Diagnostic Tests For Brain Tumours
If your doctor suspects you may have a brain or spinal cord tumour, they will take your medical history and ask about your symptoms. After that, you will have a physical examination. You may then be referred to have one or more scans/tests to confirm a diagnosis of a brain or spinal cord tumour.
Children have the same type of diagnostic tests as adults, however young children may require a general anaesthetic for some of the tests.
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Types Of Brain Tumour
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A brain tumours can be:
- low-grade not cancer, sometimes called a benign tumour
- high-grade cancer, also called a malignant tumour.
A low-grade brain tumour usually grows slowly and may not cause symptoms for a long time. A high-grade brain tumour grows faster than a low-grade tumour.
How Common Are Brain Tumors And Are They Dangerous
In the United States, brain and nervous system tumors affect about 30 adults out of 100,000. Brain tumors are dangerous because they can put pressure on healthy parts of the brain or spread into those areas. Some brain tumors can also be cancerous or become cancerous. They can cause problems if they block the flow of fluid around the brain, which can lead to an increase in pressure inside the skull. Some types of tumors can spread through the spinal fluid to distant areas of the brain or the spine.
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Medical History And Physical Exam
If signs or symptoms suggest you might have a brain or spinal cord tumor, your doctor will ask about your medical history, focusing on your symptoms and when they began. The doctor will also check your brain and spinal cord function by testing things like your reflexes, muscle strength, vision, eye and mouth movement, coordination, balance, and alertness.
If the results of the exam are abnormal, you may be referred to a neurologist or a neurosurgeon, who will do a more detailed neurologic exam and may order other tests.
What Do The Results Of A Biomarker Test Mean
The results of a biomarker test could show that your cancer has a certain biomarker that is targeted by a known therapy. That means that the therapy may work to treat your cancer. The matching therapy may be available as an FDA-approved treatment, an off-label treatment, or through participation in a clinical trial.
The results could also show that your cancer has a biomarker that may prevent a certain therapy from working. This information could spare you from getting a treatment that wont help you.
In many cases, biomarker testing may find changes in your cancer that wont help your doctor make treatment decisions. For example, genetic changes that are thought to be harmless or whose effects are not known are not used to make treatment decisions.
Based on your test results, your health care provider may recommend a treatment that is not FDA approved for your cancer type, but is approved for the treatment of a different type of cancer that has the same biomarker as your cancer. This means the treatment would be used off label, but it may work for you because your cancer has the biomarker that the treatment targets.
Some biomarker tests can find genetic changes that you may have been born with that increase your risk of cancer or other diseases. These genetic changes are also called germline mutations. If such a change is found, you may need to get another genetic test to confirm whether you truly have an inherited mutation that increases cancer risk.
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Depending On The Tumors Some Blood Tests Can Be Used To Detect A Brain Tumor Says Neurosurgeon Charles Park Md
But most of the cases, we find the brain tumor and then do the blood test to see what kind of tumor it is, says Dr. Park, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore.
For example, if someone has a pituitary tumor, we will do the blood test to see if that tumor is active and producing a certain kind of hormone.
If it produces prolactin, then we can use medicine to shrink the tumor without surgery.
How close are researchers to developing a blood test that detects the presence of a brain tumor?
Microvesicles are cell particles that are shed by cancer cells and end up in the bloodstream. They are small enough to cross the blood-brain barrier.
If these can be picked up by a blood test, they potentially can diagnose a brain tumor.
The most common primary brain tumor is a glioblastoma multiforme. By the time this is diagnosed, a patient will usually be dead within 15 months.
The only way currently to diagnose and also monitor a GBM is via imaging tests and biopsies. This is anything but efficacious.
But a simple blood test to do these tasks would change medicine.
What Is A Primary Brain Tumour
A primary brain tumour is a tumour that starts in the brain.
The brain manages how we think, feel, learn and move. It also controls other important things in the body, such as breathing and heart rate. The brain is protected by the skull.
We have separate information about tumours that start somewhere else in the body and spread to the brain. These are called secondary brain tumours or brain metastases.
Brain tumours can also affect children. If you need information about brain tumours in children, you can contact the Childrens Cancer and Leukaemia Group.
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How Is A Brain Tumor Treated
Several approaches may be taken to prevent a malignant brain tumor from growing and spreading into other areas of the brain. Although benign brain tumors arent cancer, they can still cause the symptoms mentioned above, based on the area of the brain they are compressing, so these require treatment, too.
