Modulation of the coupling of light into a waveguide via a grating, together with a novel approach to analyzing the data, is used to investigate the attachment of human embryonal carcinoma stem cells to three substrata: silica-titania (representative of artificial implants); poly-lysine (a commonly used laboratory cell culture substrate); and mucin (the coating of the mucosae). By considering both in-coupling peak width and position, the secretion of microexudate by the cells, the formation of filopodia, and the overall change in their shape (spreading) can be distinguished. This cannot be achieved by the conventional microscopic imaging approach. Moreover, we obtain the kinetics of these processes with excellent time resolution.