Brain metastasis refers to the spread (metastasis) of cancer to the brain from another part of the body. Over the last few decades, the improved effectiveness of surgery, chemotherapy and radiotherapy has meant people now survive cancer for longer than ever before.
In addition, more advanced diagnostic and screening methods mean cancer is often detected early, well before it has spread from its site of origin to other parts of the body. However, brain tumors still occur in patients months or years after they first received treatment.
The prognosis of brain metastasis is poor and most patients with this condition eventually die. In many cases, patients do not experience any symptoms as a result of having cancer until it has spread to the brain. Once the cancer does involve the brain, symptoms may be wide ranging and examples include:
- Nausea and vomiting
- Loss of memory
- Cognitive changes
- Behavioral changes
- Visual disturbances
- Numbness and tingling of limbs
- Balance problems
- Bell’s palsy
A study of 2,700 patients being treated for brain metastasis showed that common cancers from which the brain tumors originated included lung cancer, breast cancer, genitourinary cancer, osteosarcoma, melanoma, head and neck cancer, pancreatic cancer, neuroblastoma and lymphoma.
The treatment of brain metastasis is usually focused on relieving symptoms and prolonging survival. In some cases, procedures such as open craniotomy, aggressive chemotherapy and radiosurgery may be attempted if a patient is young and fit.
Some of the symptomatic therapies that may be administered include corticosteroids to prevent edema (swelling) in the brain and anti-epileptic drugs to prevent seizures.
Radiotherapy may be given in the form of whole-brain irradiation, radiosurgery or fractionated radiotherapy. Surgery is often used to remove a single tumor or a limited number of tumors that are located close to each other.
Reviewed by Sally Robertson, BSc