Metastases to the brain occur when cancer cells spread from their site of origin to the brain. Any type of cancer can spread to the brain, but the types most likely to metastasize to the brain are cancer of the lung, breast, colon, kidney, and melanoma.
Brain metastases can form a single tumor or multiple tumors in the brain. As metastatic brain tumors grow, they put pressure on surrounding brain tissue and change its function. This causes signs and symptoms, such as headaches, personality changes, memory loss, and seizures. Treatment for people whose cancer has spread to the brain may include surgery, radiation therapy, chemotherapy, immunotherapy, or a combination of treatments. Other treatments may be recommended in certain situations. Treatment is often focused on reducing the pain and symptoms resulting from the cancer.
Symptoms of brain metastases
The signs and symptoms caused by brain metastases can vary depending on the location, size and growth rate of the metastatic tumors.
The signs and symptoms of brain metastases are as follows:
– headaches, sometimes accompanied by vomiting or nausea
– Mental changes, such as increasing memory problems
– Epileptic attacks
– Weakness or numbness on one side of the body.
When to consult a doctor
Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. If you’ve been treated for cancer in the past, talk to your doctor about your medical history.
Causes of brain metastases
Brain metastases occur when cancer cells break away from their original location. Cells can travel through the bloodstream or lymphatic system and spread (metastasize) to the brain where they begin to multiply. Metastatic cancer that spreads from its original location is known as primary cancer. For example, cancer that has spread from the breast to the brain is called metastatic breast cancer, not brain cancer.
Risk factors
Any type of cancer can spread to the brain, but some types of cancer are more likely to cause brain metastases, including:
– lung cancer
– breast cancer
– colon cancer
– kidney cancer
– melanoma
Diagnosis of brain metastases
If it is suspected that you have brain metastases, your doctor may recommend a number of tests and procedures.
A neurological examination
A neurological exam may include, among other things, checking your vision, hearing, balance, coordination, strength, and reflexes. Difficulty in one or more areas can provide clues as to which part of your brain may 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 into a vein in your arm during your MRI scan. A number of specialized components of MRI, including functional MRI, perfusion MRI, and magnetic resonance spectroscopy, can help your doctor assess the tumor and plan treatment.
Other imaging exams may include computed tomography (CT) and positron emission tomography (PET). For example, if the primary tumor that caused your brain metastases is unknown, you might have a chest CT scan to look for lung cancer.
Collection and analysis of an abnormal tissue sample (biopsy)
A biopsy can be done as part of an operation to remove a brain tumor, or it can be done with a needle. The biopsy sample is then examined under a microscope to determine if it is cancerous (malignant) or non-cancerous (benign) and if the cells are metastasizing or are from a primary tumor. This information is essential for establishing a diagnosis and prognosis and for guiding treatment.
Processing
Treating brain metastases can help relieve symptoms, slow tumor growth, and prolong life. Even with effective treatment, brain metastases often reappear. Your doctor will therefore recommend close monitoring after treatment.
Treatment options for people with brain metastases often include medication, surgery, stereotaxic radiosurgery, whole-brain radiation therapy, or a combination of these treatments. In some situations, your treatment team may consider drug treatments for brain metastases. The treatments that are best for you will depend on the type, size, number and location of the tumors, as well as your signs and symptoms, your general health and your preferences. Talk to your doctor about your treatment goals.
Medicines to control symptoms
Medication can help control the signs and symptoms of brain metastases and make you more comfortable. Options may include:
Steroid drugs. High doses of corticosteroids can be used to reduce swelling around brain metastases to reduce signs and symptoms.
Anti-seizure drugs. If you have a seizure, your doctor may recommend medicine to prevent further seizures.
Surgery
If surgery is an option for you and your brain metastases are located in places that make them accessible for surgery, your surgeon will work to remove as much of the cancer as possible. Even removing part of the tumor can help reduce your signs and symptoms. Surgery to remove brain metastases carries risks, such as neurological deficits, infections, and bleeding. Other risks may depend on the part of your brain where your tumors are located.
Radiotherapy
Stereotaxic radiosurgery for brain metastases
Radiation therapy uses high-energy beams, such as x-rays and protons, to kill tumor cells. For brain metastases, your treatment may involve one or both of the following radiation therapy methods:
Irradiation of the whole brain
Whole-brain radiation therapy involves irradiating the entire brain to kill tumor cells. People who have whole brain irradiation usually need 10 to 15 treatments over two or three weeks. Side effects can be fatigue, nausea, and hair loss. In the long term, radiation from the whole brain is associated with cognitive decline.
Stereotaxic radiosurgery
In the case of stereotaxic radiosurgery (SRT), each beam of radiation is not particularly strong, but the point where all the beams meet, at the brain tumor, receives a very high dose of radiation to kill the cells. tumor. SRS is usually done as a single treatment, and doctors can treat multiple tumors in one session. Side effects may include nausea, headache, seizures, dizziness, or dizziness. It is believed that the risk of long-term cognitive decline after treatment with SRS is lower than that of irradiation of the whole brain.
In recent years, doctors and researchers have made tremendous progress in their understanding of whole brain radiation therapy, stereotaxic radiosurgery, and how these two methods affect people’s survival, cognitive abilities, and quality of life. . When deciding what type of radiation therapy to use, you and your doctor will consider many factors, including what other treatments you are having and the risk of the cancer coming back after treatment.
Medications
In some situations, your treatment team may recommend medications to control your brain metastases. The usefulness of medications depends on where the cancer started and your personal situation. Options may include:
Chemotherapy
Chemotherapy uses drugs to kill rapidly growing cells in the body, including cancer cells.
Targeted therapy drugs
Targeted drug treatments focus on specific abnormalities found in cancer cells. By blocking these abnormalities, targeted drug therapies can cause cancer cells to die.
Immunotherapy
Immunotherapy uses your immune system to fight cancer. Your body’s immune system may not attack your cancer because cancer cells make proteins that help them hide from cells of the immune system. Immunotherapy works by interfering with this process.
Rehabilitation after treatment
Since brain tumors can develop in parts of the brain that control motor skills, speech, vision, and thinking, rehabilitation may be a necessary part of healing. Your doctor can refer you to services that can help you:
Physiotherapy can help you regain lost motor skills or muscle strength.
Occupational therapy can help you return to your normal daily activities, including your job, after a brain tumor or other illness.
Speech therapy with language specialists (speech therapists) can help if you have difficulty speaking.
Supportive (palliative) care
Palliative care is specialized medical care that aims to relieve pain and other symptoms of serious illness. Palliative care specialists work with you, your family, and your doctors to provide additional support to complement your other treatments. Palliative care is provided by a team of specialists in medicine, psychology and social work. This team works to improve the quality of life of people with cancer and their families.
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