Davina McCall has undergone brain surgery for a non-cancerous tumour, she revealed today.
In a video posted on Instagram, the television presenter explained that a private health check – that she expected to “ace” – showed she had a colloid cyst. “It needs to come out because if it grows, it would be bad,” the 57-year-old said.
Dr Helen Bulbeck, the founder and director of services and policy at the charity Brainstrust, has explained what the cyst is, the warning signs and how it is treated.
What is a colloid cyst?
A colloid cyst is a round, slow-growing, fluid-filled sack in the brain.
They are rare and only account for around 2 per cent of the 12,000 primary brain tumours that are diagnosed in the UK each year. Most cases are detected amongst adults in their 40s and 50s but the cysts are thought to be present from birth, Dr Bulbeck explains.
Colloid cysts are classed as a non-malignant tumour (also known as non-cancerous or benign). This means that the tumour is well-defined and encased. By contrast, a malignant tumour can spread and infiltrate other parts of the body.
However, even though colloid cysts are not cancerous, they put pressure on the brain.
What are the risks of colloid cysts?
Colloid cysts can, in severe cases, lead to life-threatening complications.
One is hydrocephalus, which is when cerebrospinal fluid (a fluid surrounding the brain) builds up, causing pressure to increase and potentially damage brain tissue. If this is not treated, it increases pressure in the brain which can lead to a coma and death.
Hydrocephalus typically causes symptoms such as headaches, vomiting and blurred vision. Treatment is emergency surgery to insert a shunt into the brain to drain the build-up of cerebrospinal fluid and relieve the increased brain pressure, Dr Bulbeck explains.
However, colloid cysts can be monitored for decades without causing any problems.
“In terms of prognosis and life, you should be able to live the full life you were expecting to live with a colloid cyst,” Dr Bulbeck says. “It’s just that symptoms may impact quality of life.”
“When I talk to patients, the biggest shift for them is living with uncertainty. They feel more vulnerable and lose the resilience that they might have developed over time,” she says.
What are the signs that you have one?
The first symptoms of a colloid cyst tend to be headaches, nausea, vomiting and visual disturbances, Dr Bulbeck says. Other warning signs can include memory problems, tinnitus, behaviour change, and loss of consciousness.
These symptoms are a result of the cyst putting pressure on the brain. “If that cyst was in a softer part of the body, it probably wouldn’t have any impact at all,” Dr Bulbeck says.
“Symptoms can be very debilitating. It can be like living with a migraine a lot of the time, where you’re sick and have got blinding headaches that pain relief doesn’t touch,” she says.
Some people are asymptomatic, meaning they show no signs of having the tumour. “They might live with it for their whole life and not know they’ve had one,” Dr Bulbeck explains.
How is it diagnosed?
A colloid cyst is diagnosed using an MRI or CT scan.
More than 60 per cent of people who present with a brain tumour go to A&E, Dr Bulbeck says. Others go to their GP with symptoms but report that it can take multiple visits before they are referred for further checks, she says.
As colloid cysts can be asymptomatic, they can also be diagnosed incidentally during routine scans, as was the case for McCall, Dr Bulbeck notes.
What are the causes?
Doctors don’t know for certain what causes a colloid cyst.
“It’s thought that they start as part of embryo development,” Dr Bulbeck says. “So when they’re diagnosed, they’ve probably already been there for a long time.”
No lifestyle factors – such as smoking, alcohol intake or weight – have been linked to an increased risk of developing a colloid cyst, she says.
Is there a connection between colloid cysts and HRT?
There is no known link between colloid cysts and hormone replacement therapy (HRT).
However, a study in France found that some progesterone treatments – such as HRT and some contraceptives – very slightly heightened risk of meningiomas.
These are a different set of brain tumours that occur in the layers of tissue that cover the brain and spinal cord. Meningiomas are usually non-cancerous and grow slowly.
Experts have noted that no link has been found between meningiomas and the HRT and contraceptives available in the UK.
How are colloid cysts treated?
There are two treatment routes for patients diagnosed with a colloid cyst: active surveillance or surgery.
“Active surveillance is an observation method for smaller cysts,” Dr Bulbeck says. “This might involve having an MRI twice a year to start with, before dropping down to annual scans.” This will detect if the tumour has grown and if surgery should be considered.
Most patients who are asymptomatic stop having these scans after five to 10 years and live with the knowledge that they have a non-cancerous cyst in their brain, she says.
Surgery is usually only performed on cysts that are larger than 9mm or in patients who have severe symptoms that are interfering with daily life, she says. McCall shared that her tumour was 14mm. However, in some cases, smaller colloid cysts can be removed.
What are the risks of surgery?
Surgery to remove a colloid cysts can involve removing a small part of the skull to expose the brain, so that the cyst can be extracted (known as a craniotomy).
“Colloid cysts are deep-seated in the brain and adjacent to critical structures, including quite big veins,” Dr Bulbeck says. This means that the risk of a brain bleed during surgery is quite high, she says.
“That’s why you wouldn’t want to have scans that might find incidental tumours that people haven’t had symptoms for because then you’re in the danger of over-treatment,” she says.
What are the chances of recovering from surgery?
When the tumour is completely removed, the prognosis is “good”, according to US health chiefs. It is very rare that the tumour will return after surgery.
How long is recovery from surgery and does it require lifestyle changes?
“Most people find that it takes longer to get over the anaesthetic than it does the actual surgery,” Dr Bulbeck says. Recovery is usually days or weeks, rather than months.
McCall shared that she expects to be in hospital for around nine days after the operation.
Patients with colloid cysts are not required to implement any lifestyle changes, Dr Bulbeck adds.