Metastatic brain tumors account for the majority of brain lesions that occur in adults. Thanks to advances in cancer therapy, patients are now able to live longer with the disease than ever. Treating metastatic brain cancer may begin with surgery to remove or reduce the tumor. If metastatic brain cancer surgery is part of your cancer treatment plan, knowing what to expect in the days and weeks after your procedure can make your recovery easier.
Metastatic Brain Cancer Surgery
Metastatic brain tumors arise when cancer cells from a primary tumor elsewhere in the body, such as the lungs, kidneys, colon or breast, travel to the brain and begin to proliferate there. Unlike primary brain tumors — those that originate in the brain — metastatic brain cancers typically behave like the cells of the original tumor, and those characteristics can help determine the treatment plan.
Treatment for metastatic brain cancer is a part of the overall cancer care plan and generally includes surgery, radiation therapy, some kinds of chemotherapy or a combination of these. For people whose primary cancer is being managed and who have a single tumor in an accessible location, surgery can reduce or eliminate symptoms caused by the tumor and improve overall well-being.
Surgery for metastatic brain cancer usually takes two to three hours under general anesthesia in a hospital setting. The procedure begins with a craniotomy — a small piece of skull is removed to expose the brain. An incision is made in the dura, the tissue covering the brain, and with the aid of sophisticated ultrasound and stereotactic MRI imaging technology, surgeons locate and remove the tumor, or as much of it as possible. The skull bone is replaced and secured, and the incision is closed with stitches or staples. After surgery is completed, the road to recovery begins.
Recovery Begins in the Hospital
Intensive Care Unit (ICU)
Right after surgery, you’ll be moved to the hospital’s intensive care unit, where specially trained staff can closely monitor your recovery from anesthesia and check for any problems arising from surgery. When you wake up, you can expect to feel about the same as you did before surgery and should be able to do the things you were doing beforehand as well.
Because surgery is an invasive procedure that can cause trauma to brain tissue, some people might experience temporary deficits in functions such as speech, coordination or memory. These neurological problems typically subside over time, and physical or occupational therapy might be recommended in the hospital and at home to help cope with them.
Regular Hospital Room
After spending the first night post-surgery in the intensive care unit without complications, patients are typically moved to a regular hospital room for a stay of around two days. During this time, you’ll be encouraged to start walking and resume a normal diet. If you experience any neurological problems arising from surgery, you may meet with a physical therapist to assess the extent of the deficits and create a plan to address them when you return home.
When you leave the hospital, you’ll be given a set of discharge instructions and prescriptions for any medications you may need for pain and swelling. If you regularly take other medications, your doctors will let you know when to resume taking them.
Recovery Continues at Home
After metastatic brain cancer surgery, patients typically return gradually to normal activities within a week or two. Fatigue and lethargy are common reactions to surgery, and people who experience post-surgery neurological issues may need extra support during this time to manage those problems. In the days following surgery, prescription medications may be prescribed that can possibly affect your daily activities as well.
During this recovery period, patients can expect to see the doctor for follow-up appointments to remove stitches, check the progress of recovery and plan the next stages of treatment. If needed, therapy for problems with speech, hearing, coordination or other issues might continue as well.
Treatment Can Continue After Surgery
In many cases, treatment for a metastatic brain tumor continues beyond surgery as part of the larger cancer care plan.
In the weeks after surgery, radiation therapy or stereotactic radiosurgery might be recommended to destroy remaining tumor cells. Stereotactic radiosurgery, a highly targeted form of radiation therapy that delivers radiation so precisely that surrounding healthy tissues are not affected, is usually given in one treatment. Whole brain radiation therapy is given over the course of several weeks to minimize side effects such as temporary brain inflammation.
Some forms of chemotherapy may be a part of the post-surgery treatment plan. Because metastatic brain tumors share characteristics of the primary tumor elsewhere in the body, chemotherapy drugs that target those kinds of tumors may also have some effect in treating brain metastases as well as the original systemic disease.
As part of a comprehensive cancer care plan, metastatic brain cancer surgery is a generally safe procedure that can reduce symptoms and improve quality of life in most patients. Recovering from surgery takes time and patience, but knowing what to expect can make the process easier to manage.