When You First Get Your Diagnosis
Perhaps the news was expected. The headaches were just a little too often, a little different from most headaches. Or maybe you didn’t have the slightest idea. In any event, you have suddenly been diagnosed with a brain tumor and chances are your mind is filled with anxiety and questions.
The first thing you will need to learn is to become an advocate for your own health. Start uncovering the basic facts: a brain tumor is an abnormal mass of cells growing in, or on the brain and some are cancerous but many are not. Ask questions of your health care team and find out as much as you can about your specific brain tumor. Prepare yourself with a notebook to write your questions and record information in one central location. The more you become informed, the better prepared you will be to aid your healthcare team in your effective care.
Identifying Your Brain Tumor Type
Identifying a brain tumor typically involves a neurological exam, brain scans, and possibly, an evaluation of the brain tumor. Through this information, doctors are able to identify the type of tumor from the least aggressive (benign) to the most aggressive (malignant). Both benign and malignant tumors also have various sub-classifications.
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Your Neurological Exam
The first action your doctor may take is to order a series of tests that measure the function of your nervous system and your alertness, muscle strength, coordination, reflexes and response to pain. Your doctor also examines your eyes to look for swelling caused by the tumor pressing on the nerve that connects the eye and brain. If he or she sees something that is not normal, a computerized tomography (CT) scan or magnetic resonance imaging (MRI) scan will likely be ordered.
Your Brain Scan
Many people know brain scans through other terms: an MRI or a CT. An MRI provides photographs of the brain from various angles using a powerful magnet linked to the computer. Typically, it offers a higher sensitivity for detecting the presence of, or changes within, a tumor. A CT scan – another reliable diagnostic tool, often ordered for those with pacemakers and other devices that interfere with magnets – is a series of detailed pictures of the brain, created by a computer linked to an X-ray machine. Either one may provide the first meaningful diagnosis of your brain tumor.
The next step in diagnosis is the confirmation that you have – or do not have – a cancerous brain tumor. A small sample of the mass – a biopsy – is removed and then analyzed. The biopsy can be simply a diagnostic procedure or the first step in a surgical procedure to remove the whole tumor. The standard biopsy takes about an hour and is done under general anesthesia. When the tumor is in areas of the brain inaccessible to open surgery, the neurosurgeon will insert a narrow needle through brain tissue to get a sample. This is called a closed or stereotactic biopsy.
Evaluating the Biopsy
Another doctor – a pathologist – will examine the biopsy under a microscope in order to determine the type of cells causing the tumor, a procedure that typically takes one to three days. There are close to 100 types of brain tumors. Each name shows where the tumor originated, its pattern of growth and whether it is benign or cancerous. The tumor is also graded by its degree of malignancy and its chances of growing and spreading. The results from the pathologist will guide your doctor in determining your course of treatment.