Exams and Tests

If findings of your medical interview and physical examination suggest to your health-care provider that you may have a problem in the brain or brain stem, additional tests may be done.

• In most cases, you will have a CT scan of the brain.
  
  
• This test is like an x-ray but shows more detail in three dimensions.
  
  
• Usually, a harmless dye is injected into your bloodstream to highlight abnormalities on the scan.

People with brain cancer often have other medical problems; therefore, routine laboratory tests may be performed.

• These include analysis of blood, electrolytes, liver function tests, and a blood coagulation profile.
  
  
• If you have mental status change as the main symptom, blood or urine tests may be done to detect drug use.

Often, the MRI scan is used instead of CT scan for suspected brain tumors.

• This is because MRI has a higher sensitivity for detecting the presence of, or changes within, a tumor.
  
  
• Currently, however, most institutions still use the CT scan as the first diagnostic test.

Skull x-rays are not widely used any longer to diagnose brain cancer.

If your scans indicate the presence of a brain tumor, you will be referred to a specialist in brain surgery. If one is available in your area, you should be referred to a specialist in brain tumors (neuro-oncologist).

The next step in diagnosis is confirmation that you have a cancer. A small sample of the tumor (a biopsy) is taken to identify the type of tumor.

• The most widely used technique for obtaining a biopsy is surgery. The skull is opened, usually with the intention of removing the whole tumor if possible. A biopsy is then taken from the tumor.
  
  
• If the surgeon is unable to remove the entire tumor, a small piece of the tumor is removed.
  
  
• In some cases, it is possible to collect a biopsy without opening the skull. The exact location of the tumor in the brain is determined stereotactically, that is, by using CT or MRI scans while the head is held still in a frame. A small hole is then made in the skull and a needle guided through the hole to the tumor. The needle collects the biopsy and is removed. This technique is called stereotaxis, or stereotactic biopsy.
  
  
• The biopsy is examined under a microscope by a pathologist (a physician who specializes in diagnosing diseases by looking at cells and tissues).

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Brain Cancer - Symptoms at Onset of Disease

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The symptoms of brain cancer can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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