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The grading and prognosis of brain cancer

Grading tumours

The tumour will be given a grade based on how the cells look compared to normal cells. The grade 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.

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.

Grade 1 – These tumours are low grade, slow growing and benign.

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, faster growing and malignant. They can spread to other parts of the brain and tend to come back after treatment.


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, including:

  • the tumour type, location, grade and genetic make-up
  • your age, general health and family history
  • whether the tumour has damaged the surrounding healthy brain tissue
  • how well the tumour responds to treatment.

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

Some brain or spinal cord tumours, particularly gliomas, can keep growing or come back. They may also 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 2022 by the following expert content reviewers: A/Prof Lindy Jeffree, Neurosurgeon, Royal Brisbane and Women’s Hospital, QLD; Emma Daly, Neuro-oncology Clinical Nurse Consultant, Cabrini Health, VIC; A/Prof Andrew Davidson, Neurosurgeon, Victorian Gamma Knife Service, Peter MacCallum Cancer Centre and Department of Neurosurgery, Royal Melbourne Hospital, VIC; Beth Doggett, Consumer; Kate Fernandez, 13 11 20 Consultant, Cancer Council SA; Melissa Harrison, Allied Health Manager and Senior Neurological Physiotherapist, Advance Rehab Centre, NSW; A/Prof Rosemary Harrup, Director, Cancer and Blood Services, Royal Hobart Hospital, TAS; A/Prof Eng-Siew Koh, Radiation Oncologist, Liverpool Cancer Therapy Centre, Liverpool Hospital and University of New South Wales, NSW; Andy Stokes,