Brain cancer: life expectancy with a brain tumour and prognosis

How long people live with a brain tumour: in brief

There is no single figure. Life expectancy depends on the type of tumour, its grade (from 1 to 4), its location, the patient's age, whether the tumour could be removed completely, and its molecular features. With a benign tumour that has been fully removed, most people live as long as they would have without it. For malignant tumours the range is enormous: from 12–18 months for glioblastoma to 10–15 years or more for grade 2 oligodendroglioma.

All the figures below are averages for large groups of patients. They do not predict what will happen to an individual: only the treating doctor, who sees the scans and the pathology, can give a prognosis for you or someone close to you.

Brain cancer: life expectancy with a malignant tumour

In everyday speech “brain cancer” means any malignant brain tumour. Most often these are gliomas, tumours of the cells that surround and support neurons. On average about one adult in three with a malignant brain tumour lives five years after diagnosis, but that figure covers very different diseases.

Grade 4 glioblastoma: how long people live

Glioblastoma is the most common and most aggressive brain tumour in adults. With standard treatment (surgery, then radiotherapy with temozolomide) average survival is 12–18 months. About 25–30% of patients live two years and about 5–7% live five years. The outlook is better in people under 50, after the fullest possible removal of the tumour and when the MGMT gene is methylated, which makes the tumour more sensitive to chemotherapy.

Brain glioma: life expectancy

Glioma is a whole group of tumours, and the outlook is determined by the grade. For grade 2 gliomas it is a matter of years and decades: on average 5–10 years for diffuse astrocytoma and 10–15 years or more for oligodendroglioma. For grade 3 gliomas the average is 2–5 years, longer for anaplastic oligodendroglioma. Favourable features are an IDH mutation and 1p/19q codeletion. More detail is in our article on brain glioma.

Astrocytoma

Astrocytoma occurs in all four grades. Pilocytic astrocytoma (grade 1) is more common in children and is usually cured by removal. Diffuse astrocytoma (grade 2) grows slowly but can become more malignant over time, so regular MRI scans are needed after treatment.

Ependymoma

Ependymoma develops from the cells lining the ventricles of the brain and the central canal of the spinal cord. The main prognostic factor is how completely it is removed. Five years or longer is reached by 85–90% of adults and about 75% of children; the figures are lower for anaplastic ependymoma and when the tumour has spread through the cerebrospinal fluid.

Benign brain tumour: life expectancy

Benign tumours grow slowly and do not invade brain tissue. They are dangerous because they press on neighbouring structures, so size and location matter.

• Meningioma. About 80% of meningiomas are benign. After complete removal most patients have a normal life expectancy; small meningiomas without symptoms are often only monitored. Atypical (grade 2) and anaplastic (grade 3) meningiomas recur noticeably more often.
• Pituitary adenoma. With timely treatment it has practically no effect on life expectancy.
• Acoustic neuroma (vestibular schwannoma). It grows slowly, and the outlook for life after surgery or radiosurgery is favourable.
• Brain haemangioma (cavernoma). This is not cancer but a vascular lesion. In itself it does not shorten life; the main risk is bleeding, which on average is about 1–2% a year and higher for brainstem cavernomas and after a previous bleed. Many cavernomas are only monitored.
• Haemangioblastoma. A benign grade 1 tumour; the outlook after complete removal is favourable.

Life expectancy with a brain tumour without treatment

Without treatment, average survival is about 3 months for glioblastoma and 2–3 months for CNS lymphoma. Untreated low-grade gliomas may cause almost no change in wellbeing for years, but they grow gradually and transform into more aggressive tumours. A small benign meningioma may not grow for decades, in which case follow-up MRI is enough. The decision to treat or to observe is made by a neurosurgeon on the basis of the scans, not of how the patient feels.

Life expectancy after removal of a brain tumour

After complete removal of a benign tumour most people return to normal life, and the disease does not affect how long they live. For gliomas surgery is the first step: the more tumour is removed, the longer the period without growth. After removal of a grade 2 glioma patients live on average 5–15 years; after removal of a glioblastoma followed by chemoradiotherapy, 12–18 months, and some patients considerably longer. After surgery a follow-up brain MRI is done every few months to detect recurrence in time.

