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Metastatic Brain Tumor: 6 Things You Need to Know

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A metastatic brain tumor is caused when cancer from elsewhere in the body spreads to the brain and forms another tumor.

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Have you or has someone you love recently been diagnosed with a metastatic brain tumor? If so, you may feel overwhelmed juggling doctors’ appointments, managing symptoms and treatments, and facing the unknown.

Johns Hopkins neurosurgeon Michael Lim, M.D., of the Johns Hopkins Comprehensive Brain Tumor Center  is familiar with these concerns and answers some important questions.

Q. What is a metastatic brain tumor?

A. When cancer that began somewhere else in the body spreads to the brain and causes a lesion or brain tumor, it’s called a brain metastasis.

Q. How do you diagnose a metastatic brain tumor?

A. At the Johns Hopkins Comprehensive Brain Tumor Center, we have experience diagnosing and treating thousands of patients.

We first confirm a brain tumor through an MRI scan or other imaging scans. We recommend surgery in situations where the diagnosis is unclear or to ease symptoms. Soon after, you’ll meet with one or more doctors to discuss treatment options. The faster you start treatment, the better the chances of killing or controlling the disease.

Because brain metastases are different in each person, our treatment teams spend time determining what’s best for each patient before moving forward with a treatment.

Q. How do you treat a metastatic brain tumor?

A. The two main treatments for brain metastases are brain surgery and radiation.

Q. What happens during brain surgery or neurosurgery?

A. While brain surgery can sound daunting, medical advancements in the field have come a long way in the past 50 years. Many patients not only get back to their lives within weeks of surgery, but some live for many years with a good quality of life after surgery.

Today, doctors use advanced tools to map your brain before surgery to plan your surgery precisely. This imaging acts as a sort of GPS, helping guide your surgeons to perform a more accurate and safer procedure.

In addition, during the surgery, image-guided therapy — using images from a specialized MRI scan, for example — gives doctors real-time pictures of your brain. This gives surgeons even more insight into how your brain works, which often leads to better results.

Q. Does radiation therapy have side effects?

A. Every treatment comes with side effects. That’s why Johns Hopkins doctors have a risk-benefit conversation with every patient about every treatment. We weigh the potential benefits of a specific treatment option against the possible risks and side effects.

Because radiation therapy has been so successful in treating brain metastases — and because many patients are living so long after treatment — studies are now looking at how to manage the long-term effects of the treatment.

There are two main types of radiation therapy:

  • Whole-brain radiation targets the entire brain to hit any disease that hides from an MRI scan. It can cause hair loss, hearing loss, and memory and cognitive problems.
  • Stereotactic radiosurgery directs a high dose of radiation targeted to the specific shape of the tumor, sparing surrounding healthy tissue from unnecessary radiation exposure. Stereotactic radiosurgery could cause radiation necrosis (dead tissue).

Q. How do you know which brain tumor treatment is right?

A. An expert medical team will guide you in finding the best treatment or combination of treatments for your disease and circumstances. You must talk about your individual case with a knowledgeable doctor.

At Johns Hopkins, medical specialists work closely together and with you to determine your best way forward, considering:

  • The size, location and number of tumor(s)
  • The pathology (structure and function) of the tumor
  • Your overall health
  • Your personal preferences and lifestyle

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