When is stereotactic radiosurgery recommended for brain metastases?

Brain metastases are cancer deposits that have spread to the brain from another part of the body. Stereotactic radiosurgery uses highly focused radiation aimed at one or more visible deposits while limiting dose to nearby brain tissue. Specialists review contrast-enhanced MRI, the number and size of deposits, their position, swelling, symptoms and whether there is disease elsewhere. The primary cancer, previous treatment and medicines also shape the plan.

Focused treatment may be discussed when deposits are limited and can be targeted safely. Surgery, whole-brain radiotherapy, medicines that reach the brain, or supportive treatment may be considered instead or in combination. The team also plans how to manage swelling and monitors the treated areas with follow-up imaging.

Ask for a coordinated review involving the relevant oncology and brain-treatment specialists. Bring details of previous cancer treatment, medicines such as steroids or blood thinners, and any history of seizures. Discuss whether treatment is intended to control known deposits, relieve symptoms, or support the broader cancer plan. Take prescribed medicines exactly as directed and keep imaging appointments so swelling, treatment response and new deposits can be checked.

Seek emergency care for a seizure, sudden weakness or numbness, new trouble speaking, severe confusion, fainting, a rapidly worsening headache, repeated vomiting or difficulty staying awake. Contact the cancer team promptly for new balance problems, vision changes or persistent headaches. Neurological symptoms can worsen quickly and should not be attributed to treatment without assessment.

How many deposits are present, and are their size and location suitable for focused treatment? Would surgery, whole-brain treatment or medicines be better or need to be combined? How will swelling and seizure risk be managed? Which symptoms require emergency care, and when will the next MRI take place?