Cancer screening exams can help find brain cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. 

Although there are currently no screening tests available to detect brain cancers early, expert brain cancer researchers at the OSUCCC – James are working to develop tests that can detect and diagnose these diseases early, leading to improved outcomes, faster responses and fewer side effects.

If you have a strong family history of brain tumors, there may be certain genetic tests that can help identify specific conditions associated with brain tumors. These tests are usually done when a patient is healthy and has no specific symptoms. Most brain cancers arise in people with no known risk factors.

Diagnosing Brain Cancers

An accurate, complete diagnosis is essential for effectively treating brain cancers. Because there is no routine brain cancer, the OSUCCC – James’s world-renowned brain cancer specialists and sub-specialists reach across multiple disciplines and modes of treatment to offer patients the latest technologies and the most advanced procedures to understand brain cancers at the molecular and genetic levels – the levels that drive each patient’s specific kind of brain cancer.

The OSUCCC – James is home to world-renowned diagnostic experts in brain cancers. In fact, our team includes experts who specialize in brain cancer – and only brain cancer, 24/7 – studying, discovering and treating each kind, and developing and delivering leading-edge therapies.

These sub-specialists and super sub-specialists use the most accurate, advanced diagnostic testing and technology to analyze your cancer, enabling an entire team across multiple medical disciplines to determine the most effective, targeted treatment specifically for you.

If a brain tumor is suspected, your OSUCCC – James specialist will examine you and ask you about your medical history, including information about symptoms and any risk factors you may have.

These experts may also conduct the following tests to form a diagnosis:

Physical Exam

During a physical exam, an OSUCCC – James specialist examines the body carefully for any signs of disease. The patient is asked about medical history, lifestyle, any past disease, treatments and family history.

Neurological Exam

During a neurological exam, our experts use a series of specialized questions and tests to check the patient’s brain, spinal cord and nerve function. An OSUCCC – James sub-specialist will analyze the patient’s mental status, capabilities, coordination, muscles and reflexes, and how well all five senses are working.

Visual Field Exam

Your specialist will examine your general eye health and total field of vision by measuring how much you can see when looking straight ahead versus in all other directions.

Any disruption of normal vision may be a sign that a tumor is pressing on parts of the brain involved in eyesight.

Tumor Marker Test

This is a test in which a sample of blood, urine or tissue is taken to measure the presence of a certain substances that organs, tissues or tumor cells may produce when there are tumors present. Tumor marker tests may also help determine whether or not a germ cell tumor is present.

Hormonal testing can help diagnose pituitary tumors.

Genetic Testing

The OSUCCC – James experts may recommend genetic testing if you have an inherited syndrome associated with brain tumors. Using a sample of blood or tissue, this test will check for changes in the DNA that may be linked to a certain type of tumor.

Imaging Tests

Imaging tests produce pictures of the inside of the body and they can help the experts determine the extent, or grade, of the disease. Tests may include:

Computed Tomography Scan (CT Scan)

A type of X-ray test that produces detailed, cross-sectional images of your body. This procedure is also called computed tomography, computerized tomography or computerized axial tomography.

Magnetic Resonance Imaging (MRI) with Gadolinium

MRI scans use radio waves and strong magnets to help the OSUCCC – James sub-specialists see inside the brain and spinal cord. A radioactive substance called gadolinium is injected into a vein before the test. The gadolinium will collect around cancer cells, and then a computer translates the radio waves into a detailed picture to help determine if a tumor is present.

Single Photon Emission Tomography Scan (SPECT)

A SPECT scan produces a 3-D image with a special camera linked to a computer that rotates around the patient’s neck. The images highlight areas where a small amount of a previously injected radioactive substance collects.

This procedure can help the OSUCCC – James experts distinguish between a tumor that began in the brain versus one that moved there from another site in the body.

Positron Emission Tomography (PET)

A PET scan uses a small amount of a radioactive agent mixed with glucose to identify cancer cells in the body. A special imaging camera displays images of these cells brighter that those of normal healthy cells.


This X-ray procedure enables the OSUCCC – James experts to evaluate a patient’s arteries and blood vessels. The patient receives an injection of a small amount of contrast, or dye, which highlights the blood.

Imaging tests may be repeated after treatment to help your OSUCCC – James specialists determine how much, if any, of the tumor is left.


The OSUCCC – James brain cancer experts may perform a biopsy or a resection to diagnose a brain cancer.

Stereotactic or Open Biopsy

A piece of tissue or tumor is removed so that a specially trained OSUCCC – James pathologist can examine the cells under a microscope for any signs cancer. If a tumor is deep within the brain making it difficult to reach with surgery, the OSUCCC – James glioma experts may perform a stereotactic brain biopsy.

In this procedure, the surgeon uses a 3-D scanner and computer to help find the tumor. Using a thin needle placed through an incision in the scalp and an opening in the bone, your OSUCCC – James brain cancer surgeon will remove tumor tissue to be analyzed for cancer cells by a specially trained brain cancer pathologist. If more tissue is needed, the experts may perform an open biopsy by make an opening in skull to remove a small amount of tumor tissue.


If imaging tests show that a tumor can be surgically removed, the OSUCCC – James brain cancer surgeon may remove a part of the skull and, with the help of ultrasound or MRI scan, remove all or part of the tumor.

The following tests may be done on tissue:


A test in which a radioactive antibody (a protein) is used to check for certain antigens in the tissue sample. Cancer cells that produce these antigens will show a distinct staining under a microscope and help the specially trained OSUCCC – James pathologists to determine what type of cancer is present.

Light and Electron Microscopy

A laboratory test in which the experts use a high-powered microscope to examine cells for certain changes that may indicate cancer.

Cytogenetic Analysis

This test analyzes the cells and identifies abnormal chromosomes (where the genes are) that contribute to brain cancer. Identifying these abnormalities can help the OSUCCC – James brain cancer specialists decide the very best kind of personalized treatment for the patient.

Genetic Analysis

In this test, genetic material is obtained from the tumor tissue and examined for changes in genes that may help predict how a tumor may behave.

Staging & Grading Brain Cancers

If you are diagnosed with a brain cancer, grading the tumor is just one of many ways your OSUCCC – James brain cancer experts can determine the amount and location of your cancer, and it can help them choose the most effective, personalized treatment options for your particular cancer.

Tumors that begin in the brain may spread to other parts of the brain and spinal cord, but they rarely spread to other parts of the body. For brain tumors, there is no standard staging system. Instead, brain tumors are grouped by grade.

The tumor grade refers to how the cells look under a microscope:

  • Grade I: The tissue is benign (non-cancerous). The cells look almost like normal brain cells, and they grow slowly.
  • Grade II: The tissue is malignant (cancerous). The cells look less like normal cells than do the cells in a Grade I tumor.
  • Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing (anaplastic)
  • Grade IV: The malignant tissue has cells that look most abnormal and tend to grow quickly

Cells from low-grade tumors (Grades I and II) look more normal and generally grow more slowly than cells from high-grade tumors (Grades III and IV).

Over time, a low-grade tumor may become a high-grade tumor. The change to a high-grade tumor, however, happens more often among adults than children.

(Source: National Cancer Institute)

If you’ve been diagnosed with brain cancer, would like a second opinion or would like to speak with a brain cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

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Columbus, Ohio 43210

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