Stage 4 lung cancer that has spread to the brain

Brain metastases are deposits of lung cancer in the brain or its surrounding structures. They can cause headache, seizures, weakness on one side, balance problems, speech or vision changes, nausea, or changes in behaviour and alertness. Some people have no neurological symptoms and are diagnosed through imaging.

A clinician may use brain imaging and a neurological examination to assess number, size, position, swelling, and bleeding. The lung cancer subtype, genomic findings, other areas of spread, previous treatment, and general health help shape the plan. Symptoms alone cannot show how extensive the disease is.

Tell the oncology team about any new headache, seizure, weakness, clumsiness, or change in thinking. Treatment can include medicines to reduce swelling or control seizures, radiotherapy directed at brain deposits, surgery in selected situations, and systemic treatment for cancer throughout the body. Palliative care can be involved alongside these treatments to support comfort, function, communication, and family needs.

Call emergency services for a first seizure, a seizure that does not stop, sudden weakness or facial drooping, new trouble speaking, collapse, severe sudden headache, repeated vomiting, or difficulty staying awake. Do not drive yourself after a seizure or sudden neurological change. The oncology team should also hear about milder but persistent changes without delay.

How many brain deposits are present, and where are they located? Is there swelling or bleeding? What is the purpose and timing of each treatment? Could genomic tumour profiling affect systemic options? What should my family do if I have a seizure or become confused?