The treatment of brain metastases depends on factors such as the tumor of origin (for example, adenocarcinoma of the lung), the number and location of the lesions within the brain, and the extent of cancer in places other than the brain. Most patients are placed on steroids (Decadron) to relieve significant brain swelling that can cause severe symptoms. Many patients may also take an anti-seizure medicine, since seizures are a common complication.
The standard approach with brain metastases of any other origin is to decide whether the tumor can be removed. A head CT scan or a head MRI is helpful in determining if there is more than one tumor and to define the specific sites in the brain where the tumor or tumors are located. In patients with only a single brain tumor who are otherwise well, it may be possible to surgically remove the tumor and then treat with irradiation.
Patients with brain metastases from lymphoma, leukemia or small cell cancer are generally given radiation therapy to the entire brain, although these tumors may also be treated with systemic chemotherapy. In patients with multiple metastases or widespread disease, the prognosis is often gloomy and treatment is palliative (reducing the severity of symptoms).
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