What are metastatic brain tumors?

Sometimes tumors growing in the brain start there. These are called primary brain tumors. But other types of brain tumors come from cancers that started in another part of the body. These cancers might start in the lung, breast, skin, kidney, colon, or other body parts. They may spread to the brain even if the cancer is controlled at the original site. These are called secondary or metastatic brain tumors.

In adults, metastatic brain tumors are more common than tumors that start from cells in the brain. They are also treated differently from tumors that start in the brain.

What causes metastatic brain tumors?

Over time, cancer cells can break off from a primary tumor in another part of the body, such as the lungs, and travel to the brain. The cancer cells can travel to the brain through your lymph system or your bloodstream. The tumor that then grows in the brain looks and is treated like the tumor that started in another part of the body, like the lungs. Metastatic brain tumors are becoming more common because people are living longer after having cancer somewhere else in their body.

In most cases, the metastatic brain tumor is found in the cerebrum. This is the outer part of the brain that controls your thoughts, emotions, and language ability. It's also involved in movement and sensing the outside world. But metastasis can be found in other areas of the brain, too.

Metastatic brain tumors are most common in people with lung cancer. Other types of cancer that tend to metastasize to the brain include melanoma, kidney cancer, and breast cancer.

What are the symptoms of metastatic brain tumors?

Symptoms of a metastatic brain tumor vary, depending on the size and number of tumors in the brain and where they are. Here are some possible symptoms:

• Trouble walking

• Mood changes

• Abnormal behaviors

• Headaches

• Changes in personality

• Memory loss and confusion

• Loss of feeling or movement on one side of the body, often the arm or leg

• Trouble speaking

• Seizures

• Vision changes

• Vomiting

• Sleepiness

How are metastatic brain tumors diagnosed?

Metastatic brain tumors may be found before, after, or at the same time cancer is diagnosed somewhere else in your body.

Some of the tests used to look for and find metastatic brain tumors are:

• MRI, CT, or PET scan. These are imaging scans used to get pictures of your brain. A PET scan looks at your whole body. It might be done to find out if there are any other tumors in your body.

• Spinal tap (lumbar puncture). This test looks for cancer cells in the fluid around your brain and spinal cord.

• Other tests. Your healthcare provider may do scans of other parts of your body to look for the primary cancer that led to the brain tumor.

• Biopsy of the tumor. This is when a tiny piece of the tumor is removed for testing. It might be done with a needle. Or it may be done as part of surgery to remove part or all of the tumor.

How are metastatic brain tumors treated?

Sometimes a tumor can be removed during brain surgery. In some cases, the surgeon may be able to remove only part of it. When there's more than one metastatic brain tumor, surgery may not be an option. But other types of surgery might still be used to help ease pressure on the brain and treat symptoms, even if the tumor can't be removed.

Brain tumors can also be treated with radiation. Radiation therapy may involve radiation of the whole brain. Or it may be a more focused radiation treatment that's aimed at the tumor.

Chemotherapy may be used. But chemo has a hard time reaching the brain. Other medicines might be used to help ease swelling in the brain, reduce the number of seizures, and relieve pain.

What are possible complications of metastatic brain tumors?

These tumors can be very hard to treat. They can also lead to changes in how well you can communicate or make decisions. You may want to talk to your family, a friend, or a member of your treatment team about your long-term treatment wishes. An advance directive is a legal document that you may want to complete in case you become too sick to say what you want.

How are metastatic brain tumors managed?

Sometimes healthcare providers aren’t able to cure this disease. In some cases, they'll suggest ways you can stay comfortable during your remaining time. These may include certain treatments and medicine to reduce pain, seizures, nausea, or other symptoms.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have:

• New symptoms or symptoms that get worse

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about metastatic brain tumors

• Metastatic brain tumors are tumors caused by cancer that starts in another part of the body and then spreads to the brain.

• Cancer may spread to the brain through your lymph system or your bloodstream.

• Symptoms can include trouble walking or speaking, mood changes, headaches, memory loss, behavior changes, and loss of feeling or movement on one side of the body.

• A surgeon may be able to remove the tumor during brain surgery. In some cases, only part of the tumor can be removed. If there's more than one tumor, surgery may not be an option.

• Radiation, chemotherapy, and other medicines are treatment options. But in some cases, this disease can’t be cured.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.