Symptoms, prognosis, diagnosis and more
Brain metastases occur when cancer spreads from one area of the body to the brain. About 20% of people with cancer develop brain metastases. Most brain metastases occur in people with cancer of the lung, colorectal, breast, melanoma, or kidney cells.
This statistic comes from a
Brain metastases are one of the many forms of metastatic cancer, which is cancer that spreads from the original site of the cancer.
Metastasis increases the risk of dying from cancer, but targeted therapies and whole brain radiation therapy can prolong survival.
In this article, we discuss brain metastases in detail, including their symptoms, diagnosis, treatment, and outlook.
Brain metastases develop when cancer cells from another part of the body enter the bloodstream. This allows them to travel far beyond the site of origin of the cancer. If cancer cells cross the blood-brain barrier, they can affect the brain.
If the cancer cells cause a single tumor in the brain, then it is called a single brain metastasis. Multiple growths are known as brain metastases.
Cancer cells are different from normal cells because they do not respond to normal body processes that prevent cells from growing out of control.
Mutations in cancer cells cause them to multiply quickly without dying, forming tumors that can damage organs.
In most cases, brain metastases could mean the cancer is terminal. A 2018 analysis found that out of a total of 145 people, the average survival time was
According to American Cancer Society, symptoms of brain metastases vary depending on many factors, including the size of the tumor (s) and their location in the brain.
Sometimes brain metastases can bleed, causing sudden and severe symptoms. For example, cancer that affects the temporal lobe can affect language and learning, for which this region of the brain is responsible.
However, not all people with brain metastases have symptoms. For this reason, ongoing cancer care is essential to detect metastatic cancer early.
Some symptoms that may develop include:
Some of these symptoms are similar to those that experts associate with cancer treatment or the original cancer itself. Therefore, people should not assume that cancer has spread to the brain, based solely on their symptoms.
Instead, they should see an oncologist immediately for an evaluation.
If a doctor suspects brain metastases, they will usually do a physical exam and get a full medical check-up.
A person may also need a neurological exam to watch for changes in their brain functions, such as thinking.
If the initial examination suggests that the cancer may have spread to the brain, a doctor may recommend one or more of the
- Blood tests: Blood tests can help detect some signs of metastatic cancer. They can also show damage to organs, such as the liver.
- TDM: A CT scan of the head allows a doctor to examine the brain and look for signs of metastatic cancer. However, this test may not show all types of cancer, so a doctor may recommend follow-up with an MRI.
- MRI: This test uses magnets to visualize parts of the brain, including blood flow to various areas of the brain. It can detect signs of brain damage and swelling, as well as the location of brain tumors.
There is no cure for metastatic brain cancer. Treatment usually focuses on several goals:
- slow down or reduce brain damage
- extend a person’s life
- reduce pain
Some of the treatment options for brain metastases include:
- Steroids: Steroids can reduce swelling in the brain caused by a tumor. This
can helpalong with other symptoms, such as headaches and neurological problems. However, this will not cure the cancer.
- Surgical removal: It is possible to remove some tumors by surgery. This can prolong survival and, in some cases, help a person get rid of cancer. However, tumors can grow back later.
- Whole brain radiation therapy: Whole brain radiation therapy uses radiation to shrink the tumor. While it can prolong survival, it can also cause neurological damage.
- Chemotherapy: Chemotherapy
is usually notimprove brain metastases and is not standard treatment. However, some tumors are sensitive to certain chemotherapy drugs or targeted drugs. If a person has such a tumor, chemotherapy can improve their chances of survival or help them live longer.
- Stereotaxic radiosurgery (SRS): This approach uses radiation and targets the tumor rather than the entire brain. Doctors can use SRS alone or in conjunction with whole brain radiation therapy.
- Psychological support and end-of-life planning: Dealing with a terminal illness can be extremely difficult. Support groups, psychotherapy, family support, and help with planning for the end of a person’s life can make the process less overwhelming, allowing a person to choose to live as they see fit.
It is important to discuss the risks and benefits of treatment with a doctor and to think about how treatment might affect quality of life and family relationships during this time.
Metastatic brain cancer is usually terminal. While some people can live longer than others and a few survive much longer than average, most people still have months to live before being diagnosed.
Even if a surgeon removes tumors from the brain, it is common for them to come back.
Among those who underwent SRS to remove the tumor, the outcome was better, with 72% of them without recurrence at 1 year.
Survival rate for metastatic brain cancer have improved considerably over the past 3 decades due to technologies such as whole brain radiation. Clinical trials continue to test more effective treatments.
Brain metastases occur when cancer cells travel through the bloodstream to the brain, causing tumors to grow.
Symptoms include pain, changes in behavior, or seizures. Not everyone has symptoms, however, so it’s important to have regular follow-up with an oncologist to spot signs at an early stage.
Metastatic brain cancer is aggressive and can quickly change a person’s life. There is no right or wrong way to react to a diagnosis. Some people prefer to treat cancer aggressively, trying everything they can to prolong their life. Others prefer to ease the pain and maximize the time spent with loved ones.
People may find it beneficial to discuss treatment options as well as obtain social and emotional support.
For more information and resources based on cancer research, please visit our dedicated hub.