The complications of malignant brain tumour can be severe, multifaceted, and life-altering. As these tumours develop within the central nervous system—one of the body’s most sensitive and vital areas—their effects can be widespread, even beyond the immediate site of the tumour. The complications stem not only from the tumour itself but also from the treatments used to control or eradicate it, including surgery, radiotherapy, and chemotherapy.
This section explores the main complications of malignant brain tumour. We group them into neurological, cognitive, physical, and emotional effects. We also highlight why a team approach is vital to handle each problem.
1. Increased Intracranial Pressure (ICP)
One of the most urgent and dangerous complications of malignant brain tumour is increased intracranial pressure. As the tumour grows, it takes up space inside the skull. This pressure can push on nearby brain tissues, cause fluid buildup, or even lead to brain herniation.
Common signs include:
- Severe, ongoing headaches
- Nausea and vomiting, especially in the morning
- Feeling very sleepy or loss of alertness
- Swelling of the optic nerve (papilledema)
- Changes in vision or double vision
Doctors often treat this emergency with corticosteroids to lower swelling. Sometimes, surgery such as draining fluid through a shunt or ventriculostomy is needed.
2. Neurological Deficits from Malignant Brain Tumour
Malignant brain tumour complications often cause neurological problems. Depending on where the tumour grows and its size, brain functions can be disrupted badly.
Symptoms may include:
- Weakness or paralysis on one side of the body (hemiparesis or hemiplegia)
- Seizures, especially if the tumour is near the cerebral cortex
- Trouble with balance and coordination
- Numbness or tingling sensations
- Difficulty with speech or language (aphasia)
- Loss of part of the visual field
These problems may appear slowly or suddenly. Physical, occupational, and speech therapy are usually part of recovery plans.
3. Cognitive Decline
Cognitive decline is one of the hardest complications of malignant brain tumour for patients and families. The tumour and treatments like radiotherapy and chemotherapy can harm brain function over time.
Common signs include:
- Trouble remembering, especially short-term memory
- Difficulty focusing or understanding information
- Confusion or disorientation
- Trouble with planning, reasoning, or multitasking
These issues may be mild or severe. They often affect independence, work, and relationships. Doctors use special tests to measure how bad the problems are and to plan help.
4. Emotional and Psychological Challenges
Mental health problems often go hand-in-hand with the physical impact of malignant brain tumour. Depression, anxiety, and mood swings are common. These can happen because of the tumour’s location (especially if it affects the frontal lobe), worries about the future, or side effects of treatment.
Patients may feel:
- Anxiety about disease progress
- Depression from physical weakness or tiredness
- Changes in personality, like irritability or lack of interest
- Sudden mood changes
Counselling, psychiatric care, and support groups help patients and families handle these feelings.
5. Treatment-Related Complications of Malignant Brain Tumour
Treatments used to fight malignant brain tumour can cause their own problems.
a. Surgical Complications:
- Infection (such as meningitis or wound infections)
- Bleeding in the brain
- Swelling or damage to healthy brain areas
- Seizures after surgery
b. Radiotherapy Complications:
- Fatigue and tiredness
- Skin irritation where treatment was done
- Death of some brain tissue (radiation necrosis)
- Long-term damage to brain white matter, causing thinking problems
c. Chemotherapy Complications:
- Weakened immune system and higher infection risk
- Nausea and vomiting
- Hair loss
- Bone marrow problems
- Damage to organs like liver and kidneys
Doctors watch for side effects closely and treat them quickly to keep quality of life as good as possible.
6. Endocrine Dysfunction
Malignant brain tumours can press on the pituitary gland or hypothalamus. This pressure can cause hormone problems that lead to serious health issues.
Problems might include:
- Low adrenal gland function
- Low thyroid hormone (hypothyroidism)
- Lack of growth hormone
- Infertility
- Diabetes insipidus (a rare condition causing excessive thirst and urination)
Patients need hormone tests and often lifelong hormone replacement to avoid other health troubles.
7. Seizure Disorders
Seizures are both a symptom and a complication of many malignant brain tumours. They may continue even after treatment. Patients often need long-term medicines called anticonvulsants.
Types of seizures include:
- Focal (partial) seizures
- Generalised tonic-clonic seizures (whole-body shaking)
- Status epilepticus (a life-threatening emergency)
Seizures can lower quality of life and make driving or working unsafe. Regular doctor visits and sometimes surgery help control seizures.
8. Functional Decline and Disability
Neurological, physical, and cognitive problems together often cause patients to lose independence. This is a tough complication of malignant brain tumour, especially if the disease gets worse or comes back.
Common effects include:
- Losing the ability to walk or move alone
- Needing help with daily activities
- Trouble swallowing (dysphagia)
- Loss of bladder or bowel control (incontinence)
Early rehab, assistive tools, and caregiver help can slow down decline and keep independence longer.
9. Recurrence and Progression of Malignant Brain Tumour
Even after strong treatment, malignant brain tumours—especially glioblastomas—often come back. This recurrence is one of the most serious complications of malignant brain tumour.
Recurrence can:
- Cause new neurological problems
- Need more surgery or radiation, with limited results
- Shorten life expectancy
Doctors use regular MRI scans to find tumour return early. Treatment options may become fewer in later stages.
10. Terminal Stage and Palliative Needs
In late or terminal stages, care focuses on comfort and quality of life. This means:
- Managing pain and other symptoms
- Providing mental and spiritual support
- Planning for end-of-life care
- Using hospice services
The final stage may include coma, loss of brainstem functions, and failure of multiple organs. Compassionate care is crucial for patients and families during this time.
Summary
The complications of malignant brain tumour affect all parts of a patient’s life—from brain and body to emotions and social life. They come from tumour growth, treatment side effects, or the tumour’s brain location. While many complications cannot be reversed, spotting them early and using a team of specialists can ease their impact. A team made up of cancer doctors, neurologists, rehab therapists, palliative care workers, and mental health experts helps improve results and keeps dignity for the patient throughout their journey.
