Communication difficulties

The ability to communicate is something we often take for granted. When communication difficulties occur, they can make us feel frustrated, angry, embarrassed and isolated. Carers, family and friends, too, can find it confusing and frustrating, often reporting feeling helpless or even guilty.

Understanding communication difficulties and knowledge of coping strategies can help people affected by a brain tumour (and those around them) to feel more able to cope and so reduce these feelings.

How do brain tumours affect communication?

It is important to realise that not everyone with a brain tumour will experience communication difficulties, or they may be so mild that they do not greatly affect daily life.

Whether and how a brain tumour affects your communication skills will depend largely on where it is in the brain. Each section or lobe of the brain (see diagram below) is responsible for different functions, some of which are involved in communication.

For example, the frontal lobe is involved in language production and the temporal lobe is involved in understanding language. As a result, if your tumour is in one of these lobes, pressure from the tumour itself, swelling around it or treatment directed atthat area may have an effect on your communication skills.

a graphic diagram of the different areas of the brain and their functions

The brain is also divided into two hemispheres - left and right. The side on which your tumour is located, as well as the lobe, can affect the type and likelihood of communication effects. If your tumour is located in the left hemisphere, you are more likely to experience language and speech difficulties, as this is where the language areas are generally found. (It is important to note that for some people, the language areas are found in the right hemisphere.)

Surgery can also cause communication difficulties, if the area of the brain operated on is involved in communication. These effects may be temporary and reduce with recover, but some effects may be more permanent if that area is removed or damaged.

What communication difficulties might someone with a brain tumour experience?

There is a range of different communication difficulties that you may experience:

  • language impairment (also known as 'dysphasia')
  • speech difficulties
  • cognitive communication difficulties; problems with cognitive functions, such as memory, attention, social cognition, can lead to communication difficulties due to forgetting words, losing the thread of a conversation, or not knowing when to talk and when to listen during a conversation

    Read more about cognition difficulties


Dysphasia is the most common communication difficulty experienced by people with brain tumours. Sometimes the term 'Aphasia' is used, which is complete loss of language. It is important to note that dysphasia does not affect intellect although, unfortunately, this a common misperception.

You may have difficulty producing language, which could involve:

  • difficulty speaking and may only be able to produce a small number of words in halting sentences, for example “want … tea … sugar"
  • getting words muddled up e.g. confuse “yes" and “no".
  • being able to describe an object, but not name it
  • only being able to say a few words, which may be linked to emotions and could be swear words

In these instances, it is usually possible for other people to understand your speech, but it may take you some time to say what you want to say. With this type of dysphasia, you are usually aware that you have a communication difficulty.

You may have difficulty understanding language or producing meaningful language, which could involve:

  • not understanding what others are saying, particularly long sentences
    i.e. you forget the beginning of what has been said
  • having difficulty understanding if there is background noise or several people speaking at once
  • being able to read headlines, but not the main body of the text
  • being able to write, but not read back what you have written

In other words, you may have speech that sounds fluent, but it is made up of 'non–words'. As a result, other people may not be able to understand what you are trying to say.

In general, someone with this type of dysphasia will not be aware that they have a communication difficulty.

There are various types of dysphasia and the three most common types are: 'Broca's aphasia', 'Wernicke's aphasia' and 'Global aphasia'. More information about these types can be found in our fact sheet which can be downloaded at the bottom of this page.

Emotional effects of dysphasia

The effects of dysphasia can be exceedingly frustrating as being able to communicate efficiently is important to many aspects of daily life. As a result you might feel emotionally 'cut off' from those around you, and your relationships may suffer.

If the effects are severe, you may feel extremely isolated, and depression is not uncommon in people affected by dysphasia. Carers, family & friends can feel lonely and isolated too. Read more about depression.

What can I do to help communication?

There are some simple changes you can make that may help communication problems.

If you are experiencing communication difficulties:

  • try to create a relaxed environment - dysphasia often worsens with stress
  • reduce background noise and distractions
  • consider taking a break if you are tired

If someone you care for is experiencing communication difficulties:

  • don't rush your speech - speak clearly and at a steady pace
  • give one point at a time rather than all of the information at once
  • don't be tempted to speak more loudly - remember that the person does not have a problem with their hearing
  • if the person has not understood you, try rephrasing what you have said
  • if the person is having difficulty with a particular word, you could ask them to describe it instead
  • use all forms of communication, including mime, gesture, intonation, writing, drawing, and facial expressions. There are also communication boards and other aids that can help.
  • make giving answers easy. For example, instead of asking “Would you like tea or coffee?" you could ask, “Would you like tea?"
  • don't pretend to understand what the person has said if you do not. They will probably be aware that you are doing this and you could leave them feeling very frustrated
  • take care not to talk down to the person with the communication difficulty - the problem is not with their intelligence
  • don't interrupt or fill in words for a person unless they ask you to
  • relax and be natural
  • consider taking a break if you are both tired

One key way others can help is by being supportive, and to adapt to the way they communicate in order to facilitate your understanding and self expression. Also, many carers have found that it is important not to do too much for their loved one just because it is easier, and to remember that the person with dysphasia is:

  • still an intelligent person
  • knows what they want to say
  • can still make their own decisions

There are also many organisations that specialise in equipment, or other forms of support, for people with communication difficulties. These can be found in our full fact sheet.

What interventions are available to help with speech and communication difficulties?

If you have not been referred to a speech and language therapist (SLT), you can ask your health team to be referred.

The SLT will give you a variety of spoken and written tests to assess which sort of communication difficulties you are having and to what degree. These tests may include naming objects, engaging in conversation, telling a story/joke, or writing a shopping list.

They will use various tools and exercises to work with you towards:

  • relearning lost or damaged communication skills (if possible)
  • making the best use of remaining communication skills
  • finding new ways of communicating

Page last reviewed: 03/2016

Next review date: 03/2019

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