Patients who are eventually diagnosed with a brain tumor often experience a frustratingly long journey to get to that point. New research highlights a recurring pattern of missed opportunities for earlier diagnosis, with both patients and general practitioners frequently dismissing early and subtle symptoms. This delay can be problematic, as brain tumors that are not detected early may require more invasive treatment. The challenge lies in the fact that the initial signs of a brain tumor can be vague and easily mistaken for more common, less serious conditions.
The symptoms of a brain tumor can overlap with everyday experiences such as stress, fatigue, or migraines. They can also mimic the symptoms of other common ailments like anxiety or sinus infections. This overlap makes it difficult for individuals and their doctors to recognize the potential severity of the issue, especially when appointments with a general practitioner can be difficult to obtain. As a result, many patients may wait until their symptoms become too persistent or severe to ignore. One study found that about 30% of brain tumor patients had three or more consultations with their doctor before being referred to a specialist.
Subtle changes in communication and cognition
Among the earliest and most easily dismissed symptoms are subtle changes in a person’s ability to communicate and think clearly. Some individuals later diagnosed with a brain tumor recall experiencing difficulty finding the right words in conversation, struggling to form complete sentences, or feeling a noticeable delay when trying to speak. This is not the occasional “tip-of-the-tongue” phenomenon that everyone experiences, but a more persistent and worsening problem. Another related symptom is a general feeling of “brain fog.” Patients have described this as a persistent mental cloudiness that makes it difficult to focus, think clearly, or remember things. These cognitive disturbances can be attributed to many other causes, from lack of sleep to stress, making them easy to rationalize away.
Memory problems and personality shifts
Memory complaints, in particular, have been associated with a longer time to diagnosis. This may be because memory loss is often thought of as a normal part of aging. However, when it is a symptom of a brain tumor, it is often a progressive issue. Personality changes are another significant, yet often misinterpreted, sign. A person with a brain tumor might become more withdrawn, moody, or inefficient at work. These behavioral shifts can be subtle at first and may be noticed by family members or colleagues before the individual themselves becomes fully aware of the change. Over a period of a few months, these changes can become more pronounced, with some individuals struggling with tasks they were once proficient at, such as managing their finances or playing a musical instrument.
Physical manifestations and sensory disturbances
Physical symptoms are also common, but like cognitive changes, they can be non-specific. Headaches are a well-known symptom of brain tumors, but they are also incredibly common in the general population. Doctors are more concerned about “headache plus,” meaning a headache accompanied by other symptoms. A worrisome headache is one that becomes progressively worse over a period of weeks or months, is present in the morning upon waking, or is associated with nausea and vomiting. Another physical sign that can be overlooked is numbness or tingling that seems to move around the body. Some patients have also reported changes in their hand-eye coordination, such as a noticeable decline in the neatness of their handwriting.
Vision and hearing abnormalities
Changes in vision are another early sign of a potential brain tumor. These can range from blurry or double vision to a loss of peripheral vision, which might cause a person to bump into things on one side. While many things can cause visual disturbances, sudden or unusual changes, especially when they occur with other neurological symptoms like dizziness or weakness on one side of the body, warrant medical attention. In some cases, a tumor can affect a person’s ability to interpret written words; they can see the words clearly, but the brain cannot make sense of them. Problems with hearing or smell can also occur. Studies have shown that patients who first present with visual or hearing problems have a significantly longer time to diagnosis, possibly because they are first seen by specialists like ophthalmologists or otolaryngologists who may not immediately suspect a brain tumor.
The challenge of non-specific symptoms
The wide variety of non-specific symptoms makes diagnosing a brain tumor a significant challenge for primary care physicians. The incidence of brain tumors is low, meaning that a general practitioner is unlikely to see many cases in their career. When a patient presents with a common complaint like a headache or fatigue, a brain tumor is not the most probable diagnosis. This is why it is so important for both patients and doctors to pay attention to the pattern of symptoms over time. A key indicator is the progressive nature of the symptoms. A headache that is different from any previous headache and that worsens over a few weeks is a red flag. Similarly, a gradual but steady decline in cognitive function or an increasing weakness on one side of the body should be taken seriously.
Importance of patient advocacy
Given the challenges of diagnosis, patients must be their own advocates. It is crucial to pay attention to your body and seek medical advice if something feels persistently “off” or out of character. While it is important not to panic, as these symptoms are more likely to be caused by something other than a brain tumor, it is also important not to dismiss them. One patient reported having symptoms for two or three months before seeking help. Keeping a log of symptoms, noting when they started and how they have changed over time, can be very helpful for your doctor. If you feel that your concerns are not being taken seriously, do not be afraid to seek a second opinion. Early diagnosis is important, and you know your body best.