Brain Metastases Causes, Symptoms, and Treatments

Brain metastases are tumors that originate in a different part of the body and then spread to the brain.

Although any cancer can spread to the brain, lung, colon, kidney, and melanoma cancers are the most likely to cause brain metastases.

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What Are Brain Metastases?

Brain metastases are cancers in the brain that started somewhere else in the body.

Cancer cells can travel through the blood or lymph system to the brain and the brain stem. Once in the brain, they start to replicate.

Metastatic brain cancers, also called secondary brain tumors, are the most common brain tumors. Primary tumors, or cancers that start in the brain, are far less common.

What causes brain metastases?

The longer cancer is in the body, the greater the chance it will spread to other parts, including the brain.

As people are living longer with cancer, due to treatment advances, brain metastases are becoming more common.

What are brain metastases risk factors?

Studies have found that cancer will spread to the brain in about 10 to 20% of people who have cancer.

Some cancers are much more likely to spread to the brain, such as:

Breast cancer.
Colon and rectal cancer.
Kidney cancer.
Lung cancer, which accounts for half of all brain metastases.
Skin cancer.

How to prevent brain metastases

Many studies are looking into ways to reduce the spread of cancers to the brain.

Potential options include radiation to the brain and treating the primary cancer with certain types of chemotherapy. Researchers base these treatments on the cancer's origin and type.

Brain Metastases Symptoms and Diagnosis

What are the symptoms of brain metastases?

Symptoms of cancers that spread to the brain include:

Changes in behavior or personality.
Confusion.
Headaches that get worse and more frequent over time, and don't respond well to treatment.
Loss of bladder control.
Nausea and throwing up.
Numbness in the limbs or face, often on only one side.
Poor coordination or clumsiness.
Speech problems.
Seizures.
Trouble swallowing.
Weakness in the legs or arms, perhaps only on one side of the body.

How do you diagnose brain metastases?

Your doctor will ask about your symptoms and health history.

They may ask you to do simple tasks to assess brain function by testing your:

Balance.
Eye movements.
Reflexes.

If the doctor suspects a brain tumor based on this assessment, they'll order the following tests.

MRI to diagnose brain cancer

This is the most common test to diagnose a brain metastasis.

MRIs are safe scans that don't use radiation. Instead, they use magnetic fields and radio waves to make an image of the brain.

When an MRI could interfere with a metal implant in the body, then the doctor will order a CT scan.

Other tests to diagnose brain metastases

Sometimes, doctors find a brain metastasis before they find the primary cancer.

In these cases, the doctor will order blood tests to look for markers, or proteins, in the blood. This can help them find out where the cancer started.

Your doctor may do a biopsy. They will take a tiny sample of the brain tumor and send it to the lab to find its origin and type.

The doctor may also order a chest CT scan or PET scan to look for cancer elsewhere in the body.

What Are the Treatment Options for Brain Metastases?

Brain metastasis care is often complex, requiring experience and innovation. At UPMC Hillman Cancer Center, we offer the most advanced diagnostic and treatment options, including:

Standard chemo kills fast-forming cancer cells.

Newer, targeted chemo drugs act on unique proteins that only cancer cells use, rather than targeting all fast-dividing cells. For this reason, targeted therapies often have fewer side effects, as they don't affect healthy cells as much.

Many chemo drugs that work for cancers elsewhere in the body don't work as well for tumors in the brain. This is because they don't get past the blood-brain barrier — the brain's complex system that stops many molecules from entering.

For brain metastases, doctors choose chemo drugs that can pass this barrier and effectively treat the cancer.

Medical therapies may or may not work, depending on the type of cancer. If it's not an option for your type of brain tumor, we will pursue other treatments.

Radiation involves high-energy beams to damage the DNA of the cancer cells, which limits their ability to divide.

Leading-edge treatments feature linear accelerator-based fractionated radiation therapy. We utilize various treatment planning technologies, including 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT). These advanced techniques allow for precise targeting of cancer cells while minimizing damage to surrounding healthy tissue.

Your doctor may use radiation on the whole brain or directly to the locations of one or more tumors. Whole-brain radiation has more side effects than radiation aimed at one or more tumors in the brain.

We also offer spine stereotactic body radiation therapy (SBRT), a specialized approach used to treat patients with oligometastatic and irradiated spinal metastases. This innovative therapeutic approach provides a viable treatment option in situations where none were available, offering hope to patients facing challenging circumstances.

Radiation can also damage normal cells and cause side effects like:

Hair loss.
Headaches.
Memory loss.

But fast-dividing cancer cells are much more sensitive to the damaging effects of radiation compared to normal cells.

Surgery is an option if you have a small number of brain tumors that doctors can access.

In some cases, doctors don't suggest surgery because it could damage too much healthy brain tissue.

This is a new option for treating metastatic brain cancers. These drugs help the immune system fight tumors.

For instance, doctors can inject lab-produced antibodies into the bloodstream to kill some types of cancer cells.

Immunotherapy drugs can work against certain brain metastases. but don't yet have an established role for treating primary brain tumors. It's hard for the immune system to recognize primary brain tumors as a target and for immune cells to traffic into it.

Doctors at UPMC are taking part in several clinical trials working to find ways to make immunotherapies more effective.

Laser interstitial thermal therapy to destroy brain tumors with pinpoint precision.

UPMC Hillman Cancer Center and other UPMC hospitals utilize this technology for patients with brain tumors and radiation necrosis worldwide.

LITT's main advantage is its minimally invasive nature, using a thin laser probe directly inserted into the target tissue. This allows for precise and localized treatment, reducing the risk of damage to surrounding healthy tissues.

LITT benefits brain tumors and lesions, offering an alternative to open surgery, reducing complications, shortening hospital stays, and aiding faster recovery. LITT uses real-time MRI guidance, allowing the neurosurgical team to adapt the treatment for the best results. Moreover, LITT results in reduced morbidity and enhanced patient quality of life by preserving neurological function and avoiding open craniotomy.

Along with drugs that act on the cancer cells, doctors also treat brain metastases symptoms with:

Drugs to reduce nausea.
Steroids to reduce swelling in the brain.

Brain Metastases Survival Rate

People with metastatic brain cancer live, on average, between 8 to 16 months. The survival depends on how early doctors find that the cancer has spread to the brain, and from where in the body.

For instance, people with breast cancer that spreads to the brain live longer, on average, than those with other brain metastases.

People whose tumors harbor certain mutations that doctors can target with precision drugs can often do quite well for several years.

Learn more about brain and nervous system cancer treatments at UPMC Hillman.

Why Choose UPMC Hillman Cancer Center for Brain Metastases Care?

UPMC Hillman:

Brings together top doctors in all types of cancers. This allows us to treat brain metastases in a highly focused way, with the latest cancer treatment advances.
Has more than 70 cancer centers throughout four states – Pennsylvania, New York, Maryland, and Ohio.
Is one of only three National Cancer Institute-designated comprehensive cancer centers in Pennsylvania.
Our care navigator, social worker, and dietician help you cope with the new fears and stress of a cancer diagnosis. We also offer a program to help you manage cancer symptoms and treatment side effects in a holistic way.
Provides seamless, state-of-the-art cancer care between our flagship in Pittsburgh, Pa. to our network locations. This means you have access to our experts closer to where you live.
Takes a whole-person treatment approach. This means we treat more than just your brain cancer. We also provide emotional, nutritional, and social supports.