If it's suspected that you have a brain tumor, your doctor may recommend a number of tests and procedures, including:

• A neurological exam. A neurological exam may include, among other things, checking your vision, hearing, balance, coordination, strength and reflexes. Difficulty in one or more areas may provide clues about the part of your brain that could be affected by a brain tumor.

• Imaging tests. Magnetic resonance imaging (MRI) is commonly used to help diagnose brain tumors. In some cases a dye may be injected through a vein in your arm during your MRI study.

  A number of specialized MRI scan components — including functional MRI, perfusion MRI and magnetic resonance spectroscopy — may help your doctor evaluate the tumor and plan treatment.

  Other imaging tests may include computerized tomography (CT) scan and positron emission tomography (PET).

• Tests to find cancer in other parts of your body. If it's suspected that your brain tumor may be a result of cancer that has spread from another area of your body, your doctor may recommend tests and procedures to determine where the cancer originated. One example might be a CT scan of the chest to look for signs of lung cancer.

• Collecting and testing a sample of abnormal tissue (biopsy). A biopsy can be performed as part of an operation to remove the brain tumor, or a biopsy can be performed using a needle.

  A stereotactic needle biopsy may be done for brain tumors in hard to reach areas or very sensitive areas within your brain that might be damaged by a more extensive operation. Your neurosurgeon drills a small hole into your skull. A thin needle is then inserted through the hole. Tissue is removed using the needle, which is frequently guided by CT or MRI scanning.

  The biopsy sample is then viewed under a microscope to determine if it is cancerous or benign. This information is critical to establish a diagnosis and prognosis and, most importantly, in guiding treatment.

  Treatment

  Treatment for a brain tumor depends on the type, size and location of the tumor, as well as your overall health and your preferences.

  Surgery

  If the brain tumor is located in a place that makes it accessible for an operation, your surgeon will work to remove as much of the brain tumor as possible.

  In some cases, tumors are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumors can't be separated from surrounding tissue or they're located near sensitive areas in your brain, making surgery risky. In these situations your doctor removes as much of the tumor as is safe.

  Even removing a portion of the brain tumor may help reduce your signs and symptoms.

  Surgery to remove a brain tumor carries risks, such as infection and bleeding. Other risks may depend on the part of your brain where your tumor is located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.

  Radiation therapy

  Radiation therapy uses high-energy beams, such as X-rays or protons, to kill tumor cells. Radiation therapy can come from a machine outside your body (external beam radiation), or, in very rare cases, radiation can be placed inside your body close to your brain tumor (brachytherapy).

  External beam radiation can focus just on the area of your brain where the tumor is located, or it can be applied to your entire brain (whole-brain radiation). Whole-brain radiation is most often used to treat cancer that has spread to the brain from some other part of the body.

  Side effects of radiation therapy depend on the type and dose of radiation you receive. Common side effects during or immediately following radiation include fatigue, headaches and scalp irritation.

  Radiosurgery

  Individual radiation beams are too weak to hurt the brain tissue they travel through on the way to the target. The radiation is most powerful where all the beams intersect.

  Stereotactic radiosurgery is not a form of surgery in the traditional sense. Instead, radiosurgery uses multiple beams of radiation to give a highly focused form of radiation treatment to kill the tumor cells in a very small area. Each beam of radiation isn't particularly powerful, but the point where all the beams meet — at the brain tumor — receives a very large dose of radiation to kill the tumor cells.

  There are different types of technology used in radiosurgery to deliver radiation to treat brain tumors, such as a Gamma Knife or linear accelerator (LINAC).

  Radiosurgery is typically done in one treatment, and in most cases you can go home the same day.

  Chemotherapy

  Chemotherapy uses drugs to kill tumor cells. Chemotherapy drugs can be taken orally in pill form or injected into a vein (intravenously). The chemotherapy drug used most often to treat brain tumors is temozolomide (Temodar), which is taken as a pill. Many other chemotherapy drugs are available and may be used depending on the type of cancer.

  Chemotherapy side effects depend on the type and dose of drugs you receive. Chemotherapy can cause nausea, vomiting and hair loss.

  Targeted drug therapy

  Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

  One targeted drug therapy used to treat a type of brain cancer called glioblastoma is bevacizumab (Avastin). This drug, given through a vein (intravenously), stops the formation of new blood vessels, cutting off blood supply to a tumor and killing the tumor cells.

  The targeted drug everolimus (Afinitor) is used to treat a benign brain tumor that occurs in people with a genetic disorder called tuberous sclerosis. Everolimus blocks an enzyme in the body that plays a role in the growth of cancer cells.

  Rehabilitation after treatment

  Because brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Your doctor may refer you to services that can help, such as:

  • Physical therapy can help you regain lost motor skills or muscle strength.
  • Occupational therapy can help you get back to your normal daily activities, including work, after a brain tumor or other illness.
  • Speech therapy with specialists in speech difficulties (speech pathologists) can help if you have difficulty speaking.
  • Tutoring for school-age children can help kids cope with changes in their memory and thinking after a brain tumor.