Brain tumor - metastatic (secondary); Cancer - brain tumor (metastatic)

Treatment depends on the size and type of the tumor, the initial site of the tumor, and the general health of the person. The goals of treatment may be relief of symptoms, improved functioning, or comfort.

Radiation to the whole brain is often used to treat tumors that have spread to the brain, especially if there is more than one tumor.

Surgery may be used for metastatic brain tumors when there is a single lesion and when there is no cancer elsewhere in the body. Some may be completely removed. Tumors that are deep or that infiltrate brain tissue may be debulked (removing much of the tumor's mass to reduce its size).

Surgery may reduce pressure and relieve symptoms in cases when the tumor cannot be removed.

Chemotherapy for brain metastases is not as helpful as surgery or radiation for many types of cancer.

Stereotactic radiosurgery is used at some hospitals. This is a form of radiation therapy that focuses high-powered x-rays on a small area of the brain.

Medications for some symptoms of a brain tumor may include the following:

• Corticosteroids such as dexamethasone to reduce brain swelling
• Osmotic diuretics such as urea or mannitol to reduce brain swelling
• Anticonvulsants such as phenytoin or levetiracetam to reduce seizures
• Pain medication
• Antacids or antihistamines to control stress ulcers

When widespread cancer is discovered, treatment may focus primarily on relief of pain and other symptoms. This is called palliative or supportive care.

Comfort measures, safety measures, physical therapy, occupational therapy, and other interventions may improve the patient's quality of life. Legal advice may be helpful in forming advanced directives, such as power of attorney, in cases where continued physical or intellectual decline is likely.

For additional information, see cancer resources.

In general, the probable outcome is fairly poor. For many people with metastatic brain tumors, the cancer spreads to other areas of the body. Death often occurs within 2 years.

• Brain herniation (fatal)
• Loss of ability to function or care for self
• Loss of ability to interact
• Permanent, progressive, profound neurologic losses

Call your health care provider if you develop a persistent headache that is new or different for you.

Call your provider or go to the emergency room if you or someone else suddenly develops stupor, vision changes, or speech impairment, or has seizures that are new or different.

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Review Date: 03/02/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)