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Secondary cancer in the brain

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This page tells you about cancer that has spread to the brain from another part of the body. This is called a secondary brain tumour. There is information about

 

A quick guide to what’s on this page

Where a cancer starts is called the primary cancer. If some cells break away from the primary cancer and move to another part of the body they can form another tumour – a secondary cancer. Cancer that has spread into the brain from another part of the body is called a secondary brain tumour.

Symptoms of secondary brain tumours include headaches, feeling sick, weakness of a part of the body, fits (seizures), and personality or mood changes. The exact symptoms depend on where the tumours are in your brain and what that part of the brain does.

Tests for secondary brain tumours include a neurological examination. This tests your muscle strength and reaction times. Your doctor will also check your eyes for any changes. You may have a CT scan or an MRI scan of your brain.

The aim of treatment
is usually to control the brain tumour and any symptoms, and to prevent problems developing. This is called palliative treatment. Deciding about treatment can be difficult when you have an advanced cancer. You need to understand what treatment can do for you. You may also want to think about your quality of life during treatment.

Treatment may include

Coping with a secondary brain tumour can be difficult. Finding out you have secondary cancer is likely to bring up many feelings. You may be frightened, angry, shocked or numb. Support to help you cope is available at the hospital, from your GP and specialist nurses, and from support groups or online forums.

Research is going on all the time into improving treatments for secondary brain tumours and helping people to cope with symptoms. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

 

Secondary brain tumours

Where a cancer starts is called the primary cancer. If some cells break away from the primary cancer, they can move through the bloodstream or lymph system to another part of the body, where they can form a new tumour. This is called a secondary cancer. Secondary cancers are also called metastases (pronounced met-ass-ta-sees).

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The secondary cancer is made of the same type of cells as the primary cancer. So, for example, if your cancer started in your lung and has spread to your brain, lung cells first became cancerous, then spread from the lung tumour and formed another tumour in your brain. This is different from having a cancer that first started in the brain (a primary brain tumour). This is important because the type of primary cancer tells your doctor which type of treatment you need.

This page has information about secondary brain tumours, treatment and coping, including where you can get help and support.

 

Having secondary cancer

Finding out that your cancer has spread is likely to bring up many different feelings. You may be frightened, angry, shocked or numb or all of these. Most people have already had treatment for a primary cancer and it can feel very unfair to have to cope with cancer a second time. Some people have a secondary cancer when they are first diagnosed.

Finding out about your cancer and your treatment options can help you to feel more in control and better able to cope. Try to give yourself time. It is usually easier to deal with one issue at a time rather than trying to sort everything out at once.

You will need to get information from your own specialist to understand what the diagnosis means for you. It depends on where the cancer first started and whether it has spread anywhere else. Your specialist can also tell you about treatment and how it may help.

 

Which cancers spread to the brain

Any cancer can spread to the brain. But the most common cancers to do so are

  • Lung cancer
  • Breast cancer
  • Kidney cancer
  • Melanoma skin cancer
  • Bowel cancer (colorectal cancer)
 

Symptoms of secondary brain tumours

Sometimes secondary cancers in the brain are picked up before they cause symptoms, during tests to diagnose your primary cancer. Occasionally the first symptoms people have are from the secondary cancer.

Symptoms can include

  • Headaches
  • Feeling sick
  • Weakness of a part of the body
  • Fits (seizures)
  • Personality changes or mood changes
  • Eyesight changes
  • Confusion

The exact symptoms will depend on where the secondary tumours are in your brain. The tumours can cause pressure on the surrounding brain tissue and the symptoms will depend on what this part of the brain does.

Remember that these symptoms can be caused by other conditions. They don't necessarily mean that you have cancer that has spread to the brain. But if you have any of these symptoms, tell your doctors so that they can check them out.

 

Tests

Your doctor will examine you. This will include testing your nervous system (a neurological examination). The doctor will test your muscle strength and reaction times. They will also look into your eyes to see if there are any changes.

You may have a CT scan or an MRI scan of your brain. Or you may have both of these tests.

Your doctor can only be certain that your brain tumour is a secondary from another cancer by taking a biopsy and looking at the cells under a microscope. But having a biopsy of a brain tumour is a major medical procedure. Taking your medical history into account, it will usually be clear from looking at brain scans whether you have a secondary cancer. So you may not need to have a biopsy. If there is any uncertainty, your doctor may ask for opinions from doctors who specialise in treating brain tumours.

 

Treatment

The aim of treatment is usually to control the cancer and symptoms. It can also help to prevent problems from developing.

Deciding about treatment

Deciding about treatment can be difficult when you have advanced cancer. You need to understand what treatment can do for you. You may also want to think about your quality of life while you are having treatment. All treatment will have some side effects. You also need to think about other factors such as travelling to and from hospital. If you start treatment, you can stop whenever you want to if you are finding it too much to cope with.

