Understanding brain cancer tests and diagnosis
We know that facing the possibility of a brain tumour diagnosis can feel overwhelming, which is why we’re here to guide you through each step of the diagnostic process, informed by the latest nervous system and clinical oncology guidelines.
Whether you have noticed signs and symptoms of a brain tumour, have been referred for further tests after a scan for another reason, or simply want to know how specialists diagnose brain tumours, this guide will explain the main tests and diagnostic approaches.
Get in touch with our team today or download our brochure to find out more.
Understanding brain tumour detection
Unlike some other cancers, there is no national brain cancer screening programme for the brain and spinal cord in the UK. Most primary brain tumours are found when a person seeks medical help for new symptoms affecting the brain or spinal cord. However, understanding your risk factors, such as genetic mutations, exposure to ionising radiation, or a family history, means you can speak to health professionals and seek tests at the right time.
The importance of early investigation
Early and accurate diagnosis of a brain tumour or secondary tumours is associated with better treatment options and median survival. Early brain tumour diagnosis, before the tumour or abnormal cells cause severe symptoms or grow large, allows your healthcare team to develop the most effective plan. This reinforces the importance of seeking clinical features and medical advice for persistent or unexplained symptoms in the nervous system.
When to see your GP
Initial assessment: when you notice changes
Awareness of your body
Noticing new brain tumour symptoms, like muscle strength changes, other symptoms such as difficulties with cranial nerves, or persistent headaches, is critical. While many abnormal areas on scans or symptoms might be due to benign tumours or other conditions, it’s important not to dismiss persistent clinical features. Discussing them with a doctor or healthcare team can lead to further tests and, if needed, diagnosis and emotional support.
Common brain tumour symptoms
Brain tumour symptoms vary, depending on the tumour type, size, and part of the brain or spinal cord affected. Some of the most common signs and symptoms include:
- Headaches: Often severe, persistent, and worse in the mornings, when lying down, or when coughing due to increased cerebrospinal fluid pressure.
- Seizures (fits): Sometimes the first indication of abnormal cells or tumour cells in the brain.
- Persistent nausea and vomiting: Could indicate abnormal pressure or pituitary gland disturbance.
- Changes in vision, speech, or hearing: Including blurred vision or balance issues due to tumours pressing on cranial nerves or blood vessels.
- Changes in mood or concentration: Such as confusion or memory loss, which may emerge with certain types of brain tumours or tumours develop in specific locations.
- Weakness or numbness: Often on one side, due to tumours affecting nerve cells or brain tissue.
Brain metastases, secondary brain tumours, or metastatic brain tumours may present differently, especially if they involve the spinal cord or affect children.
Remember, early investigation gives you access to more treatment options, including clinical trials, and lets your care team manage your symptoms and overall health from the start.
Comprehensive diagnostic testing
Visiting your GP
Initial tests may begin with a discussion of your general health, physical exam, and symptoms. Your GP will conduct a neurological examination, which evaluates reflexes, muscle strength, balance, coordination, and sensory function across the central nervous system. Abnormal clinical features or neurological exam results may trigger additional imaging tests such as MRI scan or CT scan.
Neurological and blood tests
While blood tests are essential for assessing overall health, hormone production from the pituitary gland, or tumour-related metabolic disturbances, they cannot diagnose a primary brain tumour directly. However, blood flow and certain hormones (affected by pituitary tumours or pineal tumours) can sometimes be checked. The neurological exam is particularly important for identifying which part of the brain or brain stem may be affected.
Imaging tests: seeing the full picture
MRI scan: the gold standard for brain imaging
A magnetic resonance imaging (MRI) scan is the most widely used imaging test for diagnosing a brain tumour. The technique uses strong magnets and radio waves, known as magnetism and radio waves, to create detailed images and pictures of the brain, spinal cord, and blood vessels. MRI can help detect abnormal areas, diagnose a brain tumour, and provide a clearer picture of the tumour’s size, blood flow, and relation to healthy cells, parts of the brain, or vital blood vessels. Brain MRI scan may be enhanced by functional MRI, magnetic resonance spectroscopy (MR spectroscopy), or MR angiography. These advanced scans can assess brain tissue function, metabolic activity, and blood vessels.
