Metastatic brain tumor - Treatment

Treatment depends on the size and type of the tumor, the initial site of the tumor, and the general health of the person. The goals of treatment may be relief of symptoms, improved functioning, or comfort.

Radiation to the whole brain is often used to treat tumors that have spread to the brain, especially if there is more than one tumor.

Surgery may be used for metastatic brain tumors when there is a single lesion and when there is no cancer elsewhere in the body. Some may be completely removed. Tumors that are deep or that infiltrate brain tissue may be debulked (removing much of the tumor's mass to reduce its size).

Surgery may reduce pressure and relieve symptoms in cases when the tumor cannot be removed.

Chemotherapy for brain metastases is not as helpful as surgery or radiation for many types of cancer.

Stereotactic radiosurgery is used at some hospitals. This is a form of radiation therapy that focuses high-powered x-rays on a small area of the brain.

Medications for some symptoms of a brain tumor may include the following:

Corticosteroids such as dexamethasone to reduce brain swelling

Osmotic diuretics such as urea or mannitol to reduce brain swelling

Anticonvulsants such as phenytoin or levetiracetam to reduce seizures

Pain medication

Antacids or antihistamines to control stress ulcers

When widespread cancer is discovered, treatment may focus primarily on relief of pain and other symptoms. This is called palliative or supportive care.

Comfort measures, safety measures, physical therapy, occupational therapy, and other interventions may improve the patient's quality of life. Legal advice may be helpful in forming advanced directives, such as power of attorney, in cases where continued physical or intellectual decline is likely.