What Is Metastatic Brain Cancer?

When a loved one is diagnosed with cancer, it can be an overwhelming and frightening experience. The journey becomes even more challenging when cancer cells spread to the brain, leading to metastatic brain cancer.

Metastatic brain cancer is more common than primary brain cancer, and it requires a different approach to treatment and care.

We aim to shed light on what metastatic brain cancer is, its causes, symptoms, diagnosis, treatment options, and provide essential information on what to expect for patients and caregivers on this difficult path.

Metastatic brain cancer, often referred to as brain metastases, is a condition in which cancer cells from a primary tumor in another part of the body, such as the lungs, breast, or colon, spread to the brain. These cancer cells can infiltrate the brain tissue, forming secondary tumors or metastases.

Metastatic brain cancer is different from primary brain cancer, which originates within the brain itself. Metastatic brain cancer arises when cancer cells from another organ or tissue migrate to the brain through the bloodstream or lymphatic system.

The time it takes for a cancer to metastasize depends on the type of cancer, its aggressiveness, its proximity to blood vessels and lymphatic channels, along with patient factors such as age, overall health, and immune function.

Some types of cancers, such as pancreatic cancer or small cell lung cancer, may be more aggressive and spread more quickly. Other cancers, such as certain types of prostate cancer or breast cancer, may spread more slowly.  

It is essential to distinguish between primary and metastatic brain cancer because their treatment approaches and outcomes may vary significantly.    

Metastatic brain cancer occurs as a result of cancer cells breaking free from the primary tumor and traveling to the brain through blood vessels and lymphatics. Several factors increase the likelihood of this happening:

• Cancer Type: Some cancers have a higher propensity to metastasize to the brain. Common examples include lung cancer, breast cancer, melanoma, kidney cancer, and colon cancer.
• Advanced Stage: Metastasis to the brain often occurs in advanced stages of cancer when the primary tumor has grown larger or spread to other organs.
• Age: Older adults are more susceptible to metastatic brain cancer, possibly due to the aging brain's vulnerability to tumor infiltration.
• Immune System Suppression: Conditions or treatments that weaken the immune system, such as certain medications or diseases like HIV, can increase the risk of brain metastases.
• Genetic Factors: Some genetic mutations and variations may predispose individuals to develop metastatic brain cancer.

When cancer spreads to the brain, they begin to divide, growing along existing blood vessels or recruiting new blood vessels to obtain nutrients to continue cell division. Over time, the cancer grows large enough to be seen on an imaging scan, and/or produce symptoms. 

Recognizing the signs and symptoms of metastatic brain cancer is crucial for early diagnosis and intervention. Symptoms can vary depending on the location and size of the brain metastases. Common symptoms include:

• Headaches
• Changes in behaviour, personality, memory, or cognitive function.
• Seizures
• Nausea and Vomiting
• Weakness or Numbness
• Vision Problems
• Difficulty with Balance and Coordination
• Speech Difficulties

The first signs that mark when cancer has spread to the brain is nearly impossible to know. Since the cancer cells are microscopic, you cannot physically feel any difference when a small piece of the tumor breaks off and travels to the brain. 

However, when the brain metastasis grows large enough to cause symptoms, promptly seeking medical attention is the best way for you to receive timely treatment or guidance as early as possible.

It's important to remember that these symptoms can also be caused by other medical conditions, so a thorough evaluation by a healthcare professional is essential.

Diagnosing metastatic brain cancer typically involves a combination of medical history assessment, physical examinations, and imaging studies. Here's what you can expect during the diagnostic process:

• Medical History: Your healthcare provider will ask questions about your medical history, including the recent cancer diagnoses and treatments
• Physical Examination: A neurological examination will be conducted to assess your reflexes, coordination, strength, and sensory function
• Imaging Studies: Imaging tests like magnetic resonance imaging (MRI) and computed tomography (CT) scans are essential for visualizing brain metastases. These scans provide detailed images of the brain, allowing healthcare professionals to identify the location, size, and number of tumors.
• Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis and determine the type of cancer cells present.

Once the diagnosis is confirmed, your healthcare team will work with you to develop a personalized treatment plan.

The treatment approach for metastatic brain cancer depends on various factors, including the number and size of brain metastases, the type of primary cancer, overall health, and individual preferences. Treatment options may include:

• Surgery: Surgical removal of brain metastases may be considered if there are one or a few tumors that are accessible and causing significant symptoms.
• Radiation Therapy: Radiation therapy, including whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), is a common treatment option for brain metastases.
• Chemotherapy: In some cases, chemotherapy may be recommended to treat both the primary cancer and the brain metastases.
• Targeted Therapies and Immunotherapy: These treatments work by targeting specific molecular or immune-related pathways involved in cancer growth.
• Supportive Care: Palliative care and symptom management play a crucial role in improving the quality of life for patients with metastatic brain cancer.
• Clinical Trials: Participation in clinical trials may be an option for some patients. These trials test new treatments and therapies that have not yet been widely approved.

If cancer spreads to the brain, many patients wonder if they can survive and if so, for how long.

The prognosis for metastatic brain cancer can vary widely based on several factors, including the primary cancer type, the extent of brain involvement, the effectiveness of treatment, and the overall health of the patient. It's important to note that metastatic brain cancer is often considered a serious and challenging condition.

While some individuals may achieve remission or prolonged survival with aggressive treatment, others may face a more limited prognosis. However, advances in medical research and treatment options continue to improve the outlook for some patients with metastatic brain cancer.

Ultimately, the journey with metastatic brain cancer is unique to each individual, and medical professionals are there to provide guidance and support throughout the process. Early diagnosis and prompt intervention are essential for managing the condition and improving outcomes.

• Metastatic brain cancer occurs when cancer cells from a primary tumor in another part of the body spread to the brain.
• It can cause various neurological symptoms, including headaches, seizures, memory problems, weakness, and changes in behavior, depending on tumor location.
• Treatment depends on factors like the primary cancer type, number of brain metastases, and patient health.
• Treatment options include surgery, radiation, chemotherapy, targeted therapy, immunotherapy, and palliative care.

• American Association of Neurological Surgeons (AANS): Metastatic Brain Tumors
• National Cancer Institute (NCI): Brain Tumors
• National Brain Tumor Society: Signs & Symptoms
• CancerCare: Brain Cancer