What should you know about the most common brain metastases?

A metastasis is a secondary tumour, so it is named and treated in relation to the original cancer as well as its location in the brain. The number, size, position, and activity of tumours help shape the care plan. Symptoms can include headache, seizures, weakness, balance changes, speech difficulty, or changes in thinking, but these symptoms can also have non-cancer causes.

Assessment commonly includes a neurological examination and brain imaging. The oncology team may review previous scans and the biology of the original cancer before recommending treatment. Brain Metastases can cause swelling around brain tissue, which is one reason new neurological symptoms should not be ignored.

Tell the treating team promptly about new headaches, vomiting, vision changes, weakness, confusion, or a seizure. Treatment may include medicines to reduce swelling or control seizures, whole-brain treatment when many areas are involved, or focused options such as Stereotactic Radiosurgery for selected lesions. Brain Tumour Surgery may be considered when removing a tumour can relieve pressure or provide tissue for diagnosis.

Call emergency services for a first seizure, a seizure that does not stop, sudden one-sided weakness, trouble speaking, severe confusion, or a rapidly worsening headache with vomiting. Do not drive yourself after a seizure or sudden neurological change. Prompt assessment can identify swelling, bleeding, or another emergency that needs immediate treatment.

Ask where the metastases are, whether swelling is present, and how the scan findings relate to your original cancer. Ask why a focused treatment, whole-brain treatment, surgery, or supportive medicines are being considered, and what changes should trigger an urgent call.