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The grading and prognosis of brain cancer

Grading tumours

The cancer will also be given a grade based on how the cancer cells look compared to normal cells. This suggests how quickly the cancer may grow. The grading system most commonly used for brain tumours is from the World Health Organization. Brain and spinal cord tumours are usually given a grade from 1 to 4.

Grade 1 – These tumours are low grade and grow slowly.

Grade 2 – These tumours are low grade and usually grow slowly. They are more likely to come back after treatment and can develop into a higher grade tumour.

Grades 3 and 4 – These tumours are high grade and grow faster, and are called malignant. They can spread to other parts of the brain and tend to recur, often as a higher grade.

Other types of cancer are given 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.


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. Several factors may affect your prognosis. These include the tumour type, location, grade and genetic make-up; 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 (progress) and may change (transform) into a higher grade tumour. 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.

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This information is reviewed by

This information was last reviewed in May 2020 by the following expert content reviewers: A/Prof Andrew Davidson, Neurosurgeon, Macquarie University Hospital, NSW; Dr Lucy Gately, Medical Oncologist, Oncology Clinics Victoria, and Walter and Eliza Hall Institute of Medical Research, VIC; Melissa Harrison, Allied Health Manager and Senior Neurological Physiotherapist, Advance Rehab Centre, NSW; Scott Jones, Consumer; Anne King, Neurology Cancer Nurse Coordinator, Health Department, WA; Dr Toni Lindsay, Senior Clinical Psychologist and Allied Health Manager, Chris O’Brien Lifehouse, NSW; Elissa McVey, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Claire Phillips, Deputy Director, Radiation Oncology, Peter MacCallum Cancer Centre, VIC.