Metastatic Brain Tumors
Metastatic tumors develop when cancer cells spread from another area of cancer by breaking away from the primary tumor and traveling through the body by way of the blood, lymphatic vessels or membranous surfaces. When the cancer cells travel to the brain, a metastatic brain tumor develops.
Not all cancers metastasize (spread) to the brain. Some types of cancers, such prostate cancer, rarely spread to the brain. Other cancers, such as lung, breast, kidney, melanoma, thyroid, testicular, germ cell tumors and others, are more prone to spread to the brain. Often, metastasized tumor cells spread more rapidly than primary tumor cells and it is not uncommon to develop multiple tumors in several areas of the brain.
The symptoms of metastasized brain tumors depend on where the tumor is located in the brain. Most likely, the cells will travel to the cerebral hemisphere or the cerebellum. Cancer patients should notify their physician if they experience:
- Headaches – new or more severe than normal
- Seizures – new to the patient
- Decreased coordination – clumsiness, falling, loss of balance
- Weakness, numbness, tingling , particularly in the arms and legs
- Personality changes
- Memory loss; poor judgment or difficulty concentrating and solving problems
- General feeling of illness or lethargy; vomiting or fever
- Double, blurred or decreased vision
- Speech disturbance; hearing loss
Doctors have a number of tests that they use to diagnose metastatic brain tumors. After a routine physical exam, doctors may use one or more of the following tests, depending on the patient:
- Neurological exams - to determine a patient's:
- Balance and coordination
- Reasoning and memory skills
- Computed tomography (CT) - scans which may reveal tumors near the bone, swelling and bleeding
- Magnetic resonance imaging (MRI) - scans which are considered to be the best technology to diagnose brain tumors. An MRI creates a three-dimensional image of the tumor(s) and functional magnetic resonance imaging (fMRI) scans can assist the doctor in pinpointing the exact location of the functional center in the brain.
- Biopsy - used to determine the exact type of tumor present and whether it is malignant (cancerous). During a biopsy, a small amount of the cancerous tissue is taken and analyzed under a microscope. A biopsy can usually be done during surgery in which all or part of the brain tumor is removed. Tumors buried deep in the brain sometimes cannot be approached safely. In those cases, a biopsy procedure involves using three-dimensional needle technique in which special imaging equipment guides the placement of a needle to allow cells to be drawn into the needle.
- Lumbar puncture - used to test cerebral spinal fluid to look for cells related to the tumor
- Cerebral angiography - may be used to show a mass that may, or may not, be a tumor
- Diffusion tensor imaging (DTI) - used to document changes in the brain's structure over a period of time and allows the physician to study the connections between different areas of the brain
Sometimes, after examining tumor tissue, the tumor is diagnosed as a metastatic brain tumor but the patient has no history of cancer.
At this time, additional tests including a chest X-ray, mammogram, scans of the chest, abdomen and pelvis may be used to determine the site of the original cancer, which the patient may not know exists.
Metastatic brain tumors are often treatable and can be controlled. Determining the optimal treatment plan takes a number of factors into consideration, including the patient’s preferences, the type, number, location and aggressiveness of the tumor(s) as well as the overall health of the patient.
Generally, treatment of metastatic brain tumors will include surgery, stereotactic radiosurgery, conventional radiation therapy and chemotherapy, each used independently or in combination.
- Stereotactic Radiosurgery
- Radiation therapy