Investigation

In order to build up a picture of your brain, The London Clinic may offer the following:

CT scan: this machine takes a series of x-rays to build up a 3D image of your brain. It takes 10 minutes and is painless, and the radiation level used is very low. You should not eat or drink for four hours beforehand, and you may be given an injection of contrast to allow certain areas to show up more clearly under the CT scanner.

MRI scan: patients routinely undergo standard MRI as well as MR spectroscopy and perfusion imaging. This provides important information as to the likely grade of the tumour (glioma grade 1, 2, 3 or 4 / oligodendroglioma grades 1, 2 or 3). Patients also undergo a functional MRI if the tumour is close to an eloquent part of the brain (speech centre or motor strip).

Treatment

Surgery: Peter Bullock will remove as much of the tumour as possible via surgery. However, how much can be removed safely depends partly on the position of the tumour in your brain. If there is a small part left (the residuum), this may need to be treated with radiotherapy and/or chemotherapy.

Radiotherapy: if your tumour cannot be entirely removed by surgery and a small part of it is left it may be treated by conventional external beam radiotherapy, or Peter Bullock can offer state-of-the-art radiotherapy using stereotactic techniques such as the CyberKnife®. This enables him to deliver a radiation dose with pin-point accuracy.

Chemotherapy: chemotherapy may be offered hand-in-hand with whole brain radiotherapy if you have a fast-growing tumour of grade 3 or 4 (grade 1 and grade 2 tumours are normally slow-growing). Two drugs that may be used are Avastin and Temozolamide.