If your brain tumour comes back

What happens if your brain tumour comes back

A brain tumour that does not go away with treatment is called a refractory brain tumour. A recurrent brain tumour is one that comes back after treatment.

It can be a great shock to find out that your brain tumour has come back. You might feel upset, frightened and confused. Some people find that it helps to know what to expect.

You might need further tests and scans to find out more about the tumour. This also helps your doctors decide what your treatment options are.

Treatment may help to:

• keep the cancer under control for a while

• help to control the symptoms

Symptoms

You are likely to have similar symptoms to when you were diagnosed if your brain tumour comes back. Symptoms might include:

• headaches

• seizures (fits)

• feeling or being sick

• drowsiness or loss of consciousness

• problems with your eyesight, such as blurred or double vision

• feeling very tired (fatigue)

• changes in your mood and behaviour

Find out more about the symptoms of brain tumours

Tests

The tests you might have include:

• MRI scan or CT scan

• blood test

• a neurological examination - your doctor checks how well your brain and nervous system are working

Read about these tests

Deciding on treatment

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). If your tumour comes back, you may be able to have further treatment.

The treatment you have depends on:

• your type of brain tumour

• where the tumour is

• the treatment you have already had and when you last had it

• your general health

Your doctor will discuss the aim of your treatment with you, including the benefits and possible side effects. For some people, the aim is to control the tumour and help relieve symptoms. This is called palliative treatment. Palliative treatment helps you to be as comfortable as possible for as long as possible.

Your doctor will give you more information about these treatments if they are suitable for you.

Some hospitals have specialist brain tumour nurses. They go to the MDT meetings. You usually see the nurses more regularly than your cancer specialist. They can answer your questions and support you and your family.

Treatment

Treatment for a brain tumour that has come back might include:

• surgery

• radiotherapy

• chemotherapy

• treatment to control your symptoms

• clinical trials

Surgery

It might be possible for you to have surgery again to try to remove as much as possible of the tumour. But surgery doesn’t help everyone with a recurrent brain tumour. Doctors may decide that more surgery is not the best option for you if:

• there are several new brain tumours

• the tumour is growing quite quickly or is likely to grow back very quickly afterwards

There are different types of surgery that you can have. For example, you might have a craniotomy. This is a common type of surgery for brain tumours.

Find out more about craniotomy and other types of brain tumour surgery

Radiotherapy

Radiotherapy uses high energy x-rays to destroy cancer cells. Your doctor will talk to you about whether radiotherapy is an option for you. You might have it if:​

• you haven’t had radiotherapy to the brain before, or you had it some time ago

• the tumour is in a different part of the brain

You usually have a type of radiotherapy called external beam radiotherapy. External beam radiotherapy destroys cancer cells by using radiation aimed at the cancer from a machine.

You may also be able to have stereotactic radiotherapy. It targets the radiation very precisely at the tumour. You are most likely to have it for small tumours.

Read about external beam and stereotactic radiotherapy

Chemotherapy

Chemotherapy uses cytotoxic drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream. It is a common treatment for some brain tumours that have come back.

When you have more chemotherapy after a tumour comes back it is often called second line treatment. If the tumour comes back again, you may have further chemotherapy. This can be called third line treatment.

The type of chemotherapy you have depends on the type of brain tumour and any chemotherapy you have had before.

Chemotherapy drugs for brain tumours that come back include:

• temozolomide

• lomustine

• a combination of drugs called PCV (procarbazine, lomustine and vincristine)

• etoposide

• carboplatin

Find out more about chemotherapy for brain tumours

Drugs to control your symptoms

You might have medicines to help with the symptoms of a brain tumour. This includes:

• anti epileptic drugs to control seizures (fits)

• steroids to reduce the swelling inside your brain

• painkillers

These treatments won’t reduce the size of the tumour but can help you to feel better.

Read more about the treatments you might have to help control your symptoms

Clinical trials

Researchers want to improve treatments for people with a brain tumour. Talk to your doctor if you are interested in taking part in a clinical trial. They can check whether there is a suitable trial for you.

You can also search the Cancer Research UK clinical trials database for trials happening in the UK.

Find out more about the latest UK research into treatment for brain tumours

Support for you and your family

Finding out that your brain tumour has come back can be shocking and upsetting. Some people find that it helps to talk about how they are feeling. Family and friends can be very supportive. You can also speak to your doctor or specialist nurse. They will also let you know what support is available to help you cope.

Find out what you can do, who can help and how to cope with a brain or spinal cord tumour