Brain tumor - metastatic (secondary); Cancer - brain tumor (metastatic) DefinitionA metastatic brain tumor is cancer that started in another part of the body and has spread to the brain. CausesMany tumor or cancer types can spread to the brain. The most common are: Some types of cancer rarely spread to the brain, such as prostate and colon cancer. In some cases, a tumor can spread to the brain from an unknown location. This is called cancer of unknown primary (CUP). Growing brain tumors can place pressure on nearby parts of the brain. Brain swelling due to these tumors also causes increased pressure within the skull. Brain tumors that spread are classified based on the location of the tumor in the brain, the type of tissue involved, and the original location of the tumor. Metastatic brain tumors occur in about one fourth (25%) of all cancers that spread through the body. They are much more common than primary brain tumors (tumors that start in the brain). SymptomsSymptoms may include any of the following:
Specific symptoms vary. Common symptoms of most types of metastatic brain tumors are caused by increased pressure in the brain. Exams and TestsAn exam can show brain and nervous system changes based on where the tumor is in the brain. Signs of increased pressure in the skull are also common. Some tumors may not show signs until they are very large. Then, they can cause a very quick decline in nervous system function. The original (primary) tumor may be found by examining tumor tissues from the brain. Tests may include:
TreatmentTreatment depends on:
The goals of treatment may be to relieve symptoms, improve functioning, or provide comfort. Whole brain radiation therapy (WBRT) is often used to treat tumors that have spread to the brain, especially if there are many tumors, and surgery is not a good option. Surgery may be used when there is a single tumor. Some tumors may be completely removed. Tumors that are deep or that extend into brain tissue may be reduced in size (debulked). Surgery may reduce pressure and relieve symptoms in cases when the tumor cannot be removed. Chemotherapy for metastatic brain tumors is usually not as helpful as surgery or radiation. Some types of tumors, though, do respond to chemotherapy. Stereotactic radiosurgery (SRS) may also be used. This form of radiation therapy focuses high-power x-rays on a small area of the brain. It is used when there are only a few, small, metastatic tumors. Medicines for brain tumor symptoms include:
When the cancer has spread, treatment may focus on relieving pain and other symptoms. This is called palliative or supportive care. Comfort measures, safety measures, physical therapy, occupational therapy, and other treatments may improve the patient's quality of life. Some people may want to seek legal advice to help them create an advance directive and power of attorney for health care. Support GroupsYou can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Outlook (Prognosis)For many people with metastatic brain tumors, the cancer is not curable. Prognosis depends on the type of tumor and how it responds to treatment. Possible ComplicationsHealth problems that may result include:
When to Contact a Medical ProfessionalContact your health care provider if you develop a persistent headache that is new or different for you. Call your provider or go to the emergency room if you or someone you know suddenly becomes sluggish or has vision changes, or speech impairment, or has seizures that are new or different. ReferencesDorsey JF, Salinas RD, Dang M, et al. Cancer of the central nervous system. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 63. Elder JB, Nahed BV, Linskey ME, Olson JJ. Congress of Neurological Surgeons systematic review and evidence-based guidelines on the role of emerging and investigational therapies for the treatment of adults with metastatic brain tumors. Neurosurgery. 2019;84(3):E201-E203. PMID: 30629215 pubmed.ncbi.nlm.nih.gov/30629215/. National Cancer Institute website. Adult central nervous system tumors treatment (PDQ) - health professional version. www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq. Updated March 6, 2024. Accessed May 14, 2024. Olson JJ, Kalkanis SN, Ryken TC. Congress of neurological surgeons systematic review and evidence-based guidelines for the treatment of adults with metastatic brain tumors: executive summary. Neurosurgery. 2019;84(3):550-552. PMID: 30629218 pubmed.ncbi.nlm.nih.gov/30629218/. Traylor JI, Rao G. Metastatic brain tumors. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 169. | |
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Review Date: 3/31/2024 Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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Brain
MRI of the brain