CT scan: a detailed alternative
A computed tomography (CT) scan uses X-rays to create pictures of the brain and spinal cord. While MRI is usually preferred, CT scan is faster and can quickly detect abnormal areas, bleeding, swelling, or cancer in the bone, brain stem, or other brain structures. In some cases, a chest X-ray is used to rule out secondary tumours or lung cancer metastasising to the brain.
PET scan and other tests
A positron emission tomography (PET scan) or PET CT scan can be used to provide detailed information about tumour metabolism, cancer cells, or cancer spread. These imaging tests may be combined for a more comprehensive diagnosis. Advanced techniques such as MR spectroscopy and MR perfusion or lumbar puncture (to assess cerebrospinal fluid for tumour cells) are performed when needed. These detailed images and small sample analyses help at every stage of care.
Tissue sampling: confirming the diagnosis
Understanding biopsy procedures
A brain biopsy, often stereotactic, using scans to guide a needle biopsy through a small hole, removes a small sample of tumour tissue. This is critical to confirm the diagnosis, tumour types, and cancerous cells or benign brain tumour. Depending on clinical features, a neurosurgeon may perform an open biopsy or remove tumour tissue during surgery, which also provides material for molecular testing and further diagnosis.
Biopsy sample analysis identifies tumour cells, types of brain tumours, and specific characteristics to choose the most effective treatment. For some tumours in hard-to-reach areas like the pineal gland or pituitary tumours, biopsy may be challenging, and diagnosis may rely on imaging, blood tests, and clinical oncology expertise.
Advanced diagnostic testing
Grading and behaviour
Tumours are classified by how abnormal cells appear and whether they are slow-growing tumours (benign) or aggressive malignant tumours. Grading also considers how quickly the tumour is likely to grow, affect healthy brain tissue, or invade blood vessels. High-grade malignant brain tumours, such as malignant gliomas, are faster-growing and require urgent treatment, whereas benign tumours or slow-growing tumours may be monitored with next review imaging tests.
Additional imaging and planning
Your medical team may use functional MRI, MR spectroscopy, or magnetic resonance imaging with special protocols to assess tumour types, blood flow, and brain function. Mapping critical areas before surgery or radiation therapy helps to avoid damaging healthy brain tissue and support nerve cells during treatment.
Specialised testing of tumour cells
Detailed analysis of tumour cells from a brain biopsy or surgery is vital. Molecular and genetic testing can reveal genetic mutations, distinguishing primary brain tumours from secondary tumours, and can inform whether targeted therapies or clinical trials may benefit your diagnosis. For common brain tumour types, this testing helps personalise treatment, especially for rare tumours or atypical signs.
What to expect: timeline and results
The timeline for diagnosis varies. Imaging test results from an MRI or CT scan are often available within days. Biopsy sample analysis or advanced tests may take a week or more. Your healthcare team, including a specialist nurse, will explain results, provide emotional support, outline the diagnosis, and plan for treatment or next review.
Supporting your health journey
Preparing for appointments
To make the most of your appointments:
- Write down any questions, review other symptoms, and bring information about your general health.
- Keep all previous imaging (X-rays, brain scan, MRI scan) and test reports organised.
- Bring a family member or friend for emotional support.
- Record details about current medications, prior clinical oncology treatments, or any diagnosis affecting the brain and spinal cord.
Managing anxiety and stress
A possible diagnosis of brain cancer, whether for primary tumours, secondary brain tumours, or rare brain tumour types, is daunting. Support resources are available, including further tests, clinical trials, charities, and peer support. Our healthcare team is dedicated to providing compassionate, clear information and clinical care within the central nervous system pathway.
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We know the benefits of cancer care at home
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Your guide to brain cancer treatment
A brain cancer diagnosis can be overwhelming. Rest assured, you’re not alone, and there are many options for managing the condition and tailoring treatment to suit your individual needs.
Our guide is here to help you understand private brain cancer treatment and the main treatment options available.
