Brain Metastasis

There are two types of tumours of brain

1. Primary brain tumours – tumours which are originated from brain like glioma, astrocytoma, medulloblastoma and meningioma.
2. Metastatic Tumours – Tumours which originate somewhere else in body and spread in brain through blood are called metastatic brain tumours.

Brain metastasis

Tumours which originate somewhere else in body and spread in brain through blood are called metastatic brain tumours. Many tumours like carcinoma of Lung, breast, gastrointestinal tract, kidney have tendency to spread in brain. Many times, patient presents as a case of brain metastasis and on evaluation found to have primary tumor elsewhere in the body.

Symptoms of brain metastasis-

Symptoms of brain metastasis depend on the site of brain affected. Most common symptoms are headache, vomiting, convulsions, weakness of any part of body, giddiness, altered sensorium and cranial nerve palsies. If you are a diagnosed case of cancer and you find any of above symptoms then you should consult your Oncologist doctor.

How to diagnose brain metastasis?

Best test for diagnosis of brain metastasis is MRI scan of brain with contrast. CT scan is also helpful in diagnosis of brain metastasis but small lesions may not be visible on the CT scan. PET CT has low sensitivity for detection of brain metastasis.

What is the treatment of brain metastasis?

Brain metastasis is an Oncological emergency situation it should be dealt urgently. If the patient is having symptoms of increased intracranial pressure like headache, vomiting then patients should be started on steroid preferably dexamethasone and osmotic diuretics like mannitol. Patient should be started on anticonvulsant medication. Primary treatment of brain metastasis depends on size, number site of metastasis and control of systemic disease. Most commonly used treatment of brain metastasis is Radiation therapy. Second most common used treatment is surgery.

Radiation therapy in brain metastasis –

There are three types of radiation therapy techniques used in brain metastasis

1. Conventional whole brain radiation therapy
2. Stereotactic radiosurgery
3. Fractionated stereotactic radiotherapy

In conventional whole brain radiation therapy radiation therapy is given to whole brain. Most commonly 10 fractions of radiation used over 2 weeks. In stereotactic radiation therapy single large dose of radiation therapy given in 1 fraction in which radiation is given to only tumour. In fractionated stereotactic radiation therapy radiation is given to metastatic tumour in multiple fractions preferably 2 to 6 fractions.

Surgery in brain metastasis

Surgery is done in brain metastasis if there is single large metastasis causing pressure effect on brain and which can be removed easily. Even after doing surgery for brain metastasis radiation therapy should be given.

Prognosis of brain metastasis patient –

Prognosis of brain metastasis patient is generally bad.

Information is written by Dr. Jagdish Shinde – Cancer Specialist in Pune. Adity Birla Memorial Hospital Pune.