NCCN Guidelines for Patients
Brain Cancer – Gliomas, Version 1.2016
Test and treatment overview
Not everyone can have an MRI. The magnetic fields
can be an issue. You cannot get an MRI if you have
a pacemaker, some types of cardiac monitors, or
certain types of surgical clips.
Instead of MRI, you may get a CT (
omography). CT takes many pictures of a body
part from different angles using x-rays. A computer
combines the x-ray images to make a detailed
picture. Images will be made with and without
contrast. Getting a CT scan is like getting a MRI scan.
A PET (
omography) scan is not
typically used for diagnosis. It is sometimes used
in addition to MRI or CT scans if the cancer returns
after treatment. For PET, a sugar radiotracer will first
be injected into your body. After a few hours, the
radiotracer is detected with a special camera during
the scan. Cancer cells appear brighter than normal
cells because they use sugar more quickly.
You will likely undergo surgery if there may be a
primary tumor in your brain or spine. One goal of
surgery is to confirm the diagnosis. Tissue from
the tumor must be removed and tested to know for
certain if there’s cancer. Another goal of surgery is to
remove as much of the tumor as possible. For brain
tumors, surgery may be used to relieve pressure
inside the skull or to treat seizures that are hard to
The types of surgery used for gliomas are briefly
described next. Your treatment team can provide
more information. A neurosurgeon—an expert in
surgery of the nervous system—will perform your
Resection is a major surgery that removes a large
piece of tissue. A gross total resection removes all
of the cancer that your surgeon can see. A subtotal
resection removes part of the tumor. Carmustine
wafers may be inserted into your brain after surgery.
This treatment is described more in the section,
You will be given medicine to help you relax or sleep
during the surgery. Your scalp will also be numbed.
The brain does not feel pain, which is why you can
Imaging and sometimes other tests are used to get
the best results. Your surgeon needs to know where
in your brain is the tumor and the key brain areas
(eg, speech, movement). Tests will be received
before and sometimes during the operation. You may
need to be awake during the operation so that the
key brain areas can be found.
Your surgeon will first cut your scalp and fold back
your skin. Next, he or she will use a small drill to
Once home from surgery, use a
recliner that lays back but is inclined.
Get a shower chair. You should
not stand until you're stable on your
Get help with washing your hair
to keep clear of the incision. Have
someone in the bathroom to make
sure nothing happens.