Part of an MRI slide showing the cross section of a brain (from top to bottom). MRI scans help specialists identify the presence of a tumour and establish its size and exact location within the brain.
If your doctor (GP or A&E doctor) suspects you have a brain tumour, they will refer you to a specialist, such as a neurologist. These are specialists in brain and nerve disorders. If they suspect a child has a brain tumour, they will refer them to a paediatrician.
The specialist will:
- this involves looking at your vision, hearing, alertness, muscle strength, co-ordination and reflexes.
They may also look at the back of your eyes to see if there is any swelling of the optic disc. Any swelling is a sign of raised pressure inside the skull, which could be a sign of a brain tumour.
You will then have one or more further tests, such as an MRI or CT scan, to establish whether a tumour is present.
For some people, their first brain tumour symptom may be a seizure, so they are seen as an emergency. In this case they may be given a scan as their first test, after which their case will be referred to a neuro-oncology 'MDT' (multi-disciplinary team) followed by a consultation with the neurologist or a neurosurgeon.
Some GPs can refer you for a scan directly, or you may have been admitted to hospital with a problem and a brain scan was arranged to investigate this further.
If, following the scan, a tumour is found, you may be given a body scan to establish if your tumour is a primary brain tumour (one which started in the brain) or a secondary tumour and there is a primary tumour elsewhere in the body.
If the tumour is a primary tumour and is in an area of the brain which can be operated on, a biopsy (small sample of the brain tumour) may be taken to aid diagnosis of the tumour type. It is important to realise that a biopsy is an operation that takes several hours. Any risks will be explained to you by your surgical team.
Alternatively to a biopsy, and if possible, the resection (surgical removal) of the whole tumour, or as much as possible, will be undertaken at the same time. If only part of the brain tumour can be removed, this is known as 'debulking'.
Following biopsy or surgery, cells from the tumour will be analysed in a laboratory by a neuropathologist.
The neuropathologist will examine the cells, looking for particular cell patterns that are characteristic of the different types and grade of brain tumour.
Confirming the diagnosis of the different grades of some brain tumours can be difficult as some low grade and high grade brain tumours can look very similar.
Accurate diagnosis is important as it allows your medical team to give you information about how the tumour could behave in the future, and also to recommend treatment options. This could include a clinical trial.
As part of this analysis, you may like to ask about 'biomarker testing'. This is where the doctors look for markers (changes) in certain genes in the tumour cells that may indicate how well you will respond to certain treatments.
Find out more about brain tumour diagnosis and the healthcare system.
Biomarkers may be helpful in predicting how quickly your tumour may grow or how well you may respond to some treatments.
Brain tumours are graded from 1 to 4 depending on how they are likely to behave. Find out more.
To ensure that you receive the best care, a multi-disciplinary team (MDT) works to create your personalised treatment plan
You may like to ask, before your operation for a biopsy or for a resection, about the possibility of 'biobanking' some of the tissue from your tumour.
A key to accelerating research towards improving survival and quality of life for people with brain tumours, is for researchers to have access to centralised tissue banks containing patients' tumour samples, so they can carry out more research.
Currently there is no centralised tissue bank and not all centres are able to take and store samples, as they need to be licenced under the Human Tissue Act, with ethical approvals in place. As a result, routine collection of tissue for research is not yet a reality.
The Brain Tumour Charity is committed to establishing a centralised tissue bank with simpler access arrangements. As there are many types of brain tumour, some of which are very rare, we need to ensure that we learn from every patient. This will require systems and cultural changes in the approach to collecting samples. By asking about biobanking some of your tumour, you may help with the move towards this.
Speak to us, and to your health team, if this is something you are interested in doing.
If you have further questions, need to clarify any of the information on this page, or want to find out more about research and clinical trials, please contact our team:
0808 800 0004 (free from landlines and mobiles)
01252 749 999
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