Life expectancy by stage

Brain tumours rarely spread to other organs, so instead of the usual stages doctors use the grade, from 1 to 4. In everyday speech this is what people call the stage.

• Grade 1. Slow-growing tumours with clear borders. Removal usually leads to recovery.
• Grade 2. The tumour grows slowly but spreads into neighbouring brain tissue and can recur. On average 5 to 15 years of life.
• Grade 3. A malignant, actively growing tumour. Radiotherapy and chemotherapy are needed after surgery. On average 2–5 years.
• Grade 4. The most aggressive tumours, above all glioblastoma. On average 12–18 months with treatment.

Stage 4 brain cancer: what happens and how to ease it

At the final stage the tumour raises the pressure inside the skull and disrupts the brain's vital centres. In the last weeks the following usually increase:

• drowsiness: the person sleeps most of the day and is harder and harder to wake;
• weakness and inability to get up or care for oneself;
• confusion, problems with speech and memory;
• difficulty swallowing, refusing food and drink;
• headache, nausea, seizures.

In the last days the person most often stops responding to those around them and slips into a coma, and breathing becomes irregular. Death usually comes during sleep from pressure on the brainstem or from complications such as pneumonia or a blood clot. Palliative care makes it possible to go through this stage without suffering: dexamethasone reduces brain swelling and headache, anti-seizure medicines prevent fits, and painkillers and sedatives relieve pain and anxiety. Relatives should contact a palliative care service or hospice in advance.

How fast a brain tumour grows

The growth rate depends on the type of tumour:

• glioblastoma doubles in volume in about 7 weeks on average, so symptoms appear and worsen over weeks or months;
• grade 2 gliomas grow by about 4–5 mm in diameter a year and for years may show only as occasional seizures;
• meningiomas grow by 1–3 mm a year, and some do not grow at all;
• metastases from other cancers can enlarge within weeks.

What the outlook depends on

• the type of tumour and its grade;
• molecular markers: IDH mutation, MGMT methylation, 1p/19q codeletion;
• age and general condition; results are better in younger patients;
• the location of the tumour and whether it can be removed completely;
• the clinic's experience and access to modern treatments.

Symptoms of a brain tumour

• a headache that is worse in the morning and is not relieved by ordinary painkillers;
• nausea and vomiting unrelated to food;
• seizures that occur for the first time;
• weakness or numbness in an arm, a leg or one side of the body;
• worsening vision, hearing, speech, memory or coordination;
• changes in personality and behaviour.

Diagnosis and treatment

The main diagnostic method is contrast MRI of the brain; where needed it is supplemented by CT and EEG. The final diagnosis is based on histological and molecular examination of the tumour.

Treatment is provided by neurosurgery specialists. The main methods are:

• surgery: removal of the tumour with neuronavigation, intraoperative MRI and monitoring of brain function, including awake surgery;
• radiotherapy and radiosurgery: CyberKnife and Gamma Knife for small tumours and metastases;
• chemotherapy: temozolomide, the PCV regimen;
• targeted therapy and tumour treating fields (TTFields) for glioblastoma.

Frequently asked questions

Can brain cancer be cured?

Grade 1 tumours are most often cured by surgery. For grade 2–4 tumours treatment aims to hold the disease back for as long as possible and to preserve quality of life; in some patients remission lasts many years.

How long do people live with an inoperable brain tumour?

Inoperable does not mean untreatable: when surgery is not possible, radiosurgery, radiotherapy and chemotherapy are used. The time depends on the tumour type, from a few months for glioblastoma to many years for slow-growing tumours.

Can a benign brain tumour become malignant?

Meningiomas and pituitary adenomas rarely do. Grade 2 gliomas often progress to grade 3 and 4 over time, which is why they are never left without follow-up.

Where are brain tumours treated abroad?

At neurosurgical and oncology centres in Germany, Israel, Turkey, Spain and South Korea, where intraoperative MRI, radiosurgery and molecular diagnostics are available. Clinics can be chosen in the oncology section.

Still have questions? Send a request and Clinics Direct medical coordinators will help you choose a clinic and neurosurgeon, arrange a second opinion on your scans and find out the cost of treatment, free of charge.