What is a secondary brain tumour?
Secondary brain tumours are tumours that have spread to the brain from a primary tumour in another part of the body. They are also called metastases.
Primary tumours that may spread to the brain include lung, breast, melanoma and bowel cancers.
When might a secondary brain tumour be suspected?
As with all brain tumours, secondary tumours may present with:
- new seizures or fits
- worsening neurological symptoms such as limb weakness, speech problems or visual disturbance
- symptoms from raised intracranial pressure such as severe headache
- an incidental finding on a brain scan done for another reason
How is a secondary brain tumour treated?
Assessment of secondary brain tumours will involve close liaison between your treating oncologist for the primary tumour and your neurosurgeon. Your case will be discussed at the regional Neuro-oncology MDT meeting at Salford Royal.
Brain metastases are managed by a multi-disciplinary team (MDT) comprising your treating primary tumour oncologist, neurosurgeons, neuro-oncologists, radiologists, pathologist and specialist nurses.
Treatments for brain metastases include surgery (craniotomy), stereotactic radiosurgery (SRS) or radiotherapy.
Which treatment is appropriate for you depends on a number of individual patient factors such as your general well-being, level of control of your primary tumour as well as the number, size and location of any secondary brain tumours.
Many patients with brain metastases are not considered potential candidates for neurosurgery or stereotactic radiosurgery and therefore may not meet a neurosurgeon or neuro-oncologist but will be managed by their primary treating oncologist.
For those considered potential candidates for treatment, a combination of treatments may be used. Your individual case and treatment options will be discussed in detail with you by both your oncologist and your neurosurgeon.
Surgery for a secondary brain tumour
Surgery to remove a secondary brain tumour is called a craniotomy and is performed under general anaesthetic. Your surgeon will use the latest image-guidance technology and will aim to remove the tumour completely in an operation lasting 2-3 hours.
The risks of surgery for a secondary brain tumour will be discussed with you in detail on an individual basis. As a general rule there is a small risk of infection, bleeding, fluid leak or seizures. The specific risks of neurological problems such as stroke vary from case to case but a neurological complication is unlikely. The risk to life is less than 1%.
What happens after surgery?
After surgery patients receive pain relief for headache and are mobilised within 24-48 hours. Most patients are able to go home on day 3 or 4. You will have sutures or staples in the wound, which will be removed by your local district nurse service.
You will be called back for an office appointment to discuss the pathology results with your surgeon after the brain tumour MDT have reviewed your case. This will be 1-2 weeks after surgery.
After the post-operative check, you will be seen in clinic by your oncologist treating the primary tumour and post-operative radiotherapy may be recommended.