What is brain metastasis?

Lung cancer is the one that most often generates a brain metastasis. They are followed by breast, some sarcomas or melanoma. Likewise, there are other types of cancer, such as colon cancer or prostate cancer in which it is very rare to spread to the brain. In most cases the metastasis is located in the cerebral hemispheres, while in 15% of the cases it is the cerebellum that is affected and in 5% the brainstem. It should also be noted the fact that in most cases more than one brain metastasis can be found.

Symptoms of brain metastasis

Although brain metastases are usually diagnosed after performing a CT scan, a PET or an MRI, the truth is that there are a number of symptoms that can induce the suspicion of their existence, the most frequent being the following:

  • Headaches that recur and intensify over time.
  • Numbness, tingling or loss of sensation in any part of the body, for example in the legs.
  • Dificulty to walk.
  • Speech disorders
  • Vision problems (double vision, rapid loss of visual acuity, etc.)
  • Disorders of reasoning ability.
  • Seizures
  • Mood swings, behavioral disturbances or personality disorders.
  • Nausea and vomiting
  • Feeling of fatigue or weakness.
  • Inflammation of the brain and increased intracranial pressure.

Treatment  of brain metastases
The treatment of brain metastases is generally palliative and is aimed at controlling symptoms and maintaining quality of life and the ability to develop daily activities. It should be borne in mind that a large part of the drugs used in chemotherapy for the treatment of primary tumors are not able to pass the blood brain barrier, so they do not act on brain metastasis.

For this reason, depending on the symptoms manifested by the patient, different pharmacological treatments will be applied: corticosteroids to reduce inflammation and intracranial pressure, anticonvulsants, anticoagulants to prevent thrombus formation, analgesics for headache, etc.

When this is the only metastasis that has generated the primary cancer and the symptoms are very severe, sometimes the possibility of opting for surgery to eliminate it is raised, since this can relieve the pressure of the tumor on areas of the brain that control important functions such as vision, speech, etc. But on many occasions, be it because of the extension of the metastasis or because of the difficulty of accessing it in a surgical intervention, a radiosurgery treatment can be applied, which allows reducing the radiation beam to selectively metastasize, preserving the Healthy areas of its action.

Normally this type of treatment is carried out by means of a device called Gamma-knife, which converges multiple beams of gamma radiation on the surface of the brain that must be necrosed to eliminate metastasis, which implies a very extensive radiological study and a very meticulous planning using a computer program.


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