Are all brain tumors created equal?

Authored by Dr. Rosemarylin L. Or, MD, FPNA

This question might make one pause to ponder. All of these tumors are found in the brain, and, in some cases, the spine. Shouldn’t they be expected to behave in a categorical manner? But brain tumors are seen to appear in a variety of shapes and sizes as well as locations. They also exhibit diversity in terms of disease behavior and clinical symptoms.

What are brain tumors?

A brain tumor arises from a group of abnormal cells in the brain. Primary brain tumors originate from brain tissues and can either be malignant or benign. Secondary brain tumors (also called brain metastases) come from a cancer elsewhere in the body that had spread up to the brain.Brain metastases are often seen in patients with a known history of cancer. In rare cases, some brain tumors are the ones that are first detected before the primary cancer in the body.

Primary brain tumors develop when a normal brain cell has developed mutations that affect how a cell divides and grows. These mutations affect the ability in signaling cells to stop dividing or in some cases, it affects their ability to die naturally, resulting in the accumulation of abnormal cells that continuously divide and multiply, producing a mass.

What causes primary brain tumors is unclear. But a few known risk factors are exposure to ionizing radiation like previous radiotherapy treatments, or in specific cases, a family history of brain tumors that are usually seen in families with genetic syndromes. Families with genetic syndromes often exhibit multiple family members with different types of cancers, or multiple cancers in a family member.

Brain tumor grading is different compared to the usual cancer staging used in other types of cancer. Primary brain tumors are graded from grade 1 (slowest growing and more benign) to grade 4 (most aggressive and malignant). The grades depend on the aggressiveness of the tumor and does not factor in tumor size or location.

Brain tumors can present as one or more of the following symptom/s: frequent headache, seizures, nausea/vomiting, difficulty speaking, trouble hearing, problems in sleep and wakefulness, blurred or double vision, memory impairment, disorientation, changes in behavior, loss of balance, and weakness on one side of the body.

In most cases, surgery serves not just as a diagnostic tool in knowing what tumor we are dealing with, but it is also an important treatment aspect in that being able to remove most, if not all the tumor, can significantly affect one’s survival outcome.

There is a fine balance in removing the tumor bulk and making sure that the patient is able to retain most of his or her functionality. There are certain cases, like tumors located deep in the brain or those that are in areas that affect language or movement, wherein complete tumor debulking might not be possible. In these cases, especially for malignant tumors, radiation therapy and/or chemotherapy are offered to supplement the initial surgical treatment.

So, are all brain tumors created equal?

Every brain tumor patient’s journey is unique and his or her tumor may behave differently compared to its contemporaries. At The Medical City, a multi-disciplinary approach to cancer care is practiced. As individual patients have different needs, our team iscomposed of different specialists who work together to formulate a personalized treatment plan for our patients. 


Rosemarylin L. Or, MD, FPNA is a Neurologist / Neuro-Oncologist at The Medical City’s Institute of the Neurological Sciences.

For consultations with a brain tumor specialist, please call The Medical City’s (TMC) Institute of the Neurological Sciences (INS) at mobile no. 0908-86-27246, tel. nos. 8988-1000 / 8988-7000 ext. 6270, or email