Brain Cancer Diagnosis and Treatment

If it’s suspected that you have a brain tumor, your doctor may use several tests to diagnose it. The tests that are commonly used to diagnose brain cancer include:

Neurological exam

This test is used to evaluate the nervous system to determine whether any abnormalities exist and if a tumor is affecting how the brain functions. A neurological exam involves testing of vision, hearing, reflexes, balance, coordination, and muscle strength.

Magnetic resonance imaging (MRI)

This uses a magnetic field and radio waves to create detailed images of the brain. A special dye called a contrast medium is sometime injected into the bloodstream to make tumors appear different from healthy tissue. Functional MRI scans may be done to identify critical brain areas involved in speech and motor activity.

Computed tomography (CT)

Similar to a MRI, but a CT uses x-rays in order to produce images of the brain. A CT scan can help find bleeding and enlargement of the fluid-filled spaces in the brain, called ventricles. It can also be used to measure a tumor’s size.

CT scan is a less expensive test than MRI. However, this type of scan does not provide effective definition of the extent of swelling and only provides a single plane image, rather than a three-dimensional image. CT scans are useful for identifying acoustical neurinomas or meningiomas.

PET scan

A PET scan is an imaging test that uses a radioactive substance called a tracer that will inject into your arm to look for disease in the body.

After the patient has received the injection, a small amount of radiation is passed through the body, which detects the isotopes and reveals details of cellular-level metabolism. The radiation does not stay in the body for very long though.

With a PET scan, doctors are able to determine whether the tumor is benign or malignant. PET is also used to accurately determine the stage of the brain tumor.

Biopsy

When CT, MRI, or PET scans show evidence of abnormal brain tissue, a biopsy is often necessary to confirm the diagnosis. A biopsy involves removing a sample of the abnormal tissue for examination under a microscope. There are a variety of different types of biopsies and the method used to gain a tissue sample depends on the size and location of the suspected tumor.

Treatment for Brain Cancer

Treatment for a brain tumor depends on the type, size and location of the tumor. Treatment aims to remove the tumour or relieve the symptoms. Some of the treatment options include:

Surgery

Surgery is the first treatment for most brain tumors and is often the only treatment needed for a low-grade brain tumor. This operation can improve neurological symptoms, help make other brain tumor treatments more effective, and, in many cases, improve the prognosis of a person with a brain tumor.

Surgery is usually used in combination with radiotherapy and/or chemotherapy to make sure that any cancer cells remaining in the body are removed.

Surgery to remove a brain tumor carries risks, such as infection and bleeding. Other risks may depend on the part of your brain where your tumor is located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.

Radiation therapy

Radiation therapy uses high-energy X-rays or other particles to destroy tumor cells. Doctors may use radiation therapy to slow or stop the growth of a brain tumor. It is typically given after surgery and possibly along with chemotherapy.

Radiation therapy for brain cancer can be given in two ways:

  • External beam radiation (EBRT) uses a machine that directs high-energy rays from outside the body into the tumor. External beam radiation can focus just on the area of your brain where the tumor is located, or it can be applied to your entire brain (whole-brain radiation). Whole-brain radiation is most often used to treat cancer that spreads to the brain from some other part of the body and forms multiple tumors in the brain.
  • Brachytherapy uses radioactive seeds directly implanted near the tumour. This way the radiation harms as few normal cells as possible. Depending on your type of cancer and treatment plan, you might get a temporary or a permanent implant.

Side effects of radiation therapy depend on the type and dose of radiation you receive. Common side effects during or immediately following radiation include fatigue, headaches, memory loss and scalp irritation.

Chemotherapy

Chemotherapy uses drugs to kill tumor cells or slow the tumour’s growth. They can be taken orally in pill form or injected into a vein (intravenously).

Chemotherapy may be the only treatment needed but it can also be used in combination with surgery, radiation therapy or other drug therapies.

The side effects of chemotherapy depend on the type and dose of drugs you receive. Common side effects of chemotherapy include fatigue, diarrhea, nausea and vomiting, nerve and muscle pain, hair loss, weight gain or weight loss, sexual difficulties, and infections.

Targeted drug therapy

Targeted therapy is a drug treatment that targets the tumor’s specific genes, proteins, or the tissue environment that contributes to a tumor’s growth. It blocks the growth and spread of tumor cells while limiting the damage to healthy cells.

Not all tumors have the same targets, and some tumors may have more than one target. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible.

In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them.

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