What is the most effective metastatic brain cancer treatment? It depends. Many factors will determine which approach is most appropriate for you and your condition. By learning about the different treatment options available, you will gain a better understanding of why your doctor may have recommended one method over another.
Patient Factors Are Important
Metastatic brain cancer treatment is highly individual. Your specific brain tumor spread from another site of cancer in your body, rather than growing from the brain cells themselves. Different people have different primary cancers, which means your metastatic brain tumor might not be made from the same type of tissue found in someone else’s tumor. Equally variable is the size and location of your metastatic brain cancer.
Similarly, you are a unique individual with unique circumstances. You may have other health conditions that your doctor will take into consideration when developing your treatment plan, including your age, medications and overall health history.
Known vs. Unknown Diagnosis
As you know, your metastatic brain cancer originated elsewhere in the body. For your doctor to make a treatment recommendation, he or she must know the original location and what type of tissue makes up your brain tumor.
For some patients, the metastatic brain tumor is discovered first; this means the doctor does not immediately know the source of the cancer and cannot make a diagnosis without further testing on the rest of the body.
When a new mass is found in the brain first, imaging is done on the rest of the body (usually a CT scan of the chest, abdomen and pelvis). If a suspicious mass is found in these areas, a biopsy of these lesions is usually performed to make the diagnosis. If this biopsy tests positive for cancer, it is overwhelmingly likely that the brain lesion is a metastatic tumor. If nothing shows on the CT scan, then the biopsy/resection must be performed in the brain for confirmation.
Different Treatment Options
There are four approaches for metastatic brain cancer treatment: chemotherapy, radiation, open surgery and Gamma Knife radiosurgery. Based on your individual condition, one method may be more appropriate than another and your doctor may even recommend combining approaches. Remember, each patient is different and so is each treatment plan.
Chemotherapy
Chemotherapy uses medications to eliminate cancer cells from the body. However, this method tends to be less effective in the treatment of brain cancer because of the body’s natural defense system, known as the blood-brain barrier. The blood-brain barrier prevents substances from crossing out of the bloodstream and into the brain, which serves an essential protective function but also prevents potentially therapeutic medications from entering the brain.
Traditional Radiation Therapy
Traditional or whole-brain radiation therapy treats the brain with multiple low doses of radiation to damage and eliminate tumor cells. However, because the delivery of the radiation is to both healthy and cancerous cells, there can be unpleasant side effects following treatment. Despite the negative effects, radiation therapy has been standard of care for treating brain cancer due to its effectiveness.
Radiation therapy (either traditional or Gamma Knife radiosurgery) is often used in combination with surgery. Even though a surgeon often removes what appears to be all of the tumor, any cells remaining have the potential to regrow. Regrowth will require retreatment. By following surgery with radiation therapy, there is less of a chance of any malignant cells remaining after treatment.
Open Surgery
For some patients, a brain tumor doctor may recommend a surgical approach to metastatic brain cancer treatment. Sometimes a tumor is too large for radiation therapy alone, so the surgeon will remove as much as he or she can before following up with radiation. Open surgery is also used for obtaining a biopsy sample.
However, open surgery is typically only an option if the tumor is easily accessible and the surgery itself would not pose a significant risk. Your surgeon will make the decision whether you are a good candidate for surgery, based on tumor location and size, as well as your overall health.
Gamma Knife Radiosurgery
Gamma Knife radiosurgery is not actually a surgery, but rather another form of radiation therapy. Unlike traditional radiation therapy, Gamma Knife radiosurgery uses a focused beam to target only the cancer cells, sparing the healthy surrounding tissue. The result is an effective treatment that generally yields less unpleasant side effects.
Your surgeon may recommend Gamma Knife radiosurgery if:
- Your diagnosis is known and understood; it doesn’t require a surgical biopsy
- Your tumor is not amenable to surgery or you are not a good surgical candidate
- Your tumor is small and easily targeted
Finding the Right Doctor
It can’t be stressed enough that your cancer is as individual as you are and it is of vital importance that you find a doctor who understands and respects that fact. Unfortunately, there is a tendency for a doctor to recommend treatment that he or she specializes in, such as an oncologist recommending radiation therapy only, or a surgeon recommending surgery only.
Try to find a practice that emphasizes putting patients’ needs first, taking an unbiased approach when recommending a treatment path. Some patients need radiation first. Some would benefit from surgery first. In the Tristate area, Neurosurgeons of New Jersey is one such practice that takes a patient-centric approach to treatment, developing treatment plans with the individual in mind.
Remember that there is no “one size fits all” approach to metastatic brain cancer treatment. The type and location of your tumor plays a role, along with your overall health. To reiterate: what is the best treatment for metastatic brain cancer? The best treatment is one developed by an unbiased, experienced doctor with your best interests at heart, who can guide you down the treatment path appropriate for you.
