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Brain Mets:

Brain metastases are the spread of cancer cells from one place in the body to the brain. It is the most common type of cancer in the brain of adults. It appears to be increasing in numbers because better treatments for earlier diagnosed cancers have resulted in more patients being alive for longer periods of time. This has resulted in an increased risk for this to happen. In recent years there have been important advances made not only in the diagnosis of brain metastases but also in their treatment.

Brain metastases will develop in between 10% and 30% of all adults who are diagnosed with cancer. In the United States, it is estimated that as many as 170,000 new cases of brain metastases will be diagnosed each year. This compares with the 16,500 cases of primary brain cancer (those that start in the cells of the brain). The number diagnosed may be increasing not only because of earlier diagnosis and better treatment, but also because of the increased use of magnetic resonance imaging (MRI). The MRI is a more sensitive type of test that is able to detect smaller collections of cancer cells in the brain than that of CT scans. Earlier diagnosis of both the primary cancer and metastases to the brain allows for earlier treatment that, in turn, allows for patients to live longer.

In adults, the cancers that are most often metastasize, or send cells to the brain, are:
1.	Lung cancer (about 50% of cases)
2.	Breast cancer (15-20% of cases)
3.	Cancer with an unknown site of origination (10-15% of cases)
4.	Melanoma (10% of cases)
5.	Colorectal cancer (5% of cases)

When tumors from the breast, colon or kidney spread to the brain, there is often only one metastatic site. With lung cancers and melanomas there are usually more than one site.

About 80% of all brain metastases are located in the cerebral hemispheres (the large right and left outer portions of the brain), 15% in the cerebellum (the posterior portion) and about 5% in the brain stem (the part that attaches the brain to the spinal cord).

PICTURE

The diagnosis of brain metastases is usually made because of signs or symptoms in the patient. These signs and symptoms can result from the tumor increasing in size and causing swelling in the nearby normal brain tissue and/or from hydrocephalus (the inability of the fluid that bathes the brain to circulate in a normal pattern).

Patients may present with seizures (10% to 20% of all) or have problems that are stroke-like such as weakness, paralysis, slurred speech, visual loss or decreased memory just to name a few.

About 20% to 30% of patients will have problems with blood clots. At the present time, most patients have treatment using anticoagulants (medicines that reduce the clotting of blood). This treatment is carried out with much caution because excessive bleeding can be a major complication in a patient with cancer.