Definition

What is brain metastase?

Brain metastases are the spread of a primary tumor to the brain. This is different from a primary brain tumor. Differing between these two types of brain lesions is a common source of confusion for many people. For example, a lung cancer is first formed in the lung tissue, but tumor cells can break off from the original mass and travel through the bloodstream or lymph system to other areas of the body, including the brain. This spreading of the tumor is known as “metastasis’. When a lung cancer metastasizes to the brain, this “brain tumor’ is actually lung cancer cells.

How common is brain metastase?

The exact incidence of brain metastases is not known. Studies suggest brain metastases occur in 10%-30% of patients with cancer. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of brain metastase?

The common symptoms of brain metastase are:

Headache, sometimes with vomiting or nausea
Mental changes, such as increasing memory problems
Seizures
Dizziness

Brain tumor symptoms vary depending on the tumors’ size, number, location and rate of growth.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes brain metastase?

Brain metastases occur when cancer cells travel through the bloodstream or the lymph system from the original tumor and spread (metastasize) to the brain. There they begin to multiply. Metastatic cancer that spreads from its original location is known by the name of the primary cancer. For example, cancer that has spread from the breast to the brain is called metastatic breast cancer, not brain cancer.

There are many theories about what causes some cancers to spread and why some cancers travel to the brain. Brain metastases from lung cancer are often found early in the course of the disease, and those from breast cancer develop late.

Risk factors

What increases my risk for brain metastase?

There are many risk factors for brain metastase, such as:

Lung cancer
Breast cancer
Colon cancer
Kidney cancer
Melanoma

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is brain metastase diagnosed?

If it’s suspected that you have brain metastases, your doctor may recommend a number of tests and procedures.

A neurological exam. A neurological exam may include, among other things, checking your vision, hearing, balance, coordination, strength and reflexes. Difficulty in one or more areas may provide clues about the part of your brain that could be affected by a brain tumor.
Imaging tests. Magnetic resonance imaging (MRI) is commonly used to help diagnose brain metastases. A dye may be injected through a vein in your arm during your MRI study. A number of specialized MRI scan components — including functional MRI, perfusion MRI and magnetic resonance spectroscopy — may help your doctor evaluate the tumor and plan treatment. Other imaging tests may include computerized tomography (CT) and positron emission tomography (PET). For example, if the primary tumor causing your brain metastases is unknown, you might have a chest CT scan to look for lung cancer.
Collecting and testing a sample of abnormal tissue (biopsy). A biopsy can be performed as part of an operation to remove a brain tumor, or it can be performed using a needle. The biopsy sample is then viewed under a microscope to determine if it is cancerous (malignant) or noncancerous (benign) and whether the cells are metastatic cancer or from a primary tumor. This information is critical to establish a diagnosis and a prognosis and to guide treatment.

How is brain metastase treated?

If diagnosed and treated early, brain metastases usually respond to therapy. These therapies can help ease symptoms, slow tumor growth and extend life.

Treatment options for people with brain metastases often include medication, surgery, stereotactic radiosurgery, whole-brain radiation therapy or some combination of these. In some cases, chemotherapy and immunotherapy are helpful. Tumors may recur after treatment.

What treatments are best for you will depend on the size, number and location of the tumors, as well as your signs and symptoms, overall health, and preferences. Talk with your doctor about your goals for treatment.

Medication

High-dose corticosteroids may be used to ease swelling around the tumors and decrease the neurological signs and symptoms.

Surgery

If surgery is an option for you and your brain metastases are located in places that make them accessible for an operation, your surgeon will work to remove as much of the cancer as possible. Even removing a portion of the tumor may help reduce your signs and symptoms.

Surgery to remove brain metastases carries risks, such as neurologic deficits, infection and bleeding. Other risks may depend on the part of your brain where your tumors are located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays, to kill tumor cells. For brain metastases, your treatment may involve one or both of the following radiation therapy methods:

Whole-brain radiation. Whole-brain radiation applies radiation to the entire brain in order to kill tumor cells. People undergoing whole-brain radiation usually require 10 to 15 treatments over two to three weeks. Side effects may include fatigue, nausea and hair loss. Long-term, whole-brain radiation is associated with cognitive decline.
Stereotactic radiosurgery. With stereotactic radiosurgery (SRS), each beam of radiation isn’t particularly powerful, but the point where all the beams meet — at the brain tumor — receives a very large dose of radiation to kill the tumor cells. SRS is typically done in one treatment, and doctors can treat multiple tumors in one session. In most cases you can go home the same day. Side effects may include nausea, headache, seizures, and dizziness or vertigo. The risk of long-term cognitive decline after SRS is thought to be less than that with whole-brain radiation. In recent years, doctors and researchers have made significant advances in their understanding of whole-brain radiation, stereotactic radiosurgery and how these two methods affect people’s survival, cognitive ability and quality of life. In deciding which type of radiation therapy to use, you and your doctor will consider many factors, including what other treatments you’re undergoing and the potential for you to experience cancer recurrences after treatment.

Rehabilitation after treatment

Because brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Your doctor may refer you to services that can help:

Physical therapy can help you regain lost motor skills or muscle strength.
Occupational therapy can help you get back to your normal daily activities, including work, after a brain tumor or other illness.
Speech therapy with specialists in speech difficulties (speech pathologists) can help if you have difficulty speaking.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your doctors to provide an extra layer of support that complements your other treatments.

Palliative care is provided by a team of specialists in medicine, psychology, spiritual care and social work. This team works to help improve the quality of life for people with cancer and their families.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage brain metastase?

The following lifestyles and home remedies might help you cope with brain metastase:

Gentle exercise. If you get the OK from your doctor, start with gentle exercise a few times a week and add more if you feel up to it. Consider walking, yoga or tai chi.
Managing stress. Take control of the stress in your daily life. Try stress-reduction techniques such as muscle relaxation, visualization and meditation.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.