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Patient education: Brain metastases (The Basics)

Patient education: Brain metastases (The Basics)

What are brain metastases? — Brain metastases are cancerous tumors in the brain that have spread to the brain from another part of the body. Types of cancer that commonly spread to the brain include lung, breast, kidney, colorectal, and skin (melanoma) cancers.

Brain metastases are different from primary brain cancer. Primary brain cancer happens when normal cells in the brain change into abnormal cells and grow out of control. Brain metastases are made up of cancer cells from another part of the body.

What are the symptoms of brain metastases? — Brain metastases can cause different symptoms, including:

Headache – The headache is often worse when you bend over, cough, or sneeze. Some people have nausea and vomiting with their headache.

Trouble moving your arm or leg on 1 side of your body

Memory or thinking problems

Changes in mood, behavior, or personality

Seizures – Seizures are waves of abnormal electrical activity in the brain. They can make people pass out, or move or behave strangely.

All of these symptoms can also be caused by conditions that are not brain metastases. But if you have cancer and get any of these symptoms, tell your doctor or nurse.

Is there a test for brain metastases? — Yes. The test most commonly done to check for brain metastases is an imaging test called an MRI. Imaging tests create pictures of the inside of the body.

Another test that is sometimes done is a brain biopsy. For a brain biopsy, a doctor takes a small sample of tissue from the tumor. Then another doctor looks at the sample under a microscope.

How are brain metastases treated? — Treatment depends on many factors, such as:

Your symptoms

How far the cancer has spread in your body

Your overall health

Your prognosis – This is the term doctors use to describe how long they expect you to live.

Treatment for brain metastases can include 1 or more of the following:

Surgery to remove all or part of a tumor

Radiation therapy – Radiation kills cancer cells. Doctors use radiation in different ways to treat brain metastases. With "stereotactic radiosurgery," the radiation is aimed only at the area with cancer. With "whole brain radiation therapy," the whole brain is treated with radiation.

Targeted therapy – These are medicines that work only for cancers with certain characteristics. Your doctor might do tests to see if this kind of therapy is an option for you.

Immunotherapy – This is the term doctors use for medicines that work with the body's infection-fighting system (the "immune system") to stop cancer growth.

People also usually have other treatments to help with symptoms or problems caused by the brain metastases. These might include:

Medicines called steroids that can reduce swelling in the brain – These are not the same as the steroids some athletes take illegally.

Medicines to manage and prevent seizures

What happens if my brain metastases come back or spread? — It depends on your individual situation. Your doctor might recommend that you have more treatment for the brain metastases. This can include surgery or radiation therapy. It sometimes also includes targeted therapy or immunotherapy. Or your doctor might recommend treating your symptoms only and helping you feel more comfortable.

Will I need to stop driving? — It depends on your symptoms. Talk with your doctor about whether it is safe for you to continue to drive, given your symptoms.

If you have a seizure, you will need to be seizure-free for a certain amount of time before you can drive again. Each state and country has its own rules.

What else should I do? — It's important to follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.

Getting treated for brain metastases involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?

What are the downsides to this treatment?

Are there other options besides this treatment?

What happens if I do not have this treatment?

More on this topic

Patient education: Seizures (The Basics)
Patient education: Stroke (The Basics)
Patient education: Radiation therapy (The Basics)
Patient education: Medical care during advanced illness (The Basics)
Patient education: Advance directives (The Basics)

Patient education: Seizures in adults (Beyond the Basics)
Patient education: Stroke symptoms and diagnosis (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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