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Treatment for Metastatic Brain Tumors

Metastatic tumors to the brain are often treatable and can be well controlled.

The treatment for a metastatic brain (or spine) tumor(s) at the Johns Hopkins Metastatic Brain Tumor Center is tailored to each patient. Based on the location of the tumor and the type of tumor, a neurosurgeon and other members of the Metastatic Brain Tumor Center Team will determine which treatment approach is best suited to remove the tumor. There are many factors that we consider in designing an optimum treatment plan. Some of the factors include:

  • The type of primary cancer the patient has, his/her response to treatment and current status
  • The location and number of metastatic tumors within the brain (or spine)
  • The patient’s general health and preferences regarding potential treatment options
  • The patient's current symptoms

At Johns Hopkins, we can provide all of the latest and greatest technology with renowned experts to treat patients with metastatic brain tumors, including surgery and radiation therapy.

Surgery provides the fastest route in relieving mass effect and swelling of the brain. Often times, patients can recover compromised function within hours of surgery if the symptoms are due to irritated brain. The goal of surgery is to debulk (remove entirely) as much of the tumor as possible while maintaining neurological function. In general, doctors recommend surgery when:

  • A patient has one or two metastatic brain tumors, or a few tumors that are close to each other that can be safely removed.
  • The patient’s primary cancer is treatable and under control.
  • There is a clear correlation of neurologic deficits with the tumor’s location.

Radiation therapy is often performed after surgery as an attempt to prevent tumors from growing near the site of the tumor removal and in other brain tissue. However, radiation can also reduce the irritating factors secreted by tumors to possibly improve neurologic function.

Some patients receive a form of radiation therapy called stereotactic radiosurgery instead of surgery. Other patients will receive whole-brain radiation. And finally, some will receive a combination of both. The decision of which type of radiation therapy will be used is complex and tailored to each individual patient.

Traditional chemotherapy is rarely administered to treat metastatic brain tumors because chemotherapy cannot get to the brain. A newer type of chemotherapy, called targeted therapy, is sometimes administered in conjunction with radiation therapy or surgery.

Metastatic spine tumors are usually treated with radiation therapy alone or with surgery.

Treatment options for metastatic brain tumors:


The most common type of surgery to remove metastatic brain tumors is called a craniotomy. At Johns Hopkins, the craniotomy is tailored to each patient based on the location, size, and suspected type of lesion. In addition, patients will receive the latest technology in surgery to ensure the best outcomes.


Because traditional chemotherapy cannot cross the blood brain barrier, a new treatment called targeted therapy is used as the primary type of chemotherapy for treating metastatic brain tumors. These drugs identify and attack cancer cells (the target) with minimal harm to normal cells. They prevent the growth and spread of cancer cells. Targeted therapy can be administered after surgery or in conjunction with radiation therapy to destroy remaining cancer cells.

Targeted therapies used to treat metastatic brain tumors include:

  • Herceptin® for breast cancer that has metastasized to the brain
  • Tarceva® (erlotinib) for the most common type of lung cancer (non-small cell lung cancer) that has metastasized to the brain.

Some targeted therapies are available at the Johns Hopkins Comprehensive Brain Tumor Center through clinical trials.

Learn more about brain tumor clinical trials.

Treatment options for metastatic spine tumors:

Radiation therapy, alone or in conjunction with surgery, may be used to treat metastatic spine tumors. At the Johns Hopkins Metastatic Brain Tumor Center, our surgeons work closely with radiologists to ensure each patient with a spine tumor receives the best care possible.

Pre- and Post-operative images of patient with metastatic brain tumor:
pre-op metastatic brain tumor
pre-op image of metastatic brain tumor
post-op metastatic brain tumor
post-op imaging
pre-op metastatic brain tumor
pre-op metastatic brain tumor
2 months post-op metastatic brain tumor
2 months post-op imaging

For more information, contact the Johns Hopkins Metastatic Brain Tumor Center at 410-955-6406.