When is whole brain radiotherapy recommended for brain metastases?

The radiation team reviews brain imaging, the number and position of metastases, symptoms, previous treatments and overall health. Whole brain treatment uses planned radiation to cover the brain, whereas focused techniques target selected lesions. Steroids may reduce swelling around a metastasis, and anti-seizure treatment may be considered when clinically needed. The team balances likely symptom relief and control with effects such as tiredness, hair loss, scalp changes and possible effects on memory or concentration.

Tell the oncology team about headaches, seizures, weakness, vision or speech changes, balance problems and all medicines. Ask whether steroids should continue, whether focused radiation or systemic treatment is an option, and how driving, work and daily activities may be affected. Keep a symptom record and arrange help with transport, meals and rest during the treatment course.

Call emergency services for a first seizure, a seizure that does not stop, sudden weakness on one side, severe confusion, collapse, a rapidly worsening headache or new difficulty speaking or seeing. Contact the radiation team promptly for persistent vomiting, worsening drowsiness or symptoms that are changing during treatment.

Ask how many lesions are present, why whole brain treatment is preferred, whether focused radiation is suitable, how swelling will be managed, what side effects to report, and how treatment will be coordinated with medicines or treatment for the original cancer.