How brain tumours creep up on you

Often masked by common symptoms and mistaken for ageing or fatigue, brain tumours, a growth of cells in the brain or near it, can go undetected until it’s too late. Photo courtesy of Sunway Medical Centre Velocity

DANIAL HAKIM

| 13 Jun 2025 06:04 pm

Though brain tumours account for only 1.6 per cent of new cancer cases in Malaysia as of 2020, their consequences are far from minor.

OFTEN masked by common symptoms and mistaken for ageing or fatigue, brain tumours, a growth of cells in the brain or near it, can go undetected until it’s too late.As Malaysia observes growing numbers in neurological diagnoses, experts at Sunway Medical Centre Velocity (SMCV) urge the public to understand the subtle warning signs and seek medical advice early because in the case of brain tumours, time is brain.Though brain tumours account for only 1.6 per cent of new cancer cases in Malaysia as of 2020, their consequences are far from minor.Globally, brain tumours were the 19th most common cancer in 2022, yet they ranked 12th in cancer-related deaths, a reflection of the seriousness of delayed detection.According to SMCV consultant neurosurgeon Dr Mah Jon Kooi, it is not uncommon for patients to come for medical treatment during the late stages of a brain tumour.“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,” he said.Recognising the unseen signsGenerally, brain tumours are defined as abnormal cell growths within the brain and are classified as either benign or malignant.As Dr Mah described, they may be primary—originating within the brain—or secondary, meaning the tumour has spread from cancer elsewhere in the body.“Secondary tumours are more common, occurring up to five to ten times more frequently than primary brain tumours,” according to Dr Gerard Arvind Martin, also a consultant neurosurgeon at SMCV.Although the type of tumour may vary, the early symptoms often overlap with each other.These symptoms include frequent or sudden headaches, nausea, visual issues (e.g., double vision or partial blindness), difficulty with speech or memory, balance problems, and sudden personality or behavioural changes.

According to SMCV consultant neurosurgeon Dr Mah Jon Kooi, it is not uncommon for patients to come for medical treatment during the late stages of a brain tumour. Photo courtesy of Sunway Medical Centre Velocity

However, the exact presentation of symptoms depends on where the tumour is located.“Tumours in the frontal lobe may affect personality, social behaviour, impulse control, movement, and speech.“In contrast, those in the temporal lobe often interfere with language and memory.“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,” Dr Mah elaborated.Medical imaging procedures play a vital role in confirming a brain tumour as per Dr Mah.According to him, Magnetic Resonance Imaging (MRI) procedures are generally preferred due to more detailed images of the brain that can better distinguish between normal and abnormal tissues, simultaneously providing further information on the severity of the brain tumor if it is regarded as one.This clarity is especially essential in determining the tumour’s size, location, and type, all of which shape the treatment plan.What causes brain tumours?Many brain tumours don’t actually start in the brain.“Cancers such as lung, breast, colon, and melanoma are most likely to metastasise to the brain, and are commonly seen,” Dr Gerard shared.According to recorded facts, up to 40 per cent of lung cancer patients are likely to develop secondary brain tumours at some point.While the exact causes remain unclear, genetics and environmental factors often play a role.“Genetics play a significant role in determining a person’s overall susceptibility to developing brain tumours.“For individuals with genetic risk factors, lifestyle and environmental exposures could trigger tumour growth over time,” Dr Gerard said.

SMCV consultant neurosurgeons Dr Mah Jon Kooi (left) and Gerard Arvind Martin (right). Photo courtesy of Sunway Medical Centre Velocity

Treatment options that offer hopeOnce diagnosed, treatment depends on the tumour’s nature. For operable tumours, surgery remains the most effective choice.In many cases, a craniotomy—where a part of the skull is temporarily removed—allows surgeons to access and remove the tumour.For tumours located near critical brain regions, an awake craniotomy may be performed instead.This procedure involves keeping the patient awake at key moments to monitor brain functions like speech and movement, ensuring these abilities remain intact.When surgery isn't an option due to tumour size or location, non-invasive methods such as radiosurgery—which uses high-dose targeted radiation—can be considered.Despite its name, radiosurgery doesn’t involve any cuts and often requires only a single session.Another approach used at SMCV involves the use of endoscopes, particularly effective for tumours at the skull base or pituitary region.“We insert a thin, rigid endoscope through the nasal passage to access the tumour. This enables precise removal with minimal disruption to surrounding tissues,” Dr Gerard explained.In a separate instance, Dr Gerard recalled a particularly inspiring case about a lung cancer patient who had developed a secondary tumour in the cerebellum that blocked cerebrospinal fluid flow, leading to dangerous brain pressure.As he shared, instead of using a permanent shunt, SMCV’s surgical team performed an endoscopic third ventriculostomy to restore fluid circulation and remove the tumour—all in a single session.The patient fortunately recovered well and proceeded to the next stage of cancer treatment successfully.The first step to recoveryBrain tumours may be rare, but their symptoms are often real and subtle and persistent headaches, memory loss, or personality shifts shouldn’t be dismissed.As such, early detection not only improves survival chances but also opens the door to advanced, minimally invasive treatments.“It’s about recognising what’s unusual and acting fast. Patients often delay seeking help, but modern medicine gives us powerful tools to manage even complex brain tumours,” Dr Mah emphasised.On the bright side, a brain tumour diagnosis is no longer a sentence—it’s the beginning of a treatment journey that, with proper guidance and timely care, can lead to meaningful recovery and a better quality of life.

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How brain tumours creep up on you

Though brain tumours account for only 1.6 per cent of new cancer cases in Malaysia as of 2020, their consequences are far from minor.

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