Metastases

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These tumours grow in the brain after tumour cells spread there from cancers in other parts of the body. Brain metastases are the most common types of brain tumors, and are an important cause of disability and even mortality (death) in patients with cancer.

The most common types of cancer that spread to the brain are lung, breast, bowel and kidney cancer, as well as melanoma. Lung and breast cancer account for most brain metastases, however in Australia melanoma is also a very common cause.

These tumours usually occur in the brain tissue itself, but may arise in the lining of the brain or the skull.

Brain metastases may cause a number of symptoms: headaches, nausea and vomiting are frequently seen as a result of raised pressure within the skull (raised intracranial pressure), and drowsiness may occur when intracranial pressure rises more substantially. Seizures, also known as epileptic fits, are another frequent result of brain metastases, and the initial diagnosis is often made following a seizure in a previously well individual. Focal neurological symptoms, including weakness, numbness, poor balance, and speech problems, are also seen in some patients with metastatic tumors.

Cerebral metastases may be treated with significant impact using a combination of surgery or GammaKnife radiosurgery, radiotherapy, and frequently chemotherapy.

Most patients are started on medications to reduce swelling (also known as oedema) arounf the tumour- the most commonly used medication is a corticosteroid called dexamethasone. Some patients are also treated with anticonvulsants to stop seizures.

Brain surgery is an important part of the treatment of many patients with cerebral metastases, in order to obtain a diagnosis, reduce the amount of pressure on the rest of the brain, improve some of the symptoms, and possibly to extend survival.

Patients with tumors less than 3-4cm in size are often suitable for GammaKnife radiosurgery. This is a non-invasive treatment which does not involve open surgery. In appropriately selected patients the results are equivalent to surgery, but it has the advantage of fewer risks, no need to be hospitalised for more than a few hours, and a much faster recovery time.