It is difficult to put into words the fear and anxiety that comes to our minds when we learn that we have cancer. Meanwhile, the feeling can be even worse if we hear that the cancer has spread to other parts of the body, especially the brain. But don't be afraid, don't panic. Today we are talking about cancer that spreads to the brain, which is medically known as `(Brain Metastases)`. We will talk in a very simple way, in a way that you can understand, about what this condition is, why it happens, and what advanced treatments are available now.
What are brain metastases?
Simply put, this is when cancer starts somewhere else in your body (like your lungs, breast, or skin) and spreads to your brain. The place where the cancer first started is called the primary cancer . When some cancer cells break off from this primary cancer, travel through the blood vessels to the brain, where they form a new tumor or tumors.
Think of it like a weed seed in one part of a garden, blown by the wind, and sprouting in another part of the garden. The same thing happens here. Cancer cells that were in one part of the body, travel to the brain and start growing there.
How common is this condition?
In fact, the most common type of brain tumor seen in adults is a metastatic brain tumor. This means that cancers that spread to the brain from another location are more common than cancers that start in the brain itself (primary brain cancer). Research suggests that between 10% and 30% of people with cancer elsewhere in the body have a risk of developing brain cancer at some point in their lives.
This risk generally increases after the age of 45. Most people are diagnosed with this condition after the age of 65.
The important thing is that most tumors that start in the brain are non-cancerous (benign). But tumors that spread from elsewhere, called ``metastases,'' are always cancerous (malignant).
What are the symptoms of brain cancer?
The symptoms of brain cancer can vary depending on where the tumor is located in the brain and how it affects that area. Let's look at the main symptoms that can be seen.
| Symptom | A simple explanation |
|---|---|
| Headache | You may experience an unusual, severe headache. Sometimes this headache may be accompanied by nausea and vomiting. |
| Seizures | A seizure can occur suddenly, like never before in your life. |
| Loss of power on one side of the body (Hemiparesis) | An arm or leg, or both arms and legs on the same side of the body, may feel numb or weak. |
| Difficulty thinking | Short-term memory loss, sudden mood changes, and inability to make the right choices can occur. |
| Difficulty speaking | It becomes difficult to form words, and it becomes difficult to understand what others are saying. |
| Visual impairments | It may feel like you are losing vision in one side of your eyes. |
As the cancer progresses, new symptoms may appear, such as hearing loss, difficulty swallowing, and double vision. The most common symptom seen in the final stages is constant drowsiness .
Sometimes, these brain tumors can cause a stroke. However, the symptoms of a stroke appear suddenly. However, most of the symptoms of these cancerous tumors start slowly and gradually increase over time .
Why does cancer spread to the brain like this?
This is because some cells from a cancer tumor elsewhere in the body break off, enter the bloodstream, and travel to the brain with the bloodstream. Research is still ongoing into why only certain types of cancer spread in this way.
These types of cancer most often spread to the brain:
- Lung cancer: About half of people with lung cancer have the cancer spread to the brain. This is especially common with the type called ``small cell lung cancer.''
- Breast cancer: About 10% to 15% of people with metastatic breast cancer will develop brain cancer. This condition is more common in HER2+ and triple-negative breast cancers.
- Melanoma: This is a serious type of skin cancer. About half of people with melanoma have the cancer spread to the brain.
In addition, kidney cancer, colon cancer, and thyroid cancer can sometimes spread to the brain.
How does a doctor accurately diagnose this condition?
If you already have cancer and are experiencing the symptoms mentioned above, your doctor will test you for it. Sometimes, even if you don't have any symptoms, your doctor may screen you for the type of cancer that is at risk of spreading to the brain.
The main tests performed for this are:
| Test | What is happening? |
|---|---|
| Neurological exam | The doctor will check your balance, coordination, mental status, hearing, vision, and reflexes. These changes can give an idea of where the tumor is in the brain. |
| Blood tests | Some types of cancer release special substances (tumor markers) into the blood. These can be detected through blood tests. |
| MRI scan | This can take very clear pictures of the brain. In particular, MRIs that use a type of dye called contrast can show areas of cancer very clearly. |
| Biopsy | If other tests are not enough information, a small piece of tissue is taken from the tumor and examined under a microscope. This is often done during surgery to remove the tumor. |
What are the treatments for cancer that has spread to the brain?
