Brain Tumours - Diagnosis & Treatment

How are brain tumours diagnosed?

Most brain tumours are usually picked up only after symptoms appear. Your doctor will first ask details about your symptoms as well as your medical and family history. If a brain tumour is suspected, they may recommend certain tests to confirm the diagnosis and to eliminate other possible causes of your symptoms.

These tests include:

• Neurological examination. This involves a series of tests to check your vision, hearing, balance, coordination, strength and reflexes. It may also include testing your memory and ability to perform cognitive tasks such as simple calculations.
• Magnetic resonance imaging (MRI), computerised tomography (CT) or positron emission tomography (PET) scans. You will likely have to undergo several imaging scans to obtain detailed cross-sectional images of your brain and any suspected tumours.
• Electroencephalogram (EEG). If you experience epileptic seizures, an EEG may be advised to record your brain activity via electrodes attached to your scalp.
• Cerebral angiogram. This imaging test uses X-rays and a contrast dye to view the brain's arteries and see how blood is being supplied to the tumour, which offers important information for your surgeon.
• Skull X-ray. A skull X-ray scan can help determine if the tumour has caused a fracture of the skull, or reveal X-ray changes that indicate the cancer may have spread to the bone.
• Lumbar puncture. Also known as a spinal tap, this procedure involves inserting a needle into your lower spine to extract a sample of cerebrospinal fluid, which will be tested for tumour markers.
• Biopsy. For brain tumours that are in sensitive or hard-to-reach areas, a stereotactic needle biopsy may be recommended to extract tissue samples for analysis.

How are brain tumours treated?

Treatment for a brain tumour depends on its type, size and location. Your overall health will also be considered. Your doctor will evaluate your condition and propose an appropriate treatment plan, which may include a combination of surgery, drug therapies, and rehabilitation.

• Surgery. The most common approach is brain surgery (craniotomy), with the aim of removing the entire tumour. In some instances, complete removal may not be possible due to the location of the tumour, but your surgeon will endeavour to remove as much of it as safely possible. Even partial removal can be beneficial in relieving symptoms.
• Chemotherapy. This uses medications to kill tumour cells, which can be taken orally or delivered intravenously. Several types of tumours respond well to chemotherapy. Common side effects include nausea, vomiting and hair loss, depending on the type and dose of the medication.
• Radiotherapy. Radiotherapy uses high-energy beams to shrink or destroy abnormal cells. It can be performed in different ways, ranging from 3D conformal radiation therapy (3D-CRT) to intensity-modulated radiation therapy (IMRT) to proton beam therapy. Side effects vary and typically include fatigue, headaches and hair loss.
• Gamma Knife radiosurgery. This is a non-invasive and painless procedure that focuses laser beams precisely at the tumour to shrink it or prevent it from growing.
• Targeted drug therapy. Targeted therapy uses medications to block certain cell functions that contribute to the tumour's growth. It can be used in combination with chemotherapy to destroy any remaining cancer cells after surgery.

Care and recovery after brain tumour treatment

After undergoing surgery or medical therapies, it is important to continue with follow-up care to ensure the tumour does not recur and to manage any side effects of the treatment.

If the brain tumour affected your motor skills, speech or cognitive processes, you may also need rehabilitation, such as physiotherapy and occupational therapy, to help you regain these functions and return to normal daily activities.

It can take anywhere from a few weeks to months to make a full recovery from a brain tumour.