About 10%-30% of cancer patients develop brain metastases (also known as secondary or metastatic brain tumors), a serious and often life-threatening condition. The tumors are formed when cancer cells from the primary site spread to the brain. The majority of brain metastases are due to melanoma but any cancer can spread to the brain. Metastatic brain tumors are much more common than primary brain tumors.
Metastases are a common complication of melanoma that can be difficult to treat. Until recently, the prognosis for melanoma brain metastases was poor but improved radiation and systemic therapies have increased survival.
A person with a metastatic brain tumor may not have any symptoms, but they can also experience problems like headaches, memory loss, balance or coordination issues and changes in vision and hearing. The type of symptoms will depend on the area of the brain affected by the tumors and the function that is disrupted. The hippocampus is involved in memory and learning, the cerebellum controls movement and balance, and the temporal lobe is responsible for emotions and language.
Cancer that has spread to the brain is diagnosed by a healthcare provider through a medical history, physical exam and diagnostic tests. Magnetic resonance imaging (MRI) or computerized tomography (CT) scans will be ordered to examine the head for abnormalities and to identify a suspected tumor. A dye may be injected into your vein during the MRI test to help identify and measure the tumor.
In order to confirm a diagnosis, your healthcare provider will perform a biopsy of the lesion. During this procedure, they will remove a small piece of the tumor to study it under a microscope. This is typically done in conjunction with surgery.
Once they have a confirmed diagnosis, the healthcare team will begin treatment for brain metastases. This will likely include a combination of medications, targeted therapy and surgery. The most common drug used to treat metastases in the brain is thalidomide, which works by inhibiting cell division. Targeted therapy uses drugs that block the activity of specific enzymes or receptors on cancer cells. These drugs can be used alone or in combination with chemotherapy to treat a brain metastasis.
The Brain Metastases Program at Dana-Farber is one of the most comprehensive programs in the country for treating cancer that has spread to the brain. Our experts offer state-of-the-art treatments including surgery, radiation therapy and chemotherapy, along with an extensive clinical trial program. We are dedicated to helping people with any type of metastatic brain disease live longer and more fulfilling lives. We are continuing to explore how to improve the outcomes of people with brain metastases, especially from melanoma. Increasing our understanding of the molecular characteristics of these tumors and how they relate to the primary cancer is vital in order to identify new treatment strategies. We also need to continue to make progress in developing more effective radiotherapies that can cross the blood-brain barrier and deliver therapy to these very difficult-to-treat tumors.