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Brain Metastasis

What is brain metastasis?

Brain metastasis is cancer that has spread within your brain or spreads from your body to your brain. Some examples are lung, breast, skin, and colon cancer. One or more tumors form in your brain.

What are the signs and symptoms of brain metastasis?

Signs and symptoms depend on the size, number, and location of the tumors. Some people have no symptoms. The following are the most common signs and symptoms of brain metastasis:

  • Headaches that get worse or keep coming back

  • Seizures

  • Problems walking, speaking, seeing, or thinking

  • Changes in behavior or personality

  • Nausea and vomiting

  • Weakness or tiredness

  • Swelling in your body

How is brain metastasis diagnosed?

Signs and symptoms of brain metastasis can look like other health conditions, such as a stroke. Your caregiver will ask how long you have had signs and symptoms. Tell him if you are being treated for cancer or if you have had cancer before.

  • Neurologic exam: Other names for this test include neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how your brain is working. Caregivers will check how your pupils react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

  • CT or MRI scan: These scans help caregivers learn the size and location of tumors. You may be given a dye called contrast before the test. Contrast helps tumors show up better on the scan. Tell the caregiver if you are allergic to iodine or seafood. You may also be allergic to the dye. Do not enter the MRI room with any metal. Metal can cause serious injury. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Tell caregivers if you cannot lie still or you feel nervous in closed spaces.

  • PET scan: A PET scan uses a substance called tracer to help show injuries or diseases inside the brain, such as tumors. A PET scan is done in a closed space. Tell caregivers if you cannot lie still or you feel nervous in closed spaces.

How is brain metastasis treated?

Your caregivers will suggest medicines and treatments based on your symptoms and general health. The size, number, and location of the tumors also affect your treatment plan. You may choose treatments that help you maintain your normal activities for as long as possible. Other choices provide palliative (comfort) care to ease your symptoms. Ask your caregiver for more information about palliative care.

  • Medicines:

    • Steroids: This medicine helps reduce swelling in the head and body.

    • Anticonvulsant medicine: This medicine can help decrease or stop seizures.

    • Blood thinners: Blood thinning medicine helps prevent blood clots from forming in your veins. You may need regular blood tests while you are taking this medicine. Blood thinners make it easier for you to bruise and bleed. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you take.

  • Radiation and surgery: Your treatments may continue if you are receiving chemotherapy, radiation, or other treatment for cancer elsewhere in your body. You may also have 1 or more of the following:

    • Whole brain radiation therapy: Whole brain radiation therapy (WBRT) is used to help treat brain tumors and to prevent new tumors from forming. WBRT can help you maintain your normal daily activities during treatment.

    • Surgery: Surgery is often used to remove single tumors. During surgery such as craniotomy, caregivers open your skull and remove the tumor. Surgery can quickly relieve vision loss or other problems if a tumor is affecting an area of the brain that controls vision, hearing, or movement.

    • Radiosurgery: Radiosurgery is often used if you have more than one tumor or if you cannot have open surgery, such as craniotomy. Radiation beams target cancer cells without harming healthy brain tissue.

How do I manage the symptoms and effects of brain metastasis?

  • Avoid infections: Cancer treatments make it easier to get infections. Wash your hands often with soap and water. Carry germ-killing gel with you in case you do not have access to soap and water. Try to avoid people who have a cold or the flu.

  • Treat pain: Tell your caregiver if you are in pain. If you need pain medicine, learn how, when, and how often to take it. Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

  • Stay safe: Cancer treatments can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help. Ask your caregiver if it is safe for you to drive.

  • Seek support from caregivers: The disease can change the way you act, think, and feel. Your memory, concentration, and ability to learn may decline. You may act without thinking or become more emotional. These changes can be very upsetting for you and your family. Talk with your caregiver about these changes and about continuing care, treatments, and home services. Go to all follow-up appointments.

When should I follow up with caregivers?

Caregivers may suggest imaging tests, such MRI or PET scans, every 3 months. The imaging tests help check for new or returning tumors. Work with your caregivers to create a follow-up care plan that is right for you.

What are the risks of brain metastasis?

Side effects that occur with treatment for brain metastasis are similar to other cancer treatments. You may lose your hair when WBRT begins. Your skin may redden and feel dry and tender. Painful mouth sores can make it hard to eat. Other side effects include nausea and vomiting, headaches, and sleepiness. Over time, WBRT can cause swelling inside the brain. You may start to forget things, feel very tired, and have problems seeing and hearing. Surgery and radiosurgery can increase your risk of infection and bleeding inside the brain, which may be life-threatening. Cancer and its treatment also increase your risk for blood clots. A blood clot in your leg can break loose and travel to your lungs. This can be life-threatening.

Where can I find more information?

  • American Brain Tumor Association
    8550 West Bryn Mawr Avenue, Suite 550
    Chicago , IL 60631
    Phone: 1- 800 - 886-2282
    Web Address: http://www.abta.org

When should I contact my caregiver?

Contact your caregiver if:

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • New headaches develop or get worse.

  • You have new problems walking or moving one side of your body.

  • Body swelling develops or gets worse.

  • You have a seizure.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • You have chest pain or trouble breathing that is getting worse over time.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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