Brain Metastasis

A brain metastasis is a tumor that arises in the brain and has spread from a primary cancer elsewhere in the body. They are common; each year, 20-40% of cancer patients will develop at least one brain metastasis. They are usually diagnosed with a brain MRI.

While new brain metastases can be a scary and discouraging development, the good news is that they can usually be treated or controlled. In fact, the survival of a cancer patient is generally not determined by spread to the brain but rather by control of the primary cancer outside of the brain.

Treatment for brain metastases begins with either removal by craniotomy or radiosurgery.

Craniotomy tends to be used for large metastases that are pushing on the surrounding brain, while radiosurgery is better suited to smaller lesions - especially when there is more than one. Sometimes a hybrid approach is required when there is a dominant metastasis and other smaller lesions. In general, radiosurgery is used more commonly.

Most patients will need additional therapy after surgery, usually a chemotherapy agent targeted against the cancer of origin. There are also promising new therapies available for brain metastases, including immunotherapy. All patients will need follow-up surveillance MRIs to screen for recurrence or new metastases.

If you live near Denver and have a brain metastasis, please consider meeting me in consultation to learn about treatment options.