Should I see a brain tumour specialist?
This page tells you about seeing a brain tumour specialist. You can find information about
Should I see a brain tumour specialist?
Brain tumours can cause symptoms similar to many other less serious conditions. So it can be very difficult for GPs to decide who may have a brain tumour and who has something more minor. Many people worry that a constant headache might mean they have a brain tumour. In fact, fewer than 1 in every 100 people suffering from headaches has a brain tumour. So it would not be right for doctors to refer everyone with a headache urgently to a specialist.
Guidelines for urgent referral
The National Institute for Health and Care Excellence (NICE) has produced guidelines to help GPs decide who to refer to a specialist. They say that you should have an urgent referral to a specialist (within 2 weeks) if you have
- Headaches that occur in the early morning or have started recently and you also have other symptoms, such as vomiting, drowsiness, blackouts, or changes in personality or memory
- New nervous system symptoms that are getting worse
- One or more seizures (fits) – either affecting the whole body, or just one part of the body
- Changes in behaviour, mental abilities or personality that are getting worse quite quickly
If you are still worried
If you are concerned that your GP is not taking your symptoms as seriously as they should, you could print this page and ask your GP to talk it through with you.
You can view and print the quick guides for all the pages in the About brain tumours section.
Brain tumours can cause symptoms similar to many other less serious conditions. So it can be very difficult for GPs to decide who may have a brain tumour and who may have something much more minor that will go away on its own.
With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment. If GPs referred everyone who came to see them to a specialist immediately, the health system would get jammed and people needing urgent appointments wouldn't be able to get them. But there are particular symptoms that mean your GP should refer you to a specialist straight away.
Many people worry that a constant headache might mean they have a brain tumour. It is important to know that headaches are very common in the general population. A headache on its own is very, very rarely due to a brain tumour. In fact, national guidelines point out that fewer than 1 in every 100 people suffering from headaches has a brain tumour. So it would not be right for doctors to refer everyone with a headache urgently to a specialist.
The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs in the UK. The guidelines help GPs to decide which patients need to be seen urgently by a specialist.
According to the NICE guidelines you should ideally get an appointment within 2 weeks for an urgent referral. The symptoms that NICE say need urgent referral are
- Headaches that occur in the early morning or have started recently and are accompanied by other symptoms, such as vomiting, drowsiness, blackouts, or changes in personality or memory
- New nervous system symptoms that are getting worse, such as fits (seizures), mental changes, deafness on one side, double vision, weakness of an arm or leg, or loss of feeling in part of the body
- A recent seizure (fit) or fits – this could be a fit affecting the whole body, or affecting just one part of the body, such as jerking or twitching in a hand, arm or leg
- Changes in your behaviour, mental abilities or personality that are worsening quite quickly
The guidelines say that your GP should examine you if you have any nervous system symptoms, headaches or fits (seizures). This will include looking into the back of your eyes with a special light. This will show if there is any sign of swelling at the back of the eye. This swelling is called papilloedema. It is a sign of raised pressure inside your skull.
If you have personality changes or changes in your mental abilities, your GP is likely to want to talk to someone who knows you well and can confirm this. This is most likely to be a close relative or partner.
The guidelines suggest that your GP should consider referring you urgently to a specialist if you have started to have headaches recently (but have had them for at least a month) and they are not migraines. But this is only if you have other symptoms that suggest you may have increased pressure in your head (raised intracranial pressure). Other symptoms include
- Being sick
- Being woken by a headache
- A headache that gets worse or better depending on your position.
If you have continuing headaches that do not come on with other symptoms, your GP may think about discussing your case with a specialist or making a non urgent referral for you. NICE have included this because headaches can often be part of a chronic condition, such as depression, or caused by stress.
NICE are advising GPs to use their judgement. If you have been having the same symptoms on and off for years, have had them investigated, and have been found not to have cancer, your GP should not be expected to refer you as an urgent case each time your symptoms come back.
If, after examining you, your GP thinks it necessary, they may arrange for you to have tests. They may refer you to a brain specialist (neurologist) to discuss your symptoms with them. If your test results suggest a brain tumour, a neuroscience multidisciplinary team will discuss your case. If you are drowsy, your GP should arrange for you to see a hospital specialist immediately.
If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you. Then you may be able to decide together whether you need to see a specialist and if so, how soon.
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