What are the treatment options for brain metastases?

Brain metastases are cancer deposits that have travelled from another part of the body. The team considers brain scans, the primary cancer, general health, neurological symptoms and whether disease is present elsewhere. Surgery can remove a lesion that is accessible and causing pressure, or provide tissue for diagnosis. Stereotactic radiosurgery focuses radiation on selected lesions. Whole brain radiotherapy treats a wider area when there are multiple deposits or a broader pattern of involvement. Medicines may treat the original cancer and swelling or seizures may need separate treatment.

Ask for a coordinated plan from oncology, radiation oncology and neurosurgery when appropriate. Bring a list of medicines, previous cancer reports and any changes in balance, speech, strength, vision or memory. Your team may advise a corticosteroid for swelling or an anti-seizure medicine when clinically indicated. Treatment goals can include controlling a brain lesion, protecting neurological function and treating cancer outside the brain. Read about Brain Metastases and the relevant treatment options before deciding.

Seek emergency help for a new seizure, sudden weakness or numbness on one side, new trouble speaking, severe confusion, fainting, a sudden severe headache, repeated vomiting or rapidly worsening balance. Contact the treating team promptly for a new or increasing headache, vision change, unusual sleepiness or a noticeable change in behaviour.

Which treatment is intended to control the brain lesions, and which treats the original cancer? How many lesions are present and where are they located? What benefits and side effects should I expect from surgery or radiation? Do I need help with swelling, seizures, driving, work or daily activities? How will follow-up scans assess the response?