Tests for brain tumours

Usually you begin by seeing your family doctor who will examine you and ask about your general health.

Your doctor will ask you about your symptoms. This will include what they are, when you get them and whether anything you do makes them better or worse.

Your doctor will ask you to have a physical examination. This includes an examination of your nervous system.

Testing your nervous system is called a neurological examination. It involves a number of simple tests. Your doctor will do the following.

• Test your muscle strength by asking you to squeeze their hand with each of yours or push against their hand with your feet
• Test your reflexes, tapping your knee with a rubber hammer
• Look into your eyes to see if there are any changes inside the eye
• Shine a light at your eyes to see if your pupils react
• Ask you to follow a moving finger with your eyes

Your doctor may also do the following tests.

• Check to see that you have normal sensation (feeling) throughout your body
• Ask about your hearing and sight
• Get you to walk in a straight line or stand on one leg
• Ask you to touch your nose with your finger while your eyes are shut
• Ask you to answer simple questions
• Ask you to remember a short list for a few minutes and repeat it back
• Ask about your general health, including periods for women, or general growth and development (including puberty) for children

You may think it odd if your doctor asks to examine your breasts, tummy (abdomen) or back passage (rectum). This is because your GP wants to make sure there is no obvious sign of a cancer somewhere else in your body (primary cancer). It is more common for an adult to have a cancer that has spread to the brain from somewhere else (secondary brain tumour) than a tumour that starts in the brain (primary brain tumour).

After your examination, your doctor will refer you to hospital for tests and X-rays if anything appears to be wrong. Even if your doctor can find nothing wrong, you may still need to have more tests if your symptoms suggest you may have a brain tumour. Your GP may send you directly to a specialist. You may be admitted to hospital so that you can have tests done quickly.

If you see a specialist, you will be asked about your medical history, symptoms and general health. The specialist will then do another neurological examination. You may have blood tests and a chest X-ray to check your general health. Then your other tests will be arranged in the outpatient department. Your specialist may want you to have one or more of the following tests.

A CT scan is a computerised scan using X-rays. Brain tumours will usually show up on this type of scan. When you have your CT, you have an injection during or just before the scan. This is called a 'contrast medium'. It is a dye that circulates in your bloodstream to the brain and makes the CT pictures of the brain clearer. There is detailed information about having a CT scan in the section about cancer tests.

MRI is a scan using magnetism. It usually gives the clearest picture of the brain of any type of scan and will almost certainly show up a brain tumour. You usually have an injection of contrast medium (see above) to make the MRI scan clearer.

It is very important to tell your doctor if you have any metal inside your body as this may mean you cannot have an MRI scan. There is detailed information about having an MRI scan in the section about cancer tests.

You may have X-rays to check your general state of health. This will be important if you are diagnosed with a brain tumour because you may need to have surgery or intensive radiotherapy treatment.

You may have blood tests to check for specific chemical markers in the blood. Some tumours, such as  pineal region tumours or germ cell tumours may change the level of particular hormones and your doctor will check for these.