What to expect from stereotactic radiosurgery for brain metastases

Stereotactic radiosurgery focuses radiation on one or more brain metastases while limiting exposure to nearby brain tissue. Despite its name, it does not involve an incision. A mask or other head-positioning device helps you stay still while the treatment team checks your position and delivers the planned beams. Treatment may be completed in one session or divided across several sessions, depending on the number, size and location of the lesions and your overall treatment plan.

You remain awake for most treatments. The team can speak with you through the treatment system, and you may notice noise or movement from the equipment. Fatigue, headache, nausea or temporary worsening of symptoms can occur after treatment; your team may prescribe medicines to reduce swelling or nausea.

Bring an up-to-date list of medicines, including steroids, blood thinners and supplements. Tell the team about a pacemaker, implanted device, allergies, pregnancy or difficulty lying flat. Follow instructions about eating, drinking and medicines on the treatment day, and arrange transport if sedation or medicines could affect alertness.

Afterward, take prescribed medicines exactly as directed and attend the planned imaging appointments. Rest when tired, drink fluids if allowed, and ask when you can drive, work or resume exercise. Follow-up scans help the team distinguish treatment effects from changes in the metastases.

Contact your oncology team promptly for a worsening headache, repeated vomiting, new weakness, increasing confusion, a seizure, trouble speaking, vision changes or difficulty walking. Seek emergency help for a seizure that does not stop, sudden loss of consciousness or severe breathing difficulty. These symptoms need assessment because swelling or another neurological problem can require urgent treatment.

Ask which lesions will be treated, whether treatment is planned in one session or several, how your medicines should change, what symptoms should prompt a call, and when your next brain scan will be arranged.