Stage 4 lung cancer with spread to the brain

A brain metastasis is a deposit of lung cancer cells in the brain, rather than a primary brain cancer. Symptoms vary with the number, size, and location of lesions. Headache, seizures, weakness, balance trouble, speech changes, vision changes, personality changes, or confusion can occur, although some people have no symptoms and lesions are found on imaging.

Doctors usually combine brain imaging with information about the lung tumour, other metastatic sites, pathology, and your general health. The word stage 4 describes distant spread; it does not by itself specify how an individual person will respond to treatment.

Your team may discuss medicines that treat cancer throughout the body, radiotherapy directed at brain lesions or wider brain tissue, surgery for selected accessible lesions, or a combination. Steroids may be used to reduce swelling around a lesion, and anti-seizure treatment may be considered after a seizure or when specialists advise it. Genomic tumour profiling can help identify systemic options for some tumours.

Tell the team about driving, work, falls, headaches, sleep, and changes in concentration. Palliative care can support symptoms, communication, and family needs alongside cancer-directed treatment. Ask for a clear plan for scans, medicines, and who to contact day or night.

Call emergency services for a first seizure, a seizure that does not stop, sudden weakness or numbness on one side, trouble speaking, severe confusion, collapse, or a sudden severe headache with vomiting. Contact the oncology team promptly for a new persistent headache, worsening balance, repeated vomiting, or a noticeable change in behaviour. Do not stop steroids or seizure medicine without medical advice.

How many brain lesions are present and where are they located? Is there swelling? Which treatment should start first, and what is its goal? Is genomic tumour profiling available? What changes require emergency help? Can I drive and exercise safely?