Treating secondary brain tumours

Secondary brain tumours are cancers that have spread to the brain from somewhere else in the body. The commonest cancers that spread to the brain are

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

Other types of cancer can spread to the brain, but these are the most common. When a cancer spreads, first some cells break away from the primary cancer (in the lung or breast, for example). These cells then travel through the bloodstream and lodge somewhere else in the body, in this case, the brain. After some time, they can begin to grow into new tumours. These secondary tumours can cause

• Headaches
• Feeling sick
• Weakness of an arm or leg
• Fits (seizures)
• Personality or mood changes

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

Fits (seizures) can mean a number of different things. The most well known type of fit affects the whole body, with jerking of the arms and legs and unconsciousness during the fit and for a short time afterwards. These are sometimes called grand mal fits. There are other less severe types of fit - just affecting one arm or leg, for example. It is also possible to have petit mal fits. These are when you just forget where you are for a few moments or don't seem to make sense to the people around you. When you come to, you will not know what happened or remember anything you said.

Your doctor can only be certain that your brain tumour is secondary to another cancer by taking a biopsy and looking at the cells under a microscope. It is usually clear that the cells are cancerous breast or lung cells, for example, and were not originally brain cells. But having a biopsy of a brain tumour is a major medical procedure. And, taking your medical history into account, it will usually be clear from looking at brain scans what has happened, without doing a biopsy. Secondary brain tumours usually look quite different to primary brain tumours on a scan. They are usually rounder and less likely to grow into the surrounding brain tissue.

Secondary brain tumours can be treated with

• Radiotherapy
• Surgery
• Chemotherapy

Radiotherapy is the commonest 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 will develop in the future. For whole brain radiotherapy, or for larger areas, you will usually have conventional external beam radiotherapy over 1 or 2 weeks. There is more about radiotherapy in this section of the website.

Your doctor may recommend targeted radiotherapy (stereotactic radiotherapy) if you have only one or two small secondary brain tumours. Or they may recommend cyberknife treatment if you have several tumours. There is more about stereotactic treatment in this section of the website and a page about cyberknife treatment in our question and answer section.

It is sometimes possible to remove secondary brain tumours with surgery. This is most likely to be done if you have a single secondary brain tumour. Secondary cancers are often too widely spread within the brain for surgery to be possible.

If it is possible to remove your secondary brain tumours, the information about brain tumour surgery in this section of the website should be helpful. The procedure for removing a secondary tumour is much the same as that for removing a primary tumour.

Your specialist may suggest radiotherapy after you have had your secondary tumours removed. 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.

Depending on the type of cancer you have, 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
• Can be treated with drugs that cross the blood-brain barrier

There is detailed information in the main chemotherapy section. There will also be information in the specific cancer chemotherapy sections for the type of cancer you have.