The main goal of treatment here is to stop or control the growth of the brain tumor and reduce your symptoms. Treatment methods can be divided into three main categories.
1. Medications to control symptoms
First, your doctor will start you on medication to control your symptoms, such as headaches. For example, they may give you corticosteroids to reduce swelling in the brain (edema) and control headaches. They may give you anticonvulsants to control seizures.
2. Radiation therapy and surgery
These are the main methods used to remove or destroy the nuts.
- Stereotactic Radiosurgery / Gamma Knife® radiosurgery: This is a very advanced form of radiation therapy. Like a sniper, a powerful beam of radiation is aimed precisely at the tumor , avoiding damage to other parts of the brain. This treatment can often be completed in one day.
- Whole Brain Radiation Therapy: If you have multiple tumors in your brain, or if the cancer has spread to the membranes covering your brain (leptomeningeal disease), radiation therapy is given to your entire brain. This is done in about 10-15 sessions over two to three weeks.
- Brain surgery: In some cases, doctors decide to perform surgery to remove the tumor or tumors.
3. Specific drugs for cancer
In addition to surgery or radiation therapy, these drug treatments may also be recommended, depending on the type of your primary cancer.
- Chemotherapy: Most chemotherapy drugs cannot enter the brain because our brain is protected by a barrier called the blood-brain barrier. However, if the cancer has spread to the fluid surrounding the brain, chemotherapy can be injected directly into that fluid.
- Targeted therapy: These drugs work by interfering with specific processes that cancer cells use to divide and grow. This approach has been found to be effective for some types of lung and breast cancer that have spread to the brain.
- Immunotherapy: These drugs help your body's own immune system find and destroy cancer cells. This treatment is used for some types of lung cancer and melanoma that have spread to the brain.
What can you expect in a situation like this?
When cancer spreads to the brain, many people think that everything is over. But that's not the case. In some cases, the condition can be completely cured . Although it can't be cured completely, advanced treatments now available can help you live longer and with a better quality of life .
In the past, the average survival time for this type of cancer was thought to be less than six months. But with new treatments, many people now live much longer and with their symptoms well controlled. In fact, many people who have cancer that has spread to the brain do not die from the brain tumor itself.
Remember, only your treating doctor can give you the most accurate information about your condition and the best prognosis. Your condition will depend on many factors, including the type of primary cancer you have, how many brain tumors you have, and how you respond to treatment.
When should I see the doctor? What time should I go to the ETU?
If you develop any new symptoms or if an existing symptom gets worse , whether related to your existing cancer or a tumor that has spread to your brain, tell your doctor right away. It is important for your doctor to be aware of these changes.
There are also times when you need to go to the Emergency Department (ETU). A brain tumor is at high risk of sudden neurological problems such as seizures and loss of limbs. Also, if you suddenly develop symptoms of a stroke, you should go to the ETU immediately. These symptoms include:
- Sudden loss of balance while walking
- Changes in vision
- Story twist
- Weakness on one side of the body
What questions should you ask your doctor?
When you're living with cancer, it's normal to have a lot of questions on your mind when you find out it's spread to your brain. Don't be afraid or hesitant to ask your doctor these questions. They will help you understand the situation.
- How will this brain cancer affect my life?
- What treatment do you recommend for me?
- What are the side effects of those treatments?
- If cancer has spread to my brain, does that mean it could spread to other parts of my body?
- Are there any other organizations or services I can get help from? (e.g. palliative care)
- What can you say about the future based on my situation?
Finding out that cancer has spread to the brain can feel like falling into a dark tunnel. But remember, you are not alone. You have a medical team and your loved ones to support you. Don't be afraid to talk to your doctors. Ask openly about what to expect from treatment and the side effects. Then you can make the best decisions for yourself.
Take-Home Message
- `Brain metastases` is the spread of cancer to the brain that started elsewhere in the body (such as the lungs, breast).
- If you experience symptoms such as an unusual severe headache, weakness on one side of the body, difficulty speaking, or seizures, notify your doctor immediately.
- There are now many highly effective, advanced treatments (such as radiation therapy, targeted therapy) to control this condition and improve your quality of life.
- Talk openly and honestly with your doctor about your treatment options, their side effects, and what to expect. Don't be afraid to ask questions.
- You are not alone in this battle. Get support from your medical team, family, and friends.
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