Metastatic Brain Tumors

More common than tumors that originate inside the brain itself, metastatic (or “secondary”) brain tumors arise from cancer that develops elsewhere in the body. Depending on the nature of your tumor and other factors, your doctor may recommend treatments including radiation therapy, surgery or stereotactic radiosurgery — or a combination of these — to eliminate or reduce the tumor and its effects.

What Is a Metastatic Brain Tumor?

When cancer occurs in the body, cells can migrate to the brain, causing tumors to form there. Common cancers associated with metastatic brain tumors include lung, breast, colon and kidney cancer, as well as the skin cancer melanoma. Because these secondary tumors generally contain the same type of cells as the original tumor, it’s possible to determine the source, or primary cancer, by examining the tumor’s tissue.

In some cases, the primary cancer site might not be found, or it might be too small to cause typical symptoms. When that happens, the primary site can be found by working backward from the tumor itself, using tissue samples and markers in the blood to track down and treat the primary cancer. Some metastatic brain tumors develop as a single tumor, but the majority arise as multiple tumors.

Symptoms of Metastatic Brain Tumors

Metastatic brain tumors exhibit the same range of symptoms as tumors that originate in the brain. Symptoms can be caused by pressure from the tumor on brain tissues, swelling from the leakage of fluid around the tumor or bleeding from ruptured blood vessels within the tumor itself. Depending on the area of the brain affected by the metastatic tumor, symptoms can include:

  • Headache – This is one of the most common symptoms of a tumor, caused by swelling and the leakage of fluid and blood
  • Seizures – Another typical symptom, seizures are caused by pressure and swelling, which can trigger a brief episode of abnormal electrical activity in the brain.
  • Cognitive disturbances – When a tumor occurs in an area of the brain responsible for memory, decision-making and personality, it can cause difficulties with short-term memory and mood / personality changes.
  • Motor problems – Tumors located in parts of the brain related to balance and coordination can cause difficulties such as weakness on one side, or problems with walking or balance.
  • Pain and changes in sensation – Metastatic tumors can cause pain in the back and other areas, as well as changes in sensation in the limbs.

Tumors can be diagnosed through a thorough examination using MRI or CT scanning, magnetic resonance spectrometry (MRS) or Positron Emission Tomography (PET). Examination of tumor tissue itself typically confirms the diagnosis and indicates where the cancer originated.

Treatment Options For Metastatic Brain Tumors

Treatment for metastatic brain tumors is tailored to each patient’s unique condition. Considerations include the location of the tumor or tumors in the brain, patient age and overall health, and how the primary cancer is being treated.

Radiation Therapy

Radiation therapy is a non-surgical approach to treating brain tumors using X-rays and other forms of radiation to destroy the tumor or stop its growth. Radiation therapy can often be categorized into two categories: Gamma Knife Stereotactic Radiosurgery and Whole Brain Radiation Therapy.

  • Gamma Knife Stereotactic Radiosurgery is a highly precise procedure that directs narrow beams of radiation directly to the tumor from different angles to specifically treat the tumor while sparing the normal brain tissue. This approach can be used for treating tumors in areas of the brain that might be damaged by large doses of radiation. Three-dimensional conformal radiation therapy directs X-ray beams to the brain in an arrangement specifically designed to conform to the shape of the tumor. In this way, surrounding healthy tissues receive only a minimal dose of radiation. At Neurosurgeons of New Jersey, we take full advantage of the Gamma Knife system for stereotactic radiosurgery. As a non-invasive, highly effective and durable treatment for brain metastases in a single session with no incision our surgeons believe it is one of the best systems available for treating metastatic brain tumors.
  • Whole Brain Radiation Therapy (WBRT) uses X-ray radiation to deliver low-dose radiation to the entire brain including tumor and normal tissue. This is a fractionated radiation plan (multiple treatments of relatively low radiation doses) and had long been considered the standard of care for treating brain tumors until recently, as stereotactic radiosurgery is now recognized as an efficient and effective method of treatment. While WBRT is effective, it has been shown to have higher rates of post-treatment cognitive deficits (learning/memory) than stereotactic radiosurgery. The higher precision of Gamma Knife spares the normal brain, thus effectively treating the tumor but having little effect on normal brain function.

Radiation therapies are painless, but side effects can occur. With Whole Brain Radiation Therapy, side effects can include hair loss, skin and scalp irritation, headaches caused by swelling in the brain, and nausea, vomiting and loss of appetite. Some patients experience fatigue or temporary problems with memory and speech. Because healthy tissues can be damaged during treatment, risks can include permanent neurological deficits, stroke or coma.

With Gamma Knife, these side effects are a rare occurrence.

Surgery

Radiation therapy is the primary treatment for metastatic brain tumors, but surgery may be indicated to reduce the size of a tumor to ease symptoms caused by pressure or make radiation therapy possible. Surgery may also be performed if the source of the tumor is unknown and a tissue diagnosis by the pathologist is necessary.

During surgery, your brain cancer surgeon performs a craniotomy to remove a portion of the skull in order to access the tumor. Depending on circumstances, the entire tumor or only a portion may be removed.

Recovery

Recovery from surgery depends on factors including your overall health, the location of the tumor and what areas of the brain were affected by the procedure. Fatigue and headaches are common after effects of surgery, and problems with balance, memory and coordination can also occur. After surgery, follow-ups will check the status of the tumor, as well as the overall progress of cancer treatment.

Studies have shown that even gross total resections recur almost 50% of the time without post-operative radiation therapy. At our practice, we follow all surgeries with Gamma Knife Radiosurgery and have excellent local control within the resection cavity.

Why Choose Neurosurgeons of New Jersey?

Neurosurgeons of New Jersey provides patient-centered care coupled with cutting-edge technology and decades of experience and research on metastatic brain tumors and how to treat them.

The neurosurgeons and specialists of our brain tumor centers provide state-of-the-art treatment options including radiotherapy, chemotherapy and surgery tailored to the unique needs of each individual. At Neurosurgeons of New Jersey, your brain tumor surgeon and healthcare team work with you to create the treatment plan that’s right for you.