What should you know about bone and brain metastases?

They remain the same cancer type as the original tumour rather than becoming primary bone cancer or primary brain cancer. Treatment is tailored to the sites involved, symptoms, overall health and behaviour of the original cancer.

Bone deposits can weaken affected areas and irritate nearby nerves, while brain deposits may cause swelling or affect movement, speech, vision, balance, thinking or seizures. Some metastases are found on imaging before they cause symptoms. Scans help map their location and extent; tissue testing or review of the original cancer can guide treatment choices.

Your oncology team may combine treatment that works throughout the body with treatment directed at a particular lesion. Options for the brain can include medicines to reduce swelling, focused radiation, broader-field radiation or surgery. Bone care may include pain relief, radiotherapy, medicines that support bone strength, or an orthopaedic procedure when a bone is at risk. Do not stop steroids or anti-seizure medicines suddenly unless the prescribing team directs you.

Call emergency services for a first seizure, loss of consciousness, sudden weakness, new trouble speaking or a severe rapidly worsening headache. Seek urgent assessment for new confusion, repeated vomiting or a sudden change in vision or balance. New severe back or neck pain with limb weakness, numbness around the buttocks or difficulty controlling urine or bowel movements may indicate spinal cord compression and also needs emergency evaluation.

Ask which lesions are causing symptoms, whether any bone needs protection from fracture and whether brain swelling requires medication. Clarify the goal of each proposed treatment, how the treatments will be sequenced and whom to contact after hours if symptoms change. Ask whether driving, flying, exercise or working at height is safe in light of seizure risk and bone stability.