If a brain tumor is found on an MRI scan, there are several steps the doctors will take to confirm the diagnosis and determine the best course of treatment. An MRI (magnetic resonance imaging) is one of the main imaging tests used to look for brain tumors. It creates detailed pictures of the brain and can often detect tumors that may not show up on other scans.
Confirming the Brain Tumor Diagnosis
The radiologist who interprets the MRI will be looking for certain signs of a brain tumor, such as an abnormal mass or lesion in the brain. However, other conditions like infections, cysts, or abnormalities in blood vessels can also look similar on an MRI. So an MRI finding suspicious for a brain tumor is not enough to definitively diagnose it.
To confirm there is a brain tumor, the doctor will typically recommend getting a biopsy of the concerning area seen on the MRI. This involves a neurosurgeon surgically removing a small piece of the abnormal tissue. It is then examined under a microscope by a pathologist to determine if cancer cells are present. Knowing the type of tumor cells allows the doctors to diagnose the specific type of brain tumor.
In some cases if the brain tumor appears to be in a location that is difficult to access for biopsy, the doctor may diagnose it based on the MRI results combined with the clinical picture – the symptoms the patient is exhibiting that are typical with a brain tumor in that location. But a biopsy is still the gold standard for diagnosis.
Brain Tumor Treatment Planning
Once a brain tumor is definitively diagnosed, further imaging tests may be done to aid in treatment planning. For example, CT or positron emission tomography (PET) scans are often used to get additional views of the tumor location and determine if it has spread. MRI scans may also be repeated periodically to monitor tumor growth and check for any new areas of disease.
The medical team, often led by a neuro-oncologist who specializes in brain tumors, will determine the best treatment plan based on:
- The type of brain tumor cells (e.g. whether astrocytoma, meningioma, etc.)
- The tumor’s grade, which indicates how aggressive it looks under the microscope
- The tumor’s exact location and size
- Whether it has spread to other areas
- The patient’s age, overall health, and preferences
Treatment options that may be recommended include:
- Surgery – The primary treatment for most brain tumors is surgical removal, unless the tumor is inaccessible in an area like the brain stem. How much of the tumor can be removed depends on its location and grade.
- Radiation – This uses concentrated beams of radiation to target and destroy remaining abnormal tumor cells after surgery. It may also be the main treatment if the tumor cannot be treated with surgery.
- Chemotherapy – Drugs that kill rapidly dividing tumor cells may be used alone or along with radiation, especially for cancerous tumors.
- Other drugs – Medications may help treat symptoms or slow tumor growth. Examples are corticosteroids to decrease swelling or antiseizure medications.
Prognosis and Outlook After Brain Tumor Diagnosis
The prognosis after a brain tumor diagnosis can vary significantly based on the type of tumor and other factors. Here is an overview of the prognosis for some of the most common adult brain tumors:
Glioblastoma
This most aggressive type of astrocytoma brain tumor has a poorer prognosis, with median survival around 12-18 months. Only around 5% of patients live longer than 5 years.
Anaplastic astrocytoma
Survival rates are somewhat better than glioblastoma, with median survival around 2-3 years. Around 15% may live at least 5 years.
Diffuse astrocytoma
These are slow-growing tumors with better prognosis than more anaplastic astrocytomas. Median survival is around 7 years, with over 60% living at least 5 years.
Meningioma
Most meningiomas are benign Grade I tumors that may be cured if totally resected. The 15-year survival rate is over 80%. Higher grade meningiomas have higher recurrence risk and worse prognosis.
Pituitary adenomas
These common pituitary gland tumors are typically benign and when treated have a good prognosis. The 10-year survival rate is over 90%. A small percentage transform into cancerous tumors with poorer prognosis.
In addition to the tumor type, other factors impact prognosis. For example, brain tumors tend to have worse outcomes and survival rates if they are:
- Located deep in the brain or near vital structures
- Difficult to remove fully with surgery
- Cancerous (malignant) versus benign tumors
- Higher grade or very rapidly growing
- Recurrent after prior treatment
Regular MRIs will be done after treatment to monitor the brain and look for any tumor recurrence. Ongoing care with the neuro-oncology team is crucial to manage symptoms and side effects. Supportive care and clinical trials of new treatments may also help improve outlook and survival.
Coping Emotionally With a Brain Tumor Diagnosis
Being diagnosed with a brain tumor is a life-changing event that can be emotionally devastating. Patients often suffer from depression and anxiety while processing the news and its impact on their future health and mortality. In addition to pursuing the best medical treatment, it is vital to also address the psychological aspects of the diagnosis by:
- Letting yourself feel and process the emotions of fear, grief or anger. Joining a support group can help you feel less alone.
- Talking openly with your family and loved ones about your feelings and involving them in treatment decisions.
- Working with a therapist or counselor to cope with the psychological stress.
- Using relaxation techniques like meditation, yoga, or prayer to help stay calm and positive.
- Keeping up independence for as long as possible through rehabilitation and mobility aids.
- Participating in normal social activities and hobbies that you enjoy, as able.
- Setting small daily goals to maintain a sense of purpose.
While a brain tumor diagnosis represents a major challenge, patients have full productive lives for many years by following their treatment plan and focusing on emotional health. With the support of your medical team and loved ones, it is possible to adjust to the “new normal” over time.
Conclusion
Finding a suspicious brain tumor on an MRI scan warrants further evaluation and testing to confirm the diagnosis. If a brain tumor is definitively diagnosed, the treatment plan is tailored to the type of tumor and health of the individual. Average prognosis varies widely based on the tumor characteristics. While some brain tumors have poor survival, others like benign meningiomas may be cured. Processing the emotional aspect of the diagnosis and following the prescribed treatments can help patients continue living meaningful, enjoyable lives despite the challenges of a brain tumor.