Metastatic Brain Tumor

A metastatic brain tumor is cancer that has spread to the brain from a primary cancer site located somewhere else in the body.  Cancer of the lungs, breast, or kidney, can spread through the bloodstream and to the brain.  The focus of treatment for metastatic brain tumors is to relieve symptoms and prevent complications.

Your brain is located inside of your skull.  It is the control center of your body.  Your brain controls the way you think, behave, feel, and move your body.  Your brain communicates with the nerves in your body for functions you can control, such as talking or moving your arms and legs.  Your brain also controls the life sustaining functions that happen automatically, including your heartbeat, body temperature, blood pressure, and body metabolism.

Metastatic brain tumors result from cancer that originates in another part of the body and spreads to the brain through the bloodstream.  Primary lung cancer, breast cancer, and melanoma skin cancer most frequently form metastatic brain cancer.  Many other types of primary cancer commonly spread to the brain, including kidney and bladder cancer, sarcomas, testicular cancer, germ cell tumors, and cancer of unknown origin.  Primary colon cancer and prostate cancer may spread to the brain, but do so infrequently.
Metastatic brain tumors are more common than cancerous brain tumors that originate in the brain.  There are different types, locations, and sizes of metastatic brain tumors.  It is common to have multiple tumors.  Brain tumors may be confined to a small area in the brain or spread throughout the brain.  Brain tumors can directly destroy or indirectly damage brain cells.  Brain tumors can compress brain cells and tissue.  They can contribute to brain swelling and increased pressure in the brain (intracranial pressure).  Metastatic brain tumors generally have a poor prognosis.

Metastatic brain tumors may cause a variety of different symptoms based on their size and location.  Some tumors may not cause symptoms until they are large, and then symptoms may occur rapidly.  Most frequently, symptoms are caused by increased pressure in the brain.  Common symptoms include headaches, seizures, and vomiting, with or without nausea.  You may not be able to think or remember things as well as you did before.  You may be confused.  Your behavior, moods, and personality may change.  The ability to smell, breathe, swallow, hear, or talk may alter.  You may have problems moving your body, including poor coordination, clumsiness, tremors, or falling.  Vision may change, and you may have double vision.  Your pupils may be unequal in size.  Sensation may change in parts of your body.  You may feel tired or weak.

A doctor can diagnose a metastatic brain tumor by reviewing your medical history and conducting a physical examination, neurological examination, and some tests.  Your blood, urine, vision, or hearing may be tested.  Your medical team will monitor your intracranial pressure very closely.

Imaging scans are used to detect a tumor in the brain.  Common imaging tests include computed tomography (CT) scans and magnetic resonance imaging (MRI) scans.  An electroencephalogram (EEG) may be used to measure your brain wave activity.  Angiography is used to assess the blood supply in the brain and in a tumor.

With metastatic brain cancer, a biopsy is usually performed of the primary tumor located elsewhere in the body.  A biopsy is a procedure that obtains tissue or fluid from the tumor for examination.  A biopsy may be used to determine the exact type of tumor and cancer.  A spinal tap is used to test the cerebral spinal fluid.

Treatment for metastatic brain tumors is very individualized.  Treatments vary depending on several factors including the type, size, location of the tumor, intracranial pressure, and the health of the individual.  The goals of brain tumor treatment may be to relieve symptoms, prevent further complications, and prevent loss of brain function.  There are several options for treating metastatic brain tumors and your doctor will discuss the benefits, risks, and possible side effects of each treatment with you.  Treatment may include surgery, radiation, chemotherapy, or a combination of treatments.

Surgery may be used to remove all tumors that are accessible.  Surgery may not be an option for brain tumors that are located deep inside the brain because of the amount of tissue disruption that would take place to reach the tumor.  Some tumors may be debulked, meaning that they may not be able to be removed completely, but part of the tumor is removed.  A craniotomy is the most common surgery for brain tumors.  It involves removing a piece of the skull to access the brain.  After the tumor is removed, the skull is replaced.  Stereotactic craniotomy uses computers to help guide the surgeon during the procedure.
Radiation therapy is used for brain tumors that respond to radiation.  Radiation uses high-energy X-rays to damage the tumor cells and prevent them from multiplying.  Radiation may be used alone or with other types of treatment.  Radiation therapy is used to slow or stop the growth of cancer or tumor cells, reduce the size of a tumor before surgery, or following surgery to remove remaining cells and prevent tumor recurrence.  State-of-the-art technologies, such as gamma knife radiosurgery, have advanced radiation methods to help make them more effective, safer, and tolerable than they were in the past.
Chemotherapy is another method for treating brain tumors.  Chemotherapy uses special medications to kill tumor cells.  Chemotherapy may be delivered in several different ways.  Most chemotherapy is given by injection.

Brain tumors can result in functional impairments or disability.  Some people participate in rehabilitation therapies after experiencing a brain tumor to learn compensation skills.  People with end-stage cancer may receive palliative care from hospice.

The experience of cancer and metastatic brain tumor, and treatments will be a very emotional experience for you and your loved ones.  It is important to embrace sources of support.  Some people find comfort in their families, friends, co-workers, counselors, and church.  Cancer support groups are a helpful resource where you can receive support, information, and understanding from people with similar experiences.  Ask your doctor for support groups near you.

You may be at risk for a metastatic brain tumor if you have a type of primary cancer that tends to spread to the brain.  The risk may be greater for cancers with higher stage classifications.  Many types of primary cancer have the potential to spread to the brain, including but not limited to lung cancer, breast cancer, kidney cancer, bladder cancer, melanoma , sarcomas, testicular cancer, germ cell tumors, colon cancer, prostate cancer, and cancer of unknown origin.

Metastatic brain tumors have a poor prognosis.  Metastatic brain tumors cause permanent progressive loss of brain function, disability, and eventual death.