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Exploring Brain Tumours and Brain Tumour Misdiagnosis

20/01/2021

Author: Bengi Karakus

Brain Injury, Clinical Negligence

Exploring Brain Tumours and Brain Tumour Misdiagnosis

Exploring Brain Tumours and Brain Tumour Misdiagnosis

Brain tumours are the biggest cancer killer of children and adults under 40. On average, they reduce life expectancy by 20 years.

Brain tumours are graded according to how fast they grow and how likely they are to grow back after treatment.

There are two main types of brain tumours:

  • Non-cancerous (benign) brain tumours – these are low grade (Grade 1 or 2) which means they grow slowly and are less likely to return after treatment.
  • Cancerous (malignant) brain tumours are high grade (Grade 3 or 4) and either start in the brain (primary tumours) or spread into the brain from elsewhere (secondary tumours) and they are more likely to grow back after treatment.

Types of Brain Tumours

There are over 130 different types of brain tumours. Tumours can start in any part of the brain or spinal cord. They are usually named after the type of cell they develop from.

The most common type of brain tumours in adults is called glioblastoma multiforme (GBM).

Tumours that start in the brain are called primary brain tumours. Cancer that has spread to the brain from somewhere else in the body is called secondary brain cancer or brain metastases.

Brain Tumour Symptoms in Children

Around 500 children and young people in the UK are diagnosed with a brain tumour each year.

Symptoms:

  • headaches
  • changes in vision
  • nausea and vomiting
  • balance problems
  • seizures
  • behaviour changes
  • abnormal head position
  • delayed puberty
  • abnormal growth
  • excessive thirst
  • reduced consciousness

Brain Tumour Symptoms in Adults

Almost 11,000 people in the UK are diagnosed with a brain tumour each year.

Symptoms:

  • headaches
  • changes in vision
  • seizures
  • nausea and dizziness
  • tiredness
  • loss of taste and smell

How is a Brain Tumour Diagnosed?

If your doctor suspects you have a brain tumour, they will refer you to a specialist, such as a neurologist. A neurologist is a specialist in brain and nerve disorders. If they suspect a child has a brain tumour, they will refer them to a paediatrician.

Your doctor may want to carry out examinations which may include looking to the back of your eyes with an ophthalmoscope to check for swelling, which can be a sign of raised pressure in the brain. They will usually also check other things like balance, coordination, sensation and reflexes.

You may be referred for a brain scan for further assessments and tests if you experience the above symptoms.

CT or MRI scan

Most children and young people will have a CT or an MRI scan which will look in detail at the inside of the brain.

A CT scan is quick and often useful as a first-line investigation, but it does not give as detailed picture as an MRI. As it uses x-rays, usage of it being kept to a minimum is important.

An MRI scan uses no x-rays and gives more detailed pictures but it takes much longer. The machines can be noisy and often younger children cannot lie still long enough to get proper images. It may sometimes be necessary for the child to be given an anaesthetic for this scan.

Ordinary x-rays are not usually helpful for brain tumours.

Blood Tests

These are usually done to make sure it is safe to do an operation and can also be used to help diagnose certain types of tumour.

Biopsy

By removing a small part of the tumour (biopsy) to find out exactly what type of tumour it is, it will involve going into hospital for an operation under general anaesthetic. The piece of tumour will be removed and examined under a microscope by a specialist doctor called a pathologist.

A biopsy may not always be carried out and it may be better to remove the whole tumour in one operation.

Treating Brain Tumours

Treatment Methods:

Steroids: To help reduce swelling around the tumour.

Medicines: To help with other symptoms of brain tumours such as anti-epileptic medicines for seizures and painkillers for headaches.

Surgery: To remove brain tumours and remove as much abnormal tissue as safely as possible. You might have surgery to remove the whole tumour, remove part of the tumour, take a biopsy or to drain fluid on your brain (hydrocephalus).

Radiotherapy: It is not always possible to remove all of a tumour so further treatment with radiotherapy may be needed to treat any abnormal cells left behind. Radiotherapy uses high energy x-rays to treat brain and spinal cord tumours.

Chemotherapy: Similarly, chemotherapy may be needed to treat any abnormal cells left behind which could not be previously removed by surgery. Chemotherapy uses anti-cancer drugs to destroy brain tumour cells. The drugs circulate throughout your body in the bloodstream. You might have chemotherapy after surgery to lower the chances of the tumour coming back or if your brain tumour comes back.

The treatment you have will depend on:

  • Your type of brain tumour
  • Where the tumour is
  • Whether it has spread
  • How abnormal the cells look under microscope (grade)
  • Whether tumour cells have certain changes or mutations

Your general health and level of fitness

Brain Tumour Misdiagnosis

Brain tumours are most commonly misdiagnosed because a doctor may fail to order further testing based on the symptoms presented by a patient. The symptoms of brain tumours often mimic symptoms of other common diseases and, as such, a doctor may diagnose and prescribe treatment for another ailment.

Brain tumour misdiagnosis can commonly be diagnosed as the following diseases, given the similarity across symptoms a patient suffers with:

  • Alzheimer’s disease
  • Encephalitis
  • Headaches or migraines
  • Meningitis
  • Lyme disease
  • Multiple sclerosis
  • Subdual hematoma

In addition to a CT scan, MRI scan and EEG, further definitive tests may be ordered such as a myelogram, PET scan, x-ray of the skull, spinal tap or angiogram. Medical negligence would occur if, following such tests, the physician misinterprets the results or fails to order the test(s) altogether.

The initial step you should take in such matters of medical malpractice or medical negligence is to obtain a second opinion from another physician. If proper diagnosis is not made on a timely basis and the condition that has developed was preventable by doctors/ nurses/ surgeons due to their misinterpretation, then you may be entitled to a claim for compensation for the negligence caused by the medical staff. Such a claim may cover medical bills, lost wages and pain and suffering. In addition, filing a case can help prevent future tragedies from occurring.

Contact Hatch Brenner Partner Sara Westwood if you think you might have a claim for medical negligence relating to brain tumour misdiagnosis via sarawestwood@hatchbrenner.co.uk or call 01603 660 811.

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