Brain Tumor (cont.)
In this Article
- Brain tumor (primary) definition and facts*
- What are the parts of the brain?
- Brain tumor types
- Types of primary brain tumors
- Brain tumor grades
- What are the causes and risk factors for brain tumors?
- What are the symptoms of a brain tumor?
- How are brain tumors diagnosed?
- What about a second opinion for brain tumor treatment?
- What is the treatment for a brain tumor?
- What type of surgery is available for brain tumors?
- Radiation therapy for brain tumors
- Chemotherapy for brain tumors
- Nutrition during brain tumor treatment
- What supportive care is available for patients and caregivers?
- What about rehabilitation after brain tumor treatment?
- What about follow-up care after brain tumor treatment?
- Sources of support
- Taking part in cancer research
- Head and Neck Cancer Quiz FAQs
- Find a local Oncologist in your town
How are brain tumors diagnosed?
If you have symptoms that suggest a brain tumor, your doctor will give you a physical exam and ask about your personal and family health history. You may have one or more of the following tests:
- Neurologic exam: Your doctor checks your vision, hearing, alertness, muscle strength, coordination, and reflexes. Your doctor also examines your eyes to look for swelling caused by a tumor pressing on the nerve that connects the eye and the brain.
- MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your head. Sometimes a special dye (contrast material) is injected into a blood vessel in your arm or hand to help show differences in the tissues of the brain. The pictures can show abnormal areas, such as a tumor.
- CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head. You may receive contrast material by injection into a blood vessel in your arm or hand. The contrast material makes abnormal areas easier to see. Your doctor may ask for other tests:
- Angiogram: Dye injected into the bloodstream makes blood vessels in the brain show up on an x-ray. If a tumor is present, the x-ray may show the tumor or blood vessels that are feeding into the tumor.
- Spinal tap: Your doctor may remove a sample of cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). This procedure is performed with local anesthesia. The doctor uses a long, thin needle to remove fluid from the lower part of the spinal column. A spinal tap takes about 30 minutes. You must lie flat for several hours afterward to keep from getting a headache. A laboratory checks the fluid for cancer cells or other signs of problems.
- Biopsy: The removal of tissue to look for tumor cells is called a biopsy. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer, and other conditions. A biopsy is the only sure way to diagnose a brain tumor, learn what grade it is, and plan treatment. Surgeons can obtain tissue to look for tumor cells in two ways:
- Biopsy at the same time as treatment: The surgeon takes a tissue sample when you have surgery to remove part or all of the tumor. See the Surgery section.
- Stereotactic biopsy: You may get local or general anesthesia and wear a rigid head frame for this procedure. The surgeon makes a small incision in the scalp and drills a small hole (a burr hole) into the skull. CT or MRI is used to guide the needle through the burr hole to the location of the tumor. The surgeon withdraws a sample of tissue with the needle. A needle biopsy may be used when a tumor is deep inside the brain or in a part of the brain that can't be operated on.
However, if the tumor is in the brain stem or certain other areas, the surgeon may not be able to remove tissue from the tumor without harming normal brain tissue. In this case, the doctor uses MRI, CT, or other imaging tests to learn as much as possible about the brain tumor.
A person who needs a biopsy may want to ask the doctor the following questions:
- Why do I need a biopsy? How will the biopsy results affect my treatment plan?
- What kind of biopsy will I have?
- How long will it take? Will I be awake? Will it hurt?
- What are the chances of infection or bleeding after the biopsy? Are there any other risks?
- How soon will I know the results?
- If I do have a brain tumor, who will talk with me about treatment? When?
What about a second opinion for brain tumor treatment?
Before starting treatment, you might want a second opinion about your diagnosis and treatment plan. Some people worry that the doctor will be offended if they ask for a second opinion. Usually the opposite is true. Most doctors welcome a second opinion. And many health insurance companies will pay for a second opinion if you or your doctor requests it. Some companies require a second opinion.
If you get a second opinion, the doctor may agree with your first doctor's diagnosis and treatment plan. Or the second doctor may suggest another approach. Either way, you'll have more information and perhaps a greater sense of control. You can feel more confident about the decisions you make, knowing that you've looked at your options.
It may take some time and effort to gather your medical records and see another doctor. In many cases, it's not a problem to take several weeks to get a second opinion. The delay in starting treatment usually won't make treatment less effective. To make sure, you should discuss this delay with your doctor. Some people with a brain tumor need treatment right away.
There are many ways to find a doctor for a second opinion. You can ask your doctor, a local or state medical society, a nearby hospital, or a medical school for names of specialists.
Also, you can request a consultation with specialists at the National Institutes of Health Clinical Center in Bethesda, Maryland.
- Adults and children with a brain tumor: Specialists in the NCI Neuro-Oncology Branch provide consultations. The telephone number is 301-594-6767 or 866-251-9686.
- Children with a brain tumor: Specialists in the NCI Pediatric Neuro-Oncology Section of the Pediatric Oncology Branch provide consultations. The telephone number is 301-496-8009 or 877-624-4878.
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