Brain cancer symptoms
Not all brain tumours cause symptoms, and some (such as tumours of the pituitary gland) are found mainly after death. The symptoms of brain tumours are numerous and are not specific to brain tumours, meaning they can be caused by many other illnesses as well. The only way to be absolutely sure what is causing the symptoms is to consult a doctor and undergo diagnostic testing.
- Symptoms are caused by the tumour pressing on or encroaching on other parts of your brain and preventing them from functioning normally.
- Some symptoms are caused by swelling in the brain caused by the tumour or surrounding inflammation.
- The symptoms of primary and metastatic brain cancers are similar.
The following symptoms are most common:
- Difficulty walking
Other nonspecific symptoms and signs include the following:
- Altered mental status - changes in concentration, memory, attention, or alertness
- Nausea, vomiting - especially early in the morning
- Abnormalities in vision
- Difficulty with speech
- Gradual changes in intellectual or emotional capacity
In many people, the onset of these symptoms is very gradual and may be missed by both the person with the brain tumour and the family. Occasionally, however, these symptoms appear more rapidly. In some instances, the person has symptoms or signs that resemble those of a stroke.
Examinations and tests
The findings of your medical interview and physical examination will probably suggest to a doctor, whether your GP or an accident and emergency doctor, that you have a problem with the brain or brain stem.
- In most cases, you will have a CT scan of the brain.
- This test is like an x-ray but shows more detail in three dimensions.
- Usually, a harmless dye is injected into your bloodstream to highlight abnormalities on the scan.
People with brain cancer often have other medical problems; therefore, routine laboratory tests may be performed.
These include analysis of blood, electrolytes, liver function tests, and a blood coagulation profile.
If you have mental state change as the main symptom, blood or urine tests may be carried out to detect drug use or infection.
More and more, the MRI scan is being used instead of CT scan for suspected brain tumours. This is because MRI has a higher sensitivity for detecting the presence of, or changes within, a tumour.
Skull x-rays are not widely used any longer to diagnose brain cancer.
If your scans indicate the presence of a brain tumour, you will be referred to a specialist in cancer (oncologist). If one is available in your area, you should be referred to a specialist in brain tumours (neuro-oncologist).
The next step in diagnosis is confirmation that you have a cancer. A small sample of the mass (a biopsy) is taken to identify the type of tumour.
- The most widely used technique for obtaining a biopsy is surgery. The skull is opened, usually with the intention of removing the whole tumour if possible. A biopsy is then taken from the tumour.
- If the surgeon is unable to remove the entire tumour, a small piece of the tumour is removed.
- In some cases it is possible to collect a biopsy without opening the skull. The exact location of the tumour in the brain is determined stereotactically, that is, by using CT of MRI scan while the head is held still in a frame. A small hole is then made in the skull and a needle guided through the hole to the tumour. The needle collects the biopsy and is removed. This technique is called stereotaxis, or stereotactic biopsy.
- The biopsy is examined under a microscope by a pathologist (a doctor who specialises in diagnosing diseases by looking at cells and tissues).