Brain metastases: When cancer cells migrate from a primary tumor to the brain
World Brain Tumor Day, June 08, 2023
Metastases are metastases of tumors. When a tumor first develops in an organ, it is referred to as a primary tumor. Cancer cells can then migrate from this original tumor via blood or lymph channels, spread to other organs and form a metastasis there, for example in the brain. On the occasion of World Brain Tumor Day on 8 June 2023, we talk to senior physician Dr. med. Majid Esmaeilzadeh from the Neurooncology Center at MHH about what brain metastases are and how they develop.
What is the difference between a brain tumor and a brain metastasis?
Most brain tumors are called gliomas, which originate from the brain tissue itself. Metastases are metastases of tumors that first developed in another organ and formed a primary tumor there. Migrating tumor cells enter the brain via the bloodstream.
Do all cancers pose the same risk of developing metastases in the brain?
Statistically speaking, the risk is greatest for patients with lung cancer, breast cancer, renal cell carcinoma or malignant melanoma. In principle, however, almost any tumor can also spread to the brain. Therefore, brain metastases cannot be completely ruled out even in patients with other types of tumor.
Can anything be done to prevent it?
There are no specific measures that can be taken to prevent the development of metastases. It is always important that after a cancer diagnosis without metastases, the first cancer treatment, often surgery, chemotherapy or radiotherapy, is started as early as possible and that treatment is not discontinued. In general, a healthy lifestyle helps to reduce the risk of developing cancer.
How common are metastases in the brain?
In 20 to 30 percent of all cancer patients with systemic metastasis, metastases develop in the brain. The most common metastases are from bronchial carcinoma and breast carcinoma. Today, metastasis is the most common tumor in the brain.
Where do brain metastases come from?
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What can be signs of brain metastases?
Basically, the symptoms caused by brain metastases depend on their size and location. Many symptoms of brain metastases are relatively non-specific. The most common symptoms are headaches, neurological deficits such as paralysis and difficulty finding words or a so-called brain-organic psychosyndrome or an epileptic seizure. Dizziness, nausea and vomiting may also occur due to the accumulation of fluid around the metastasis.
How are brain metastases detected?
If a brain metastasis is suspected, various diagnostic procedures are available. Most patients undergo magnetic resonance imaging (MRI) or computer tomography (CT).
How are brain metastases treated?
Treatment depends on the location, number and size of the metastases. Several procedures are available for the treatment of brain metastases, which are discussed with the patient. These include surgical extirpation, i.e. the removal of the piece of tissue, radiosurgery, radiotherapy, chemotherapy and supportive measures such as psycho-oncology, speech therapy or physiotherapy.
...and what is the prognosis?
Brain metastases usually occur in the final stage of the metastatic process. The life expectancy of patients is therefore often limited. There are prognostic factors which, in addition to their significance for the survival prognosis, also play an important role in the treatment decision. These include the extent of metastasis outside the brain, the number of brain metastases, the time interval between the appearance of the primary tumor and the brain metastasis, the so-called Karnofsky Performance Score, an assessment tool for predicting survival in terminally ill patients, as well as age and histology.
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