Metastatic Brain Tumors
What is a Metastatic Brain Tumor?
Metastatic brain tumors, also known as secondary brain tumors, are tumors that have spread to the brain from cancer originating in another part of the body. These tumors occur when cancer cells break away from the primary tumor site, such as the lung, breast, colon, or other organs, and travel through the bloodstream or lymphatic system to reach the brain.
Metastatic brain tumors are more common than primary brain tumors, accounting for the majority of brain malignancies. This is because cancer cells have a propensity to invade distant organs and tissues, including the brain, through the bloodstream or lymphatic vessels. Once in the brain, these cells can form new tumors and interfere with normal brain function.
Metastatic Brain Tumor Treatment
Minimally invasive surgery & precision radiosurgery are often essential first steps in treating Metastatic brain tumors
Optimal personalized treatment of patients with metastatic brain tumors requires a team approach of medical and neuro-oncologists, radiation oncologists and neurosurgeons, as well as cutting-edge brain imaging and tumor genetic profiling. Treatment of the cancer in the body, needs to be coordinated with “brain-directed” therapies in a targeted and precise fashion.
The initial treatment of metastatic brain tumors is typically focused radiation (radiosurgery) and/or surgical removal depending upon the type, size, location and number of metastases. Fortunately, for patients who require metastatic brain tumor surgery, most can be removed through a minimally invasive keyhole approach. The goal of surgery is to achieve maximal safe tumor removal and improve quality of life. An additional goal is to obtain tumor tissue for histological subtyping and genetic profiling for novel targeted therapies options and clinical trials, which are increasingly available for patients with metastatic brain tumors.
At the Pacific Brain Tumor Center we incorporate cutting-edge technology such as MRI fiber tractography, functional MRI, surgical navigation, awake craniotomy protocols, and high-definition endoscopy, with proven surgical experience, to make metastatic tumor surgery safer, less invasive and more effective. We also have a large experience in the radiosurgical treatment and comprehensive care of all types of brain metastases. Our metastatic brain tumor surgeons Drs. Daniel Kelly & Garni Barkhoudarian work closely with our radiation oncologists, medical-oncologists, neuro-oncologists and neuropathologists to design the optimal treatment plan.
Metastatic brain tumors (also known as secondary brain tumors) arise from a cancer from another part of the body and occur in 10 – 30% of cancer patients. These are the most common type of brain tumor occurring 5 – 10 times more commonly than Primary Brain Tumors. In the United States, with over a million new cancer patients diagnosed each year, 100,000 to 300,000 of these people will develop brain metastases. The most frequent types of cancer that metastasize to the brain are lung, breast, melanoma (skin), colon, renal (kidney) and thyroid.
The symptoms and presentation of metastatic brain tumors can vary depending on the size, number, and location of the tumors. Common symptoms may include headaches, seizures, changes in cognitive function or personality, motor or sensory deficits, visual disturbances, and coordination problems. The specific symptoms experienced by an individual will depend on the regions of the brain affected by the metastatic tumors.
Diagnosing metastatic brain tumors usually involves a combination of imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, to visualize the tumors and determine their size, location, and number. Additional tests, including a detailed medical history, physical examination, and analysis of the primary cancer, may be necessary to confirm the diagnosis and guide treatment decisions.
For larger symptomatic brain metastases over 2-3 cm in diameter with associated brain swelling, surgical removal through a Keyhole Craniotomy is often indicated. In other patients with one or more smaller tumors, particularly those that are not easily accessible by surgery, precision radiosurgery (SRS) is typically used. In many patients with multiple brain metastases, keyhole surgical removal of symptomatic larger metastases is combined with radiosurgery to smaller metastases and the surgical resection site. Whole brain radiotherapy which involves radiation of the entire brain is avoided whenever possible.
Coordinating these “brain-directed” treatments with treatment of the cancer elsewhere in the body is essential to gaining control of the cancer. Fortunately, with advances in tumor genetic profiling, novel chemo- and immunotherapies and related clinical trials are available for many of our patients. One key purpose of metastasis removal is obtaining tissue for genetic profiling agents and there are always new therapies in development.
For more information about clinical trials at the Pacific Brain Tumor Center and with our colleagues in medical and neuro-oncology.
To watch metastatic brain tumor surgery, go to our video library.