The number of patients with metastatic intracranial tumors exceeds the number of those with primary brain tumors by a factor of 10. Brain metastasis can occur in 25 percent of all people with cancer. Since cancer patients are now living longer, it is expected that the number of people with metastatic tumors will continue to increase. The finding of brain metastases will radically change the intent and direction of therapy. This generally takes precedence over almost any other complication.
When someone with cancer develops headaches, drowsiness, personality changes or problems with speech, strength or balance, a brain metastasis should be suspected. Although a single metastasis can occur, it is more common for there to be multiple tumors. MRI scans are best able to detect multiple metastases.
A primary tumor in the body can cause no signs or symptoms. When a tumor in the brain is discovered, a physician will always consider the possibility that it could represent a metastasis.
If there are multiple brain tumors, there is a greater chance that they are metastatic rather than primary. A screening evaluation may then be performed to look for other tumors in the body. This evaluation includes blood tests, a chest x-ray and CT scans of the chest and abdomen. Initial therapy usually includes corticosteroid hormones such as Decadron to immediately reduce the pressure in the brain and thereby relieve symptoms.
Standard Treatment Many metastatic tumors are located over the surface of the brain and can be safely removed. Radiation is given after surgery. If there are multiple tumors, surgery is deferred and the treatment is irradiation.
