Is India witnessing a silent surge in brain tumour cases? Doctors urge attention to early warning signs

When people think of brain tumours, they imagine something dramatic. Sudden seizures. Loss of speech. Severe neurological problems that are impossible to ignore.But that’s not how it usually begins.“Brain tumors are often perceived as rare, dramatic illnesses that announce themselves with obvious neurological problems. In reality, early symptoms are often subtle, gradual, and easy to dismiss,” says Dr. (Prof.) I. C. Premsagar, Chief, Neuro & Spine Oncology services, RGCIRC (Rajiv Gandhi Cancer Institute & Research Centre).And that subtlety is exactly what makes them dangerous.A slight change in headaches. A bit of confusion. Maybe some irritability or trouble focusing. Things most people would blame on stress, poor sleep, or a busy life. The brain controls almost everything we do, so even small disruptions can show up in ways that don’t immediately seem serious.“As the brain controls nearly every function of the body, even small changes caused by a growing tumor can appear vague or unrelated,” Dr Premsagar explains.So people wait. They adjust. They normalise what’s happening.And that delay can cost time that’s hard to get back.

Are cases really rising, or are we just detecting more?

Globally, brain and central nervous system tumours are not the most common cancers, but they are among the most complex.“Although brain and central nervous system tumours represent a smaller proportion of cancers, they remain among the most challenging to treat. Globally, more than 3,22,000 new cases of brain and CNS tumours are diagnosed every year,” says Dr Premsagar.In India, the broader cancer burden is already high, with over 1.4 million new cases reported annually. And within that, brain tumours are quietly becoming more visible, says the doctor.Part of this is better diagnosis. Scans are more accessible now. More cases are being picked up earlier than before. But that’s only one side of the story.“Some of the epidemiologists feel that the number of cases of brain tumour may double by 2030,” says Dr (Brig) Anil Kumar Dhar, Clinical Director & Head – Medical Oncology, Marengo Asia Hospitals, Gurugram. And that projection is backed by emerging research trends. A recent study published in Nature (Scientific Reports, 2024) also points toward a steady global increase in brain and CNS tumour burden, driven by a mix of ageing populations, environmental factors, and improved detection. “We estimated that the number of newly diagnosed cases of brain and CNS cancers in Asia will increase by 39.30%, from 166,925 in 2020 to 232,000 cases in 2040,” the researchers have said.

But there’s another layer, especially in India.“There has been a surge of brain tumours which remain unnoticed and this surge has been observed in childhood brain tumours which is disturbing,” Dr Dhar notes.At the same time, underreporting remains a real issue.“The flip side of the story is that these statistics may not be a true reflection of the incidence of brain tumours as most of the cases from rural areas remain unreported.”So the numbers we see may only be part of the picture.

Why brain tumours are so easy to miss

One of the biggest challenges with brain tumours isn’t just treatment. It’s recognition.“One of the biggest challenges with brain tumors is that symptoms develop slowly. People adapt to changes, blame lifestyle factors, or delay seeking medical advice,” says Dr Premsagar.And sometimes, fear plays a role too.“Fear of serious diagnosis also plays a role, leading many to wait until symptoms become intolerable.”What makes it harder is how the symptoms overlap with everyday issues.A headache that feels slightly different but not severe. Nausea without a clear reason. Changes in vision that come and go. These don’t immediately point to something serious.But there are patterns doctors watch for.Persistent headaches that don’t behave like your usual ones. Vomiting that isn’t linked to food or infection. Vision or hearing changes that don’t resolve. And seizures in someone with no prior history.Then there are the changes that others notice first.“Brain tumors can affect behaviour, mood, and thinking. Family members often notice changes before the individual does,” Dr Premsagar says.Memory lapses. Difficulty concentrating. Unusual irritability. Even personality changes. These can easily be mistaken for stress or burnout.“As these symptoms can mimic stress, anxiety, or aging, they are often overlooked.”But when they persist or worsen without a clear reason, they need attention.

What could be driving the increase?

There isn’t a single cause behind brain tumours. It’s a mix of factors, some understood, some still being studied.Dr Dhar points to a few key contributors. “Factors responsible for increase in incidence of Brain tumours: early diagnosis by means of scans, pollution and exposure to toxins, long-term mobile phone usage with radiation exposure particularly in the young population.”Not all of these are fully established causes, but they are areas of concern and ongoing research.There’s also a broader lifestyle shift. More screen time. Less movement. Greater exposure to environmental pollutants. These changes don’t directly translate into tumours overnight, but they shape long-term health risks.And then there’s the simple fact that people are living longer. With age, the risk of many cancers, including brain tumours, increases.

Not all brain tumours are the same

Another reason this conversation gets complicated is that “brain tumour” isn’t a single disease.“Brain tumours are a divergent group of tumours which can be classified into two broad groups,” explains Dr Dhar.“Primary brain tumours which arise from different neuronal cells” and “Metastatic brain tumour which originate from cells outside the brain and metastasize to the brain.”Each behaves differently. Some are benign. Some are aggressive. Some grow slowly and can be managed for years. Others require urgent, intensive treatment.“In India the incidence of brain tumour is approximately 10 per 100000 population as against 30 to 35 per 100000 in the United states of America. Out of these 30 to 35 % are malignant and the rest are benign,” he says.So a diagnosis doesn’t always mean the same outcome. But it always requires timely evaluation.

Why early detection changes everything

With brain tumours, timing is critical.“Any persistent, progressive, or unexplained neurological symptom deserves attention. While most symptoms do not turn out to be cancer, early evaluation ensures that serious conditions are ruled out or detected in time,” says Dr Premsagar.Because once symptoms become severe, treatment options can become limited.“Unfortunately, this delay can limit treatment options and affect outcomes.”On the other hand, early detection can make a significant difference—not just in survival, but in quality of life.“Early detection has higher chances of cure and good quality of life.”And that’s really the shift doctors are trying to push. Not panic, but awareness. Paying attention to what feels off, even if it seems small.Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr. (Prof.) I. C. Premsagar, Chief, Neuro & Spine Oncology services, RGCIRC (Rajiv Gandhi Cancer Institute & Research Centre)Dr (Brig) Anil Kumar Dhar, Clinical Director & Head – Medical Oncology, Marengo Asia Hospitals, GurugramInputs were used to explain the silent surge of brain tumor in India and what are the early signs of the disease that could help people seek medical assistance on time.