Grading and prognosis for brain cancer

The grade of a tumour describes how quickly it is growing and how it is likely to behave. A specialist doctor called a pathologist examines a sample of tumour tissue under a microscope and looks for several features to work out the grade.

Brain and spinal cord tumours are usually given a grade on a scale of 1 to 4 (often recorded in Roman numerals as I−IV). Grades 1 and 2 are the slowest-growing tumours. They are considered low-grade and are sometimes called benign. Grades 3 and 4 are fast-growing tumours. They are considered high-grade and often called malignant.

With other types of cancer, doctors give the cancer a stage to describe the extent of the cancer in the body. Primary brain and spinal cord tumours are not staged in this way as most don’t spread to other parts of the body.

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Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease. There are many factors that may affect your prognosis. These include the tumour type, location, grade and genetic makeup; your age, general health and family history; and how well the tumour responds to treatment.

Both low-grade and high-grade tumours can be life-threatening, but the prognosis may be better if the tumour is low-grade, or if the surgeon is able to remove the entire tumour.

Some brain or spinal cord tumours, particularly gliomas, can come back (recur) and may change to a higher grade (progress). In this case, treatments such as surgery, radiation therapy or chemotherapy may be used to control the growth of the tumour for as long as possible, relieve symptoms and maintain quality of life.

This information was last reviewed in April 2018
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