Prostate cancer brain metastasis: what to know

A metastasis is a group of cancer cells that has travelled from the prostate to another part of the body. In the brain, its position and size can affect symptoms and guide treatment choices. Possible changes include headache, nausea, weakness on one side, speech or vision changes, confusion, seizures, or a change in balance. These symptoms can have other causes, so they do not by themselves confirm a metastasis. Assessment may include a neurological examination and brain imaging. The cancer team also considers the prostate cancer history, other areas involved, general health, and medicines.

Contact the oncology team promptly about new neurological symptoms, even if they come and go. Take a list of medicines, including blood thinners, and note when each symptom began. Treatment may involve medicines to reduce swelling or control seizures, focused or whole-brain radiotherapy, surgery in selected situations, and treatment directed at cancer elsewhere in the body. Your team can explain whether [Radiotherapy](/treatments/radiation-oncology/radiotherapy/) or [Targeted Radioisotope Therapy](/treatments/radiation-oncology/targeted-radioisotope-therapy/) fits the overall plan. General information about [Prostate Cancer](/conditions/prostate-cancer/) may help you prepare.

Call emergency services for a first seizure, a seizure that does not stop, sudden one-sided weakness, new difficulty speaking, severe confusion, collapse, or a sudden severe headache with vomiting. Do not drive yourself after a seizure or when confused. For a new or worsening headache, balance problem, vision change, or weakness without these emergency features, contact the cancer team the same day.

Ask where the suspected lesion is, which scan is needed, and what symptoms should trigger emergency help. Ask whether treatment aims to control the brain lesion, the wider cancer, symptoms, or several of these goals. Ask how treatment may affect alertness, movement, speech, and daily activities.