New clinical guidelines published last week by the National Institute for Clinical Excellence (NICE) on the diagnosis and treatment of brain tumour. 

The guidelines, which cover both primary and secondary or metastatic brain tumours in patients over 16,  highlights the importance of early diagnosis (including through use of MR perfusion, MR spectroscopy and early biopsies) and prompt treatment to help improve patient outcomes and survival rates. 

What is a brain tumour?

A brain tumour is an area of abnormal or uncontrolled cell growth within the brain or related structures. There are over 130 types of brain tumour: some are benign whilst others are malignant or cancerous. 

Brain tumours can develop within the brain or related structures (primary tumours) or  may arise occur when cancer spreads from them brain from elsewhere in the body (secondary brain tumours or brain metastases).

The new guidelines focus on the diagnosis and treatment of 3 forms of brain tumour: 

(i) Gliomas - brain tumours starting in the glial cells (such as astrocytomas, oligodendrogliomas and ependymomas). Glial cells are cells in the brain and central nervous systems which surround neurons to support them and insulate between them; 

(ii) Meningiomas - brain tumours in the membranes of the brain and spinal cord, usually found in the cerebrum and cerebellum;  and 

(iii) Brain metastases - these secondary tumours can develop when cancer cells break away from primary tumours in other parts of the body and travel through the bloodstream to lodge and grow in the brain. 

Symptoms

The signs and symptoms of a brain tumour or tumours will vary depending on the size and nature of the tumour and the area of the brain that is affected. However, common symptoms may include:

  • Severe and or persistent headaches
  • Sickness and nausea
  • Drowsiness
  • Vision problems/ visual disturbances
  • Speech difficulties or aphasia
  • Memory or cognitive problems
  • Behavioural or personality changes
  • Fits or seizures 
  • Weakness or paralysis

Further information on brain tumour symptoms can be found here: https://www.cancerresearchuk.org/about-cancer/brain-tumours/symptoms.

Treatment 

The main form of treatment, particularly for primary brain tumours is surgery to remove as many of the abnormal cells as possible. This may be combined with radiotherapy and or chemotherapy to shrink the area of tumour and to reduce the likelihood of regrowth.

Radiotherapy may target the area where the tumour was removed, the tumour or tumour site/bed and a surrounding margin of brain tissue, or to the whole brain. The guidelines recommend maximising the use of localised radiotherapy where possible, but in cases of multiple brain metastases whole brain radiotherapy may be indicated.  

Research into the effectiveness of treatments and the quality of care is ongoing and the guidelines also make specific recommendations in this area. 

Unfortunately, at present only around 15% of patients with malignant brain tumours are likely to survive for 5 years or more. However, individual survival rates depends on a number of factors including overall health, the type of cancer, treatment and level of fitness. Early detection and treatment can significantly improve the prognosis in specific cases. 

Brain Tumour Claims

A clinical negligence claim may arise where a delay in the diagnosis or treatment of a brain tumour is likely to have impacted significantly on the outcome for an individual patient (therefore causing an injury). 

Often this may be due to failure on the part of a GP or another doctor to recognise potential symptoms and refer the patient for appropriate investigations or diagnostic tests such as blood tests, an MRI scan or brain tumour biopsy. However, there can also be a claim when the tests are performed, but the results are misinterpreted or simply not acted on. In the case of a patient who is or has previously been treated for cancer there may also be delays or failures due to substandard monitoring or reviews.

If you or a member of your family have suffered a brain tumour and you are concerned with the standard of treatment received, then our specialist medical negligence solicitors may be able to help. 

Please contact Catherine Bell (catherine.bell@freeths.co.uk or 01865 781 140) or speak to another member of our national team:-

Carolyn Lowe, Partner (Oxford/Milton Keynes) on 0186 578 1019 or carolyn.lowe@freeths.co.uk

Jane Williams, Partner (Leicester) on 0845 272 5724 or jane.williams@freeths.co.uk

Siobhan Genever, Director (Nottingham) on 0845 271 6793 or siobhan.genever@freeths.co.uk

Karen Reynolds, Partner (Derby/Stoke) on 0845 272 5677 or karen.reynolds@freeths.co.uk

For further information please also visit our website at: http://www.freeths.co.uk/legal-services/individuals/clinical-negligence/

Catherine Bell is clinical negligence associate in the Oxford office and a specialist in brain injury claims.