Surgery is often the first line of treatment for benign tumors, primary malignant tumors and large metastatic cancers that are causing symptoms or compressing surrounding brain tissues. A neurosurgeon works to remove as much of the tumor as possible while preserving brain function. When the tumor is hard to reach, it is sometimes removed only partially or not at all. Following surgery, patients are often also treated with chemotherapy drugs and radiation therapy. For small metastases that are found before symptoms start to show, stereotactic radiosurgery is usually the only treatment needed.
What Are The Grades For Benign And Cancerous Brain Tumors
Doctors group brain tumors by grade. The grade of a tumor refers to the way the cells look under a microscope:
- Grade I: The tissue is benign. The cells look nearly like normal brain cells, and they grow slowly.
- Grade II: The tissue is malignant. The cells look less like normal cells than do the cells in a Grade I tumor.
- Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing .
- Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly.
Cells from low-grade tumors look more normal and generally grow more slowly than cells from high-grade tumors . Over time, a low-grade tumor may become a high-grade tumor. However, the change to a high-grade tumor happens more often among adults than children.
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Brain Tumour Prognosis And Survival Rates
When someone is diagnosed with a brain or spinal cord tumour, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better.
A prognosis depends on the type and stage of cancer, as well as the persons age and general health.
Low-grade and high-grade tumours can be life-threatening, but the prognosis may be better if the tumour is low grade, or if the surgeon is able to remove the entire tumour.
Some brain or spinal cord tumours can come back and may change into a higher-grade tumour.
If you have a brain or spinal cord tumour, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.
Another Possible Blood Test For Detecting A Brain Tumor
In another study, nearly all forms of cancer were identified, says cancer researcher Jonas Nilsson in the report, which proves that blood-based biopsies have an immense potential to improve early detection.
The study that hes referring to, which had a 96% detection accuracy rate, comes from Umeå University in Sweden and was published in Cancer Cell .
The test was done on 228 people with cancer. That was just the detection of a cancer.
Dr. Park specializes in minimally invasive surgical techniques for treatment of conditions affecting the brain and spine. Hes skilled in advanced procedures and techniques that utilize innovative computer technology and image-guided surgery systems.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
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Surgical Or Open Biopsy
If imaging tests show the tumor can likely be treated with surgery, the neurosurgeon may not do a needle biopsy. Instead, he or she may do an operation called a craniotomy to remove all or most of the tumor.
For a preliminary diagnosis, small samples of the tumor are looked at right away by the pathologist while the patient is still in the operating room. This can help guide treatment, including whether further surgery should be done at that time. A final diagnosis is made within a few days in most cases.
You can read more about the kinds of tests done on biopsy or tissue samples in Testing Biopsy and Cytology Specimens for Cancer.
What Is Biomarker Testing For Cancer Treatment
Biomarker testing is a way to look for genes, proteins, and other substances that can provide information about cancer. Each persons cancer has a unique pattern of biomarkers. Some biomarkers affect how certain cancer treatments work. Biomarker testing may help you and your doctor choose a cancer treatment for you.
There are also other kinds of biomarkers that can help doctors diagnose and monitor cancer during and after treatment. To learn more, visit the Tumor Markers fact sheet.
Biomarker testing for cancer treatment may also be called:
- tumor testing
- genomic testing or genomic profiling
- molecular testing or molecular profiling
- somatic testing
- tumor subtyping
A biomarker test may be called a companion diagnostic test if it is paired with a specific treatment.
Biomarker testing is different from genetic testing that is used to find out if someone has inherited mutations that make them more likely to get cancer. Inherited mutations are those you are born with. They are passed on to you by your parents.
