What Are Metastatic Brain Tumors?
Metastatic Brain tumors begin as cancer in another part of the body and spread to the brain via blood or nearby tissue.
There can be one (metastasis) or multiple (metastases) tumors.
Treatment options vary depending on the patient’s overall health, number and location of brain/spine lesions, location and severity of the primary cancer, and the type of primary cancer.
RADIATION
Radiation therapy uses controlled high-energy rays to damage the DNA inside cells, making them unable to divide and reproduce. The goal of radiation therapy is to maximize the dose to abnormal cells and minimize exposure to normal cells. There are several ways to deliver radiation, these include:
Whole brain radiotherapy (WBRT) delivers the radiation dose to the entire brain. It is often used to treat multiple brain tumors and metastases.
Patients with few, smaller metastatic lesions (< 3 cm) can be treated with a single treatment (Stereotactic Radiosurgery). Patients with multiple metastatic lesions are typically treated with whole brain radiotherapy.
SURGERY
To surgically remove a brain tumor, a neurosurgeon performs a Craniotomy to open the skull. Sometimes only part of the tumor is removed if it is near critical areas of the brain. A partial removal can still relieve symptoms. Radiation or chemotherapy may be used on the remaining tumor cells.
Surgery is typically recommended for patients with 1 or 2 metastatic brain lesions, in good health, with primary cancer that is treatable. Radiation seeds may be placed at the time of surgery to help prevent tumor recurrence.
No surgery is without risk. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Specific complications related to a craniotomy may include stroke, seizures, venous sinus occlusion, swelling of the brain, and CSF leakage.
Risks related to acoustic neuroma surgery may include:
Facial weakness is the loss of muscle control on one side of the face caused by nerve swelling or damage; it may be temporary or permanent. Temporary facial paralysis or weakness is common after surgery and may persist for 6 to 12 months. Those with facial weakness will need to take extra care of their eye with artificial tears and lubricant until facial nerve function improves. Facial nerve function is directly related to the size of the tumor.
Eye problems may occur as the result of facial weakness or paralysis that prevents the eye from closing completely. This allows the eye to become dry and unprotected. Artificial tears, eye lubricants, protective glasses, bandage contact lenses, and taping the eye shut are all options to protect the cornea.
Hearing loss is the most common complication and may be permanent in the affected ear because the tumor is wrapped around the cochlear nerve. In small tumors it is possible to save hearing when removing the tumor. Larger tumors usually have already caused some hearing loss or deafness prior to surgery.
Balance problems are common and generally improve after surgery with head exercises, Pilates, or Tai Chi. Care should be taken when using stairs or escalators. Persistent balance or dizziness problems may need treatment with vestibular (balance) rehabilitation.
Cerebrospinal fluid (CSF) leakage is the escape of CSF that flows around the brain.
Headache is common after acoustic neuroma surgery and usually subsides within several weeks. Persistent headache (>3 months) can occur after suboccipital craniotomy.