What should you know about stage 4 brain metastases?

Brain metastases are secondary tumours, not a primary brain cancer. They can arise from cancers such as lung cancer, breast cancer or melanoma. The number, size and position of deposits, the cancer’s biology and your symptoms all affect decisions.

Assessment commonly includes brain imaging and a review of the original cancer. Symptoms can include headache, seizures, weakness, balance changes, speech difficulty, vision changes, nausea or altered thinking, although symptoms vary with location.

Your team may discuss medicines to reduce swelling or control seizures, treatment for the cancer elsewhere, and local treatment for brain deposits. Stereotactic radiosurgery focuses radiation on selected areas. Whole brain radiotherapy may be considered when deposits are more widespread. Brain tumour surgery can help when a deposit is accessible and removing it is appropriate.

Ask whether the goal is to control brain disease, relieve symptoms, protect function or address another priority. A neuro-oncology, radiation and medical oncology review can bring these choices together.

Call emergency services for a first seizure, a seizure lasting longer than expected, sudden one-sided weakness, new trouble speaking, collapse or rapidly worsening confusion. Seek urgent assessment for a severe new headache with vomiting, marked drowsiness or a sudden change in vision. Do not drive yourself after a seizure or sudden neurological change.

Where are the deposits and how are they affecting brain function? Do I need medicine for swelling or seizures? Which local treatment fits their number and position? What should my family do if I have a seizure?