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Researchers At The University Of Sussex Are One Step Further To Developing A Blood Test Capable Of Diagnosing The Most Aggressive Form Of Brain Tumour
In November 2019, Prof Giamas’s lab at Sussex identified specific biomarkers that glioblastoma cell lines are able to ‘package’ within extracellular vesicles allowing for better classification between those cell lines . Biomarkers can be considered as biological signatures for a disease, and can therefore indicate the presence of cancer in the body. This new stage of research, published in Biomedicines, now proves that a liquid biopsy approach can successfully determine the presence of such biomarkers in a glioblastoma patient and therefore improve the disease diagnosis and ultimately the patients’ prognosis and quality of life.Prof Giamas now hopes to conduct further research into the clinical value of their findings, by analyzing blood samples of a larger cohort of glioblastoma patients obtained from Genomics England. The team also aims to investigate the presence and levels of such biomarkers in response to specific cancer treatments in an attempt to monitor the progression of the disease and evaluate the importance and role of these biomarkers.He added: “If we can show that the biomarker signatures of extracellular vesicles obtained from blood samples change/disappear then this could be a huge breakthrough for monitoring the success of treatments too.”Source: University of Sussex
How Are Biomarker Tests Used To Select Cancer Treatment
Biomarker tests can help you and your doctor select a cancer treatment for you. Some cancer treatments, including targeted therapies and immunotherapies, may only work for people whose cancers have certain biomarkers.
For example, people with cancer that has certain genetic changes in the EGFR gene can get treatments that target those changes, called EGFR inhibitors. In this case, biomarker testing can find out whether someones cancer has an EGFR gene change that can be treated with an EGFR inhibitor.
Biomarker testing could also help you find a study of a new cancer treatment that you may be able to join. Some studies enroll people based on the biomarkers in their cancer, instead of where in the body the cancer started growing. These are sometimes called basket trials.
For some other clinical trials, biomarker testing is part of the study. For example, studies like NCI-MATCH and NCI-COG Pediatric MATCH are using biomarker tests to match people to treatments based on the genetic changes in their cancers.
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Brain Tumor Causes And Risk Factors
Doctors donât know why some cells begin to form into tumor cells. It may have something to do with a personâs genes or his or her environment, or both. Some potential brain tumor causes and risk factors may include:
- Cancers that spread from other parts of the body
- Certain genetic conditions that predispose a person to overproduction of certain cells
- Exposure to some forms of radiation
Brain Tumour Risk Factors
There are some things that can make it more likely to develop a brain or spinal cord tumour. These are called risk factors and they include:
Family history while it is rare for brain tumours to run in families, a fault in the genes, usually passed down from either the mother or father, can increase the risk of developing a brain tumour.
Having these risk factors doesnt mean you will develop a brain or spinal cord tumour. Often there is no clear reason for getting a brain or spinal cord tumour. If you are worried about your risk factors, ask your doctor for advice.
Laser Interstitial Thermal Therapy
Laser Thermal Ablation is a newer technique that some centers are using to treat smaller tumors particularly in areas that may be more difficult to reach using previous open surgery procedures. This involves placing a tiny catheter within the lesion, possibly completing a biopsy, then using laser to thermally ablate the lesion. This technique is only more recently used in brain tumor treatments, therefore the long term efficacy has not been established.
Diagnosing Brain Tumors With A Blood Test
A simple but highly sensitive blood test has been found to accurately diagnose and classify different types of brain tumors, resulting in more accurate diagnosis, less invasive methods and better treatment planning for patients, in the future.
The finding, published in Nature Medicine on June 22, 2020, describes a non-invasive and easy way to classify brain tumors. The study is also being presented virtually today at the prestigious Opening Plenary Session of the American Association for Cancer Research Annual Meeting 2020: Turning Science into Lifesaving Care.
A major challenge in treating brain cancers is the accurate diagnosis of different types of brain cancers, and tumors ranging from low gradewhich can look almost normal under a microscopeto aggressive tumors. Cancer grades are used to determine prognosis, and assist in treatment planning.
Current methods to diagnose and establish the subtype of brain cancer based on molecular information rely upon invasive surgical techniques to obtain tissue samples, which is a high-risk procedure and anxiety-provoking for patients.
The ability to diagnose and classify the type of brain tumor without the need for a tissue sample is revolutionary and practice changing. In some cases, surgery may not even be necessary.
“It would have a tremendous impact on how we treat these cancers, and in how we plan our treatments.”
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Primary Vs Metastatic Brain Tumors
Primary brain tumors are tumors that start in the brain. Examples of tumors that most often originate in the brain include meningioma and glioma. Very rarely, these tumors can break away and spread to other parts of the brain and spinal cord. More commonly, tumors spread to the brain from other parts of the body.
Metastatic brain tumors, also called secondary brain tumors, are malignant tumors that originate as cancer elsewhere in the body and then metastasize to the brain. Metastatic brain tumors are about four times more common than primary brain tumors. They can grow rapidly, crowding or invading nearby brain tissue.
Common cancers that can spread to the brain are: