Diagnosis and Treatment
How are brain tumours diagnosed
Brain tumours are diagnosed using a combination of scans, medical assessments, and sometimes analysis of a tissue sample. Together, these results build a detailed picture of the tumour’s type, grade, and impact on the brain, guiding treatment planning. A full diagnosis can take time because symptoms often resemble other conditions, and some tests take time to process.
Imaging
The first step is usually a brain scan:
MRI (magnetic resonance imaging)
is the main test used. It provides detailed pictures of the brain and can show the size, location, and features of a tumour.
CT (computed tomography) scans
are sometimes used if MRI is not immediately available or suitable.
PET (positron emission tomography) scans
use a small amount of radioactive tracer to show how active cells are in different parts of the brain. PET scans are not always needed but may be used to plan radiotherapy or assess recurrence.
Functional or contrast scans
may help doctors see how the tumour affects brain activity or blood flow.
Biopsy and pathology
If imaging suggests a tumour, doctors may take a small sample of tissue (a biopsy) to confirm the diagnosis. This can be done during surgery to remove the tumour, or through a needle biopsy.
Pathologists examine the tissue under a microscope to identify the type and grade of tumour. Increasingly, they also run molecular and genetic tests to identify key mutations and markers that influence treatment and outcomes.
Other tests
Additional assessments may include:
- Neurological examinations to check movement, speech, memory, and reflexes
- Blood tests to assess overall health and rule out other conditions
- Spinal fluid (lumbar puncture) in some cases, to see if tumour cells have spread through the cerebrospinal fluid
Overview of treatment approaches
Brain cancer treatment is highly individualised. It depends on the tumour’s type, grade, size, location, and molecular features, as well as the person’s overall health and preferences.
Surgery
Surgery is often the first step in treating a brain tumour. The aim is to remove as much of the tumour as safely possible while protecting vital areas of the brain that control movement, speech, or other key functions.
The extent of surgery depends on the tumour’s location, size, and type. In some cases, only part of the tumour can be removed if it lies close to important brain regions. Surgery may also be done to relieve pressure, drain fluid, or take a tissue sample (biopsy) for diagnosis.
Some people have surgery while awake (awake craniotomy), allowing the surgeon to test speech or movement during the operation to reduce the risk of damage. Recovery times vary, but most people stay in hospital for several days and are closely monitored by a specialist team.
Some patients may undergo multiple surgeries at different points in their treatment.
Radiation therapy (radiotherapy)
Radiotherapy uses precisely targeted beams of radiation to destroy tumour cells or slow their growth. It is often given after surgery to treat any remaining cancer cells, or as the main treatment if surgery isn’t possible.
Treatment usually takes place over several weeks, with daily sessions on weekdays. Side effects can include fatigue, scalp irritation, and temporary hair loss in the treated area.
Newer techniques such as stereotactic radiosurgery or intensity-modulated radiotherapy (IMRT) allow very focused treatment, which can reduce damage to healthy tissue.
Chemotherapy
Chemotherapy uses drugs to kill or slow the growth of tumour cells. Chemotherapy can be taken as tablets, through an intravenous drip, or occasionally placed directly into the brain during surgery. Side effects vary but may include nausea, tiredness, lowered immunity, and hair thinning.
Response to chemotherapy can depend on the tumour’s genetic or molecular features.
Targeted and emerging therapies
These newer treatments act on specific genetic or molecular features of the tumour cells. They aim to stop cancer cells growing or help the immune system recognise and attack them.
Examples include drugs that target specific mutations, or treatments that block growth signals within tumour cells. Access to these therapies in Australia is still developing and may depend on tumour type, test results, and clinical trial availability.
Steroids and anti-seizure medicines
These medicines and often prescribed manage the side effects of brain cancer, or its treatment.
Steroids are commonly prescribed to reduce swelling (oedema) around the tumour, which can relieve symptoms like headaches, weakness, or nausea. They are usually used short term but may need careful tapering to avoid side effects.
Anti-seizure medicines (anticonvulsants) help prevent or control seizures, which can occur when the tumour irritates or presses on parts of the brain. Your care team will adjust the dose or type of medicine as needed.
Clinical trials
Some people may be eligible to take part in a clinical trial as part of their treatment plan or alongside standard care. For more information about clinical trials, see our Research section.
More information
Which health professionals will I see
Treatment of brain cancer is managed by a multidisciplinary team – a group of specialists who work together to plan and deliver your care. The exact mix of professionals will depend on your diagnosis, treatment plan, and personal preferences. Your team coordinates your care, discusses your progress, and helps you make decisions at each stage of treatment and recovery.
Core members of your treating team
- Neurosurgeon – A specialist who performs brain surgery. They diagnose and remove tumours where possible and may also take a tissue sample (biopsy) for testing.
- Medical oncologist – Oversees drug-based treatments such as chemotherapy, targeted therapy, and immunotherapy. They monitor how you respond to treatment and manage side effects.
- Radiation oncologist – Plans and supervises radiotherapy treatment. They determine the best dose and technique to target the tumour while protecting healthy brain tissue.
- Nurse – Specialist nurses provide information, coordinate appointments, and monitor symptoms or side effects. They are often your first point of contact within the hospital team.
- Brain Cancer Care Coordinator (BCCC) – A dedicated nurse or allied health professional who helps you navigate the health system. They link you to the right services, provide information, and offer emotional and practical support for you and your family.
Specialists involved in diagnosis and imaging
- Neurologist – A doctor who specialises in disorders of the brain and nervous system. They may be involved in diagnosis, managing seizures, or monitoring neurological symptoms.
- Pathologist – Examines tumour tissue under a microscope and performs molecular tests to confirm the tumour type and grade. Their report guides the treatment plan.
- Radiologist – interprets brain scans such as MRI, CT, or PET.
- Radiation therapist – delivers the radiotherapy prescribed by your radiation oncologist, ensuring accuracy and safety during each session.
Allied health and supportive care professionals
Alongside medical treatment, supportive care focuses on quality of life – managing symptoms, fatigue, cognition, mood, and physical function. Allied health support is highly individualised to the patient’s needs and stage of treatment.
Allied health support may include any of the following therapists:
- Neuropsychologist/Psychologist
- Physiotherapist
- Occupational therapist
- Speech therapist
- Exercise physiologist
General Practitioner (GP)
Your GP can play a key role in your ongoing care. They help refer you to and coordinate between hospital specialists, manage other health issues, and provide support close to home.
Palliative care specialists
Palliative care focuses on symptom relief, comfort, and emotional and practical support at any stage of illness. Palliative care is not only for the end of life and can happen either in tandem with or after treatment of brain cancer.
Palliative care specialists work alongside your treatment team to help manage pain, fatigue, and other symptoms, and to support decision-making about care goals. Accessing palliative care early can improve quality of life for both patients and families and ensure care aligns with what matters most to you.