Your doctor will be able to talk this through with you and you can ask questions. You may find it helpful to talk things over with a close relative or friend. Or there may be a specialist nurse or counsellor at the hospital you can talk to.

Your treatment will depend on a number of factors including

  • Your type of primary cancer
  • The treatment you have already had
  • The size and number of tumours in your brain
  • Whether your cancer has spread to other parts of the body
  • Your general health

Some hospitals now have specialist clinics for people with secondary brain tumours. You can ask your specialist if this is available at your hospital.

 

Types of treatment

The main treatments for cancer that has spread to the brain include the following.

Radiotherapy

Radiotherapy uses high energy waves similar to X-rays to kill cancer cells. It is the most common treatment for secondary brain tumours. The amount of radiotherapy you have will depend on the size of the area of your brain affected by cancer. The specialist may suggest treating your whole brain if there is a risk that other secondary tumours could develop in the future.

For whole brain radiotherapy, or for larger areas, you will usually have a course of external radiotherapy over 1 or 2 weeks. The picture shows a patient having external beam radiotherapy.

A photo of a linear accelerator, which gives radiotherapy

Your doctor may recommend targeted radiotherapy called stereotactic treatment, if you have only 1 or 2 small secondary brain tumours.

Steroids

Steroids occur naturally in the body and help to control many body functions. They are also made artificially and used as medicines. They are powerful anti inflammatory drugs. An anti inflammatory is a drug that helps to stop swelling.

When your secondary brain tumour is first diagnosed, you are most likely to have steroids to reduce swelling. After treatment, your specialist will slowly reduce your steroid dose. Steroids can also help to keep symptoms under control.

Find out about steroids for brain tumours.

Surgery

It is sometimes possible to remove secondary brain tumours with surgery. This is most likely if you have a single secondary brain tumour and there are no other tumours elsewhere in your body. Secondary cancers are often too widely spread within the brain for surgery to be possible.

If it is possible to remove your tumour, the information about brain tumour surgery will be helpful. The procedure for removing a secondary tumour is much the same as for removing a primary brain tumour.

Your specialist may suggest that you have radiotherapy after your operation. There may be cancer cells left in your brain that could grow into new tumours. The aim of the radiotherapy is to try to kill off these cells and stop any other secondary cancers from starting to grow.

Chemotherapy

Chemotherapy uses cell killing drugs to kill cancer cells. Depending on the type of primary cancer you have had, your specialist may suggest chemotherapy for a secondary brain tumour. For chemotherapy to be the best treatment, it will have to be a type of primary cancer that responds well to chemotherapy.

You can find detailed information about chemotherapy. There will also be information in the chemotherapy sections for the type of cancer you have.

Hormone therapy

Hormones can make some cancer cells divide and grow. So drugs that block the action of hormones, or change the levels in the body, can treat some secondary brain cancers.  Hormone therapies can stop or slow down the development of the cancer cells and can reduce symptoms for some people. 

You can find detailed information in the hormone therapy section. There will also be information in the hormone therapy sections for the type of cancer you have.

Symptom control

You may also have general symptoms including tiredness, pain, and loss of appetite. The coping physically section has information about these common symptoms and how to cope with them.

If you have fits (seizures) you will also take anti epileptic medicines to help prevent them.

 

Coping with secondary cancer

There is no set way of dealing with a secondary brain tumour. Support is available at the hospital and from cancer support groups. Getting the support you need can help you to cope. Your hospital or cancer organisations can offer emotional support or practical help, such as dealing with money matters.

It is important that you feel as well as you possibly can. Ask your specialist, GP or hospital nurse about referral to a symptom control nurse (sometimes called palliative care nurses or home care nurses). These are specialist nurses who can work with you and your doctor to help control your cancer symptoms and improve your physical well being.

Your doctor may have told you that treatment is no longer working or is not possible. This can be a shock. It is likely that you will have all sorts of questions that are difficult to answer and also difficult to ask.

Common questions include

  • How long do I have to live?
  • How will I die?
  • Will I have pain?
  • What will happen to me?

It may help to write your questions down before you talk to your doctor or nurse. Or you can contact the Cancer Research UK information nurses to talk your questions and worries through with them. You can call on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.

It is common in any family for some people to want to ask difficult questions while others don't. It can help to respect this and allow people time to talk if they want to. You may need to give your doctor permission to talk to your next of kin or other family members alone. Or if you are a relative you may need to give the person with cancer the space to talk to the doctor on their own. 

How long people with advanced cancer live varies. Some people can live for a number of years while others may only live for a couple of months. Your doctor may be able to give you some idea about your outlook. But this is always difficult to predict and will depend on how well your treatment works.

Our section about dying with cancer has information about coping with the news that a cancer cannot be cured. And you can also find out there about the help and support that should be available to you and your family.

 

Research into secondary brain tumours

Research is going on all the time into improving treatments for secondary brain tumours and helping people to cope with symptoms. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

You can find out about clinical trials in the UK.

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Updated: 13 May 2015