A brain cancer diagnosis is generally made by a neurologist. Other doctors involved in diagnosing brain cancer may include primary care physicians, oncologists, pathologists, and neoropathologists. Necessary tests, procedures, and exams required for a brain cancer diagnosis typically include a neurological exam, various diagnostic tests, blood samples, a biopsy of the tumor, and proper analysis and evaluation of the brain tissue. Brain cancer is not taken lightly and often requires a multitude of medical tests, exams, and professional opinions before a final diagnosis is determined.
Brain cancer is usually detected as a result of a patient experiencing other complications or illnesses, so a primary care physician is often the first doctor involved in the brain cancer diagnosis. If the primary care physician suspects neurological problems, he or she may recommend and schedule a neurological exam and appointment. A neurologist will likely check vision, coordination, hearing, reflexes, and balance. These exams may help the neurologist determine which areas of the brain could be affected.
After a thorough neurological exam has been performed, a number of diagnostic tests may be ordered. Tests could include magnetic resonance imaging (MRI), computerized tomography (CT), or positron emission tomography (PET). These brain scans can help determine the location in the brain where a tumor might be present. The patient generally receives a dye injection through a vein before the test. This dye enhances the image of the tumor on the brain scan, making it easier to locate and diagnose.
Once a brain tumor has been located, a biopsy is generally necessary to determine malignancy. In many cases, a biopsy is done at the time of surgery and a piece of the tumor is taken to be placed under a microscope and evaluated. If the tumor is in a difficult place to reach, a stereotactic needle biopsy may be performed. For this procedure, the patient is fitted with a stereotactic head frame and a small hole is drilled in the skull. A needle is then inserted into the hole and a sample of the tissue surrounding the tumor is taken.
The sample of tumor or tissue that is taken during the biopsy must be thoroughly analyzed by a pathologist or neuropathologist before a brain cancer diagnosis is made. A number of factors are taken into consideration when making the diagnosis. The team of doctors must properly analyze and evaluate the size, location, and grade of the tumor, as well as determine how quickly it is metastasizing and advancing before a definite brain cancer diagnosis can be made.