What are the alternatives to whole-brain radiotherapy?

Stereotactic radiosurgery delivers focused radiation to a limited number of brain lesions while sparing more surrounding brain tissue. Surgery may be considered when one accessible lesion is causing pressure or symptoms and removal is safe. Medicines may control the cancer throughout the body when the tumour type responds to a drug that reaches the brain. Supportive care can include medicines for swelling, seizures, pain or nausea, and may be the main focus when treatment burden outweighs likely benefit. Brain metastases and small-cell lung cancer can behave differently, so the cancer type and scan pattern matter.

Ask how many lesions are present, whether they are growing, and whether there is swelling or pressure. Discuss the purpose of treatment, expected effect on symptoms, possible effects on thinking and daily function, and how the rest of the cancer will be managed. Bring a medication list and mention any previous radiation, seizures or balance problems. Ask what scans will be used to check the response.

Seek emergency care for a first seizure, repeated seizures, sudden weakness, new trouble speaking, severe headache with vomiting, collapse, marked drowsiness or sudden confusion. Do not drive yourself after a seizure or sudden neurological change.

Would focused radiation treat all visible lesions? Is surgery technically possible? Could medicine reach the brain? How will you protect comfort, memory and independence during treatment?