If you develop any of the symptoms of a benign brain tumour, such as a persistent and severe headache, you must see your doctor immediately. Your doctor will examine you and refer you to a specialist if necessary. Your doctor will examine the back of your eye and look for changes to the optic disc (the inside of the back of the eye) caused by an increase in pressure inside the skull. Raised pressure in the skull may indicate the presence of a tumour.

If a growth or tumour is suspected, you will be referred to a neurologist (brain and nerve specialist).

Referral to a specialist

The specialist will ask you about your medical history and symptoms. They will examine your nervous system, which may include tests of your:

• reflexes, such as your swallow reflex and knee jerk reflex,
• facial muscles (testing whether you can smile or grimace, for example),
• hearing and vision,
• limb strength,
• balance and coordination,
• skin sensitivity to pinpricks, heat and cold, and
• mental agility (simple questions or arithmetic).

Diagnosis of brain tumour is made based on your symptoms, the examinations above and the results of certain tests.

Tests

You may have some of the following tests to help diagnose a brain tumour:

• Computerised tomography (CT) scan. This produces a detailed picture of your brain using a series of X-rays.
• Magnetic resonance imaging (MRI) scan. This produces a detailed picture of your brain using a strong magnetic field and radio waves.
• X-ray of the skull.
• Positron emission tomography (PET) scan. This produces an image of your brain by detecting radiation inside your head (after radiation is introduced into your body).
• Electroencephalogram (EEG). Electrodes record your brain activity.

If a tumour is suspected, a biopsy (surgical removal of a small piece of tissue) may be taken to establish the type of tumour and the most effective treatment. A biopsy involves making a small hole in the skull and using a fine needle to obtain a sample of tumour tissue. It involves a few days in hospital.

Treating a benign brain tumour

Some benign brain tumours can be surgically removed. Tumours do not normally come back once they have been removed and no further problems are caused.

1. Surgery

The aim of surgery is to remove as much of the tumour as possible without damaging the surrounding tissue. You will be given a general anaesthetic (put to sleep) and an area of your scalp will be shaved. A section of the skull is cut out as a flap to reveal the brain and tumour underneath. This is known as a craniotomy. The surgeon can then remove the tumour.

1. Radiosurgery

Some tumours are situated deep inside the brain and are difficult to remove without damaging surrounding tissue. In such cases, radiosurgery may be used to treat the tumour.

During radiosurgery, a dose of high-energy radiation is focused on the tumour to kill it. The treatment is completed in one session, recovery is quick and an overnight stay in hospital is not usually required.

1. Chemotherapy and radiotherapy

Occasionally, chemotherapy and radiotherapy may be used to shrink a benign tumour. Chemotherapy uses medication to kill tumour cells and can be given as a tablet, an injection or a drip. Radiotherapy involves controlled doses of high-energy radiation, usually X-rays, to kill the tumour cells.

Recovering from brain tumour

After being treated for a brain tumour, you may be offered physiotherapy, speech therapy and/or occupational therapy. These therapies aim to speed up your recovery and help you cope with any problems caused by the tumour.

• An occupational therapist will recommend any equipment or alterations to your home that may help you carry out daily activities.
• A speech therapist will help you with any speech or swallowing problems.
• A physiotherapist will help you to use parts of the body that have been affected by the tumour.

Epilepsy may effect some patients for up to six months or rarely longer after surgery.

1.    Sports and activities
After you have been treated for a brain tumour, permanently avoid contact sports, such as rugby and boxing. You can start other activities again, with the agreement of your doctor, once you have recovered.

Swimming unsupervised is not recommended for around one year after treatment, as there is a risk that you could have an epileptic fit while in the water.

2.    Sex
It is safe to have sex after treatment for a benign brain tumour. Women should avoid becoming pregnant for six months and should discuss the implications of any ongoing medication with their specialist.

3.    Going back to work
You will become tired more easily following treatment for a brain tumour. Although you may wish to return to work and normal life as soon as possible, it is a good idea to return part-time to begin with and to go back full-time when you feel able to.

If you have experienced seizures, do not work with machinery or at heights.

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