What are the first signs of brain metastases?

Symptoms depend on where a secondary tumour is located and how it affects nearby brain tissue or pressure within the skull. A headache may become persistent or change with position, while weakness, clumsiness, or altered sensation may affect one side. Some people notice problems with language, memory, concentration, vision, or walking.

These symptoms have many possible causes. In someone who has breast cancer, lung cancer, melanoma, or another cancer, new neurological symptoms deserve prompt clinical review. Brain metastases are assessed with examination and brain imaging, often guided by the person’s cancer history.

Contact your oncology or medical team promptly about a new neurological change, especially if it is worsening or interfering with walking, speaking, seeing, or daily tasks. Record when it started and whether it comes in episodes. Your team may discuss imaging and treatment options suited to the number, size, and location of lesions.

Call emergency services for a first seizure, a seizure that does not stop, sudden weakness or loss of speech, severe confusion, repeated vomiting, loss of consciousness, or a sudden severe headache. Do not drive yourself after a seizure or sudden neurological change.

Ask which symptoms need immediate reporting, what scan is planned, and whether swelling is contributing. Discuss whether stereotactic radiosurgery, whole brain radiotherapy, or brain tumour surgery could be relevant, and how treatment of the original cancer fits the plan.