KUALA LUMPUR, June 12 – Silent, often rare, but undeniably dangerous, brain tumours deserve far more public attention than they currently receive.
In Malaysia, they account for 1.6 per cent of new cancer cases in 2020 involving the brain and central nervous system. In 2022, over 300,000 cases were reported globally, placing brain tumours as the 19th most common cancer.
Yet, despite their relative rarity, brain tumours rank 12th in cancer-related deaths, underscoring the devastating consequences of a delayed diagnosis.
“It is not uncommon for us to see patients presenting in the late stages of a brain tumour,” says Dr Mah Jon Kooi, consultant neurosurgeon at Sunway Medical Centre Velocity (SMCV).
“This can be attributed to the fact that the symptoms depend heavily on the tumour’s location and how it affects specific brain functions.
“When signs such as memory or speech difficulties occur in older individuals, they are often mistaken for ageing, making early detection for brain tumour challenging.”
With Brain Tumour Awareness Day recently observed, the occasion serves as a reminder for the urgent need to prioritise neurological health and to act swiftly when subtle or unexplained symptoms emerge.
Recognising Brain Tumours
A brain tumour refers to an abnormal growth of cells within the brain and can be categorised as either benign or malignant. Dr Mah explains that brain tumours are further classified as either primary, meaning they originate within the brain itself, or secondary, also known as metastatic tumours, which occur when cancer spreads to the brain from other parts of the body.
While there are over 100 known distinct types of primary brain tumours, Dr Gerard Arvind Martin, consultant neurosurgeon at SMCV, notes that secondary tumours are more common, occurring up to five to ten times more frequently than primary brain tumours.
Although the type of tumour varies, many brain tumours present with similar early warning signs.
These may include frequent or newly developed headaches, nausea, visual disturbances such as double vision or partial vision loss, difficulty with speech or memory, loss of balance, and sudden changes in personality or behaviour.
However, the way these symptoms appear can differ significantly depending on the tumour’s location in the brain.
Dr Mah shares that tumours in the frontal lobe may affect the higher cognitive functions such as personality, social behaviour, impulse control, emotional regulation, movement, and speech.
Whereas tumours in the temporal lobe, which processes sound, language, and memory, are more likely to result in speech issues and memory loss.
Dr Mah adds that nearly half of all brain tumour patients experience some form of memory impairment, although the severity often depends on the tumour’s size and exact location.
To confirm the presence of a brain tumour, diagnostic imaging plays a crucial role. Imaging tools such as CT scans and contrast-enhanced MRI are essential for identifying the tumour’s size, type, and exact location within the brain.
“MRI is generally preferred because it provides more detailed images of the brain and can better distinguish between normal and abnormal tissues,” said Dr Mah.
This level of accuracy is vital for planning treatment and determining whether the tumour may be surgically removed.
Decoding The Causes And Risks Of Brain Tumours
In many cases, brain tumours do not originate in the brain itself but instead develop as a result of metastasis from cancers elsewhere in the body.
“Cancers such as lung, breast, colon, and melanoma are most likely to metastasise to the brain, and are commonly seen,” says Dr Gerard Arvind.
In fact, up to 40 per cent of lung cancer patients will develop secondary brain tumours at some point during their illness.
One recent and widely reported case in March 2025 is that a local politician revealed that his lung cancer had spread to his brain, resulting in a tumour measuring 3cm.
The exact reason why certain cancers are more likely to metastasise to the brain remains unclear.
This typically occurs when cancer cells break away from the primary tumour, travel through the bloodstream, and lodge in the brain where they begin forming tumoural masses.
While genetics, lifestyle, and environmental factors can contribute to the development of cancer, the exact cause of many brain tumours often remains unknown.
Dr Gerard Arvind explains that genetics play a significant role in determining a person’s overall susceptibility to developing brain tumours over the course of their life. In such cases, lifestyle-related factors may act as triggers in individuals who carry these underlying genetic traits, potentially leading to tumour development over time.
Navigating Treatment Pathways
Given the uncertainty surrounding brain tumour causes, early detection following symptom development remains the most decisive factor in determining a patient’s outcome.
Once a tumour is diagnosed, its type, size and location will determine the most suitable course of treatment. However, surgery remains one of the most effective interventions, particularly for accessible tumours.
A typically recommended procedure is a craniotomy, where a section of the skull is temporarily removed to allow surgeons access to the brain.
In selected cases, an awake craniotomy, a highly specialised procedure where the patient is kept responsive during key moments of the operation, may be performed.
This allows the surgical team to monitor neurological functions such as speech, movement, or vision in real time, helping to preserve critical areas of the brain.
For small or hard-to-reach tumours that make open surgery challenging, radiosurgery offers a non-invasive alternative.
Despite its name, it does not involve any surgical incision but uses precisely targeted, high-dose radiation to shrink or control the tumour, often completed in just a single session.
Another surgical option in cranial surgery is the use of endoscopes, particularly for tumours located at the skull base or within the pituitary region.
According to Dr Gerard Arvind, the procedure involves inserting a thin, rigid endoscope, equipped with a light and camera, through the nasal passage to access the tumour.
This method enables surgeons to operate with greater precision and minimal disruption to surrounding tissue.
As a result, patients often benefit from faster recovery times, shorter hospitalisation stay and reduced post-operative discomfort.
At SMCV, this technique has been successfully employed to treat pituitary tumour cases, often identified by general practitioners or ophthalmologists when patients present with symptoms like visual disturbances and severe headaches.
Highlighting the other common use in cerebrospinal fluid (CSF) diversion procedures, Dr Gerard Arvind recalls a memorable case involving a lung cancer patient with a secondary tumour in the cerebellum that had blocked CSF flow, causing life-threatening pressure in the brain.
Instead of placing a permanent shunt to divert the fluid into the abdomen, the SMCV surgical team performed an endoscopic third ventriculostomy to restore the CSF circulation, followed by tumour removal, all in a single session.
The patient recovered well and was able to proceed with his chemoradiotherapy treatment as planned, reflecting how advanced, well-coordinated neurosurgical care can dramatically improve outcomes.
Being Diagnosed Is Not The End, It’s The Beginning Of Getting Help
Brain tumours may be rare, but their symptoms are real, and often subtle. From constant headaches to mood changes, recognising these signs early can make a critical difference.
Early detection not only increases the chances of effective treatment, but also open doors to less invasive procedure and better recover outcomes.
A brain tumour diagnosis is not the end of the road. Thanks to ongoing advancements in diagnostics and minimally invasive surgical techniques, patients today have more options and greater hope than ever before.
With timely action and the right guidance and support, recovery is possible, and no one has to face this journey alone.
