Do all brain tumours require surgery?

The word "tumour" is frightening, but many brain tumours are benign, slow-growing, and can be safely watched. A small meningioma found on a scan done for another reason may be observed for years without any intervention.

Small pituitary tumours are often managed with medication that shrinks them, without any operation.

Metastases from cancer elsewhere are often treated with stereotactic radiosurgery rather than open surgery, particularly if there are multiple lesions or the patient is not fit for a craniotomy.

Surgery is definitely required when a tumour is causing pressure symptoms, when it is growing on serial scans, when a definitive tissue diagnosis is needed to guide treatment, or when the type and location make surgery the clear best option.

If you have been told you have a brain tumour, the next step is not automatically an operation. It is a careful conversation about type, size, location, symptoms and options — and often a multidisciplinary discussion before any decision is finalised.