Brain Metastases

What Are Metastases in the Head and How Do They Develop?

Tumors are changes in a tissue caused by alterations in individual cells' genetic material, which grow and divide excessively. In some cases, such cells no longer adhere to tissue boundaries and can grow into neighboring organs or tissue. If such cells enter the bloodstream or lymphatic system, they can be carried on, and some tumors form metastases in other parts of the body called metastases.

Tumors can spread into different tissues. Metastases form in the immediate near the original tumor and the nearby lymph nodes. If the tumor cells are washed away with blood or lymph fluid, metastases can also settle in the body's distant areas. For this to happen, the tumor cells must migrate out of the blood or lymph fluid and settle and multiply in the new tissue. Tumors spread into different tissues, different tumor types having their preferred regions.

Which Tumors Metastasize to the Brain?

Brain metastases mainly arise from breast cancer, lung cancer, renal cell carcinoma, and malignant melanoma. Brain metastases are the most common tumors in the brain.

Brain Metastasis Symptoms

Brain metastases can manifest through various symptoms, which also depend on the brain's area where the metastasis is located and its size. Symptoms can be:

• Headaches
• Seizures
• Change of Character
• Dizziness and nausea
• Visual disorders
• Visual acuity reduction
• Sensitivity disorders and loss of sensitivity in certain parts of the body
• Muscular weakness
• Tiredness

How Are Brain Metastases Diagnosed?

Brain metastases usually form solid tumors, clearly shown in computed tomography (CT) images. The brain is soft tissue and can be depicted even more precisely by magnetic resonance imaging (MRI). If the primary tumor is already known, further diagnostics are usually not necessary. In rare cases, cerebrospinal fluid may be taken from the spinal canal or biopsies from the metastasis to determine its origin.

Therapy Options

Various methods can be used in the therapy of brain metastases. The general treatment of tumors is based on three pillars: surgical removal, chemotherapy, and radiation. To decide on the treatment, it is essential to know from which tissue the metastases have developed. Depending on the cell type, tumors react more sensitively to radiation or chemotherapy. The number, size, and location of brain metastases are also significant. A single large metastasis close to the calotte of the skull can be easily removed by surgery. The surgeon must remove the entire metastasis with a small margin of healthy tissue while at the same time preserving the function of the brain. Many small scattered metastases almost exclude surgical removal. In this case, using radiosurgery to target the individual tumor sites is instead favored.

Life Expectancy and Chances of Recovery

The occurrence of a brain metastasis means that the primary tumor has already spread further, which is generally a bad prognostic sign for the course of the entire cancer disease. Promising possibilities to heal or control the brain's tumor foci are surgical removal by neurosurgeons and targeted radiation. The treatment of the primary tumor and possible other metastases determines the disease's course and the resulting life expectancy.

Which Doctors and Hospitals Are Specialized in Treating Brain Metastases?

Brain metastases are primarily treated by doctors who are specialists in the primary tumor. For example, gynecologists are responsible for brain metastases that are caused by breast cancer. For diagnosis, computed tomography and MRI of the central nervous system are taken and evaluated by neuroradiologists. To ensure the best possible individual therapy, patients are referred to an interdisciplinary tumor board. Additional physicians from radiotherapy, oncology, and neurosurgery consult with each other and work out a therapy plan together.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on the doctor’s experience.

We help you to find an expert for your disease. All listed doctors and clinics have been checked by us for their outstanding specialization in the field of brain metastases and are awaiting your inquiry or treatment request.

Sources:

Schlegel: Neurooncology. Thieme 2003, ISBN: 978-3-131-09062-1.

International Agency for Research on Cancer: WHO Classification of Tumours of the Central Nervous System. World Health Organization 2016, ISBN: 978-9-283-24492-9.