Brain Metastasis

Brain metastasis, also known as secondary brain tumors, occur when cancer cells spread from their original site to the brain. These tumors are a significant cause of morbidity and mortality in cancer patients. They are the most common type of brain tumor, accounting for slightly more than half of all brain tumors. In the United States alone, approximately 170,000 new cases of metastatic brain tumors are diagnosed each year. About 15-30% of patients with cancer elsewhere in the body develop brain metastasis. The cancer cells usually spread to the brain through the bloodstream (hematogenous spread).

The primary cancers that most commonly spread to the brain include lung, breast, melanoma (skin cancer), renal (kidney) cancer, and colon cancer. Lung cancer has the highest incidence of brain metastasis, with 30-60% of lung cancer patients developing brain secondaries. Breast cancer follows, with 20-30% of patients experiencing brain metastasis. The incidence of brain metastasis peaks between the fifth and seventh decades of life and declines thereafter. In children, only 6-13% of cancers spread to the brain.

Symptoms and Signs

The most common symptoms of brain metastasis are:

– Headache: More than half of the patients experience headaches as the initial symptom.

– Vomiting: Projectile vomiting often accompanies headaches.

– Altered Level of Consciousness: Patients may experience changes in personality, confusion, or may present in a semiconscious state or deep coma.

– Seizures (Epileptic Fits): About 35% of patients with brain metastasis experience seizures. If a patient over 45 years old has seizures for the first time in their life, brain metastasis should be suspected.

– Weakness or Numbness: Some patients may develop weakness or numbness on one side of the body.

Diagnosis

To diagnose brain metastasis, the following imaging studies are most effective:

– CT Scan with Contrast: This imaging technique helps to identify and assess the nature of the tumors.

– MRI of the Brain: MRI provides a detailed view and is the preferred method for diagnosing brain metastasis.

Brain metastases typically present as multiple lesions in the brain, but about 50% appear as a single lesion, which can mimic other primary brain tumors. Some metastases spread to the meninges (the covering of the brain), leading to hydrocephalus (blockage of cerebrospinal fluid pathways), a condition known as carcinomatous meningitis. Patients with this condition may experience neck pain and rigidity in addition to headaches and vomiting.

Treatment

The treatment of brain metastasis at Hannah Joseph Hospital involves a combination of surgery, radiation therapy, and chemotherapy:

– Surgery: Surgery is often performed to confirm the diagnosis, especially when the primary site of the cancer is unknown. A CT-guided stereotactic biopsy is used for this purpose. In cases of large solitary metastasis, surgical excision of the tumor can provide symptomatic relief and reduce the tumor burden, making radiation therapy more effective.

– Radiation Therapy: This treatment helps to control and shrink brain metastases.

– Chemotherapy: Chemotherapy drugs are designed to kill cancer cells at both the primary site and any metastatic sites, including the brain.

Gene therapy for brain metastasis is still in its early stages, and more research is needed to establish its effectiveness.

Prognosis

The overall prognosis for patients with brain metastasis is generally poor. It depends on several factors, including the extent of the cancer spread in other parts of the body, the aggressive nature of the primary tumor, and the degree of neurological deficits. Early detection and prompt treatment can enhance survival time and improve the quality of life for patients.

Our Commitment at Hannah Joseph Hospital

At Hannah Joseph Hospital, we are committed to providing comprehensive care for patients with brain metastasis. Our multidisciplinary team of specialists, including neurosurgeons, oncologists, and radiologists, work together to offer personalized treatment plans that aim to improve patient outcomes and quality of life. We utilize advanced diagnostic tools and the latest treatment modalities to ensure our patients receive the best possible care.

Why Choose Hannah Joseph Hospital?

Choosing Hannah Joseph Hospital means entrusting your care to a team dedicated to excellence in medical treatment and compassionate care. Our state-of-the-art facilities and experienced medical professionals ensure that every patient receives tailored treatment that addresses their specific needs. We are committed to staying at the forefront of medical advancements to provide our patients with innovative and effective treatment options.

Brain metastasis is a serious and challenging condition, but with early detection and comprehensive treatment, we strive to offer hope and improved outcomes for our patients. If you or a loved one is facing brain metastasis, we are here to support you every step of the way at Hannah Joseph Hospital. Contact us today to learn more about our services and how we can help you.

Author:

Dr. M. J. Arunkumar, M. Ch., DNB
Senior Consultant Neurosurgeon
Hannah Joseph Hospital
Madurai