diagnosis of a brain tumor based on a patient’s symptoms, medical history, neurological examination, and imaging studies. 

A patient should expect their healthcare provider to conduct a detailed medical history and physical exam. As brain tumor symptoms pertain to the nervous system, the physical exam will include a very comprehensive neurological examination that examines mental status, cranial nerves, motor functions, sensory, reflexes, and gait/balance. Using all this information, the healthcare provider will usually order imaging such as:

• Head CT (computed tomography) scan

• Brain MRI (magnetic resonance imaging)

• Functional MRI

• MRS (magnetic resonance spectroscopy)

• Magnetic resonance perfusion

• PET (positron emission tomography) scan

Diagnosis and surveillance of brain tumors can be a very quick or lengthy process. It is important to expect that not every patient and their course will be the same. Due to all the different factors we have discussed up until now, it is important that the healthcare provider and the patient communicate well and work together in this process.

Living with a Brain Tumor  

Managing Symptoms Effectively  

There are various treatment options for brain tumors, including surgery, radiotherapy, radiosurgery, chemotherapy, and targeted therapy. Your healthcare team, led by a neuro-oncology doctor, will plan treatment depending on the type of brain cancer.

During recovery from brain cancer treatment, many people require physical therapy, occupational therapy, and speech therapy to regain function. 

Resources and Support Systems

Here are some links to groups that offer advocacy, education, and community support for people diagnosed with brain tumors:

• American Brain Tumor Association (ABTA)

• Brains for the Cure (BFTC)

• Brain Tumor Network (BTN)

• EndBrainCancer Initiative (EBCI)

• International Brain Tumor Alliance (IBTA)

FAQs on Symptoms of Brain Tumors

How Long Can I Have a Brain Tumor Without Knowing?

How long you can have a brain tumor without knowing depends on the type of brain tumor. Low-grade benign (non-cancerous) brain tumors are slow-growing and cause subtle symptoms that may go unnoticed for months or even years. High-grade malignant (cancerous) brain tumors are fast-growing and cause sudden symptoms that quickly get worse over a few days to weeks.

Can a Brain Tumor Go Unnoticed?

Yes, symptoms of a brain tumor can go unnoticed. A low-grade, slow-growing, benign (non-cancerous) brain tumor may go unnoticed for many months or years because the brain tumor symptoms are subtle and easily missed.

If My Tumor Is Symptomatic, Is It Malignant?

Not always. Due to its size and growth, a benign tumor can sometimes exhibit symptoms. It can press on surrounding tissues and cause nausea, vomiting, headaches, vision, and hearing concerns, among other symptoms. 

What Does a Brain Tumor Headache Feel Like?

Although headaches are caused by a variety of different medical conditions, they are one of the most important and common symptoms of brain tumors. Patients with brain tumors usually complain that their headaches are the worst when they wake up in the morning. Some report their headaches are so severe that they wake them up from their sleep. A brain tumor headache is also worse with coughing or straining. The location of headaches is difficult to distinguish from the common etiologies of headaches, but it is important to be evaluated by a medical provider if these headaches persist or worsen.