Brain Metastasis
A brain metastasis occurs when cancer cells spread from their original site—such as the lung, breast or melanoma—to the brain. We understand that this diagnosis can feel overwhelming, but our multidisciplinary team is prepared to offer you the most advanced and compassionate care to manage your condition effectively and support your quality of life.
What Is Brain Metastasis?
Brain metastases are secondary tumors that have traveled through the bloodstream to the brain from a primary cancer elsewhere in the body. They are the most common type of brain tumor in adults. While they represent an advanced stage of cancer, modern treatments—including minimally invasive surgery, stereotactic radiosurgery and targeted molecular therapies—have significantly improved both survival rates and daily functioning for many patients.
At a Glance
- Brain metastases are the most common brain tumors in adults, occurring when cancer spreads from another part of the body
- Lung cancer, breast cancer and melanoma are the most frequent primary sources
- Symptoms depend heavily on the tumor's location but often include headaches, new seizures and focal weakness
- Advanced imaging, particularly an MRI with contrast, is critical for an accurate diagnosis and treatment planning
- Treatment is highly personalized and typically involves a combination of surgery, stereotactic radiosurgery (SRS) and targeted medical therapies
- Headaches that are new, persistent or noticeably worse in the morning
- A first-time seizure, which may be a full convulsion or a brief staring spell
- Progressive focal weakness, numbness,or tingling on one side of the body
- Subtle or sudden cognitive changes, including confusion, memory loss or personality shifts
- Balance issues, unsteady gait or problems with coordination
- Solitary brain metastasis — a single tumor in the brain, which is often a strong candidate for surgical removal followed by focused radiation.
- Multiple brain metastases — two or more tumors; treatment typically focuses on stereotactic radiosurgery (SRS) or whole-brain radiation therapy (WBRT), depending on the total number and overall volume.
- Solitary brain metastasis — a single tumor in the brain, which is often a strong candidate for surgical removal followed by focused radiation.
- Multiple brain metastases — two or more tumors; treatment typically focuses on stereotactic radiosurgery (SRS) or whole-brain radiation therapy (WBRT), depending on the total number and overall volume.
- Stereotactic radiosurgery (SRS) — a non-invasive treatment that delivers highly focused, high-dose radiation directly to the tumor(s) while sparing healthy surrounding brain tissue. Ideal for small to medium-sized tumors.
- Surgical resection — involves carefully removing the tumor through a craniotomy. This is often recommended for large tumors causing significant pressure (mass effect) or when a biopsy is needed to confirm the tumor type.
- Whole-brain radiation therapy (WBRT) — historically the standard of care for multiple metastases, now generally reserved for widespread disease that cannot be treated with SRS alone.
- Targeted therapy and immunotherapy — specific medications designed to attack the unique genetic mutations of the primary cancer (e.g., EGFR in lung cancer or BRAF in melanoma) that can cross the blood-brain barrier.
| Treatment Modality | Primary Goal | Notes |
|---|---|---|
| Stereotactic radiosurgery (SRS) | High local control rate (~80-90%) | Non-invasive; can be repeated if new metastases appear |
| Surgical resection | Immediate symptom relief | Best for large, symptomatic tumors; usually followed by SRS to the cavity |
| Whole-brain radiation (WBRT) | Broad disease control | Used for numerous tumors; higher risk of long-term cognitive side effects |
| Targeted therapies | Systemic and intracranial control | Highly effective for specific mutations; effectiveness varies by primary cancer type |
- Suh JH, et al. Current approaches to the management of brain metastases. Nat Rev Clin Oncol. 2020;17(5):279-299. PMID: 32203396
- Brown PD, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA. 2016;316(4):401-409. PMID: 27458945
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