Brain metastases is a term used for describing the spread of cancer cells (metastasizing) from elsewhere in the body (the primary site of origin) to the brain. Brain metastases is also known as secondary brain tumors. This happens because the cancer cells break up and separate from the primary tumor and travel to the brain, which is usually through the bloodstream.[1] Brain metastases is five times more common than primary brain tumors.[2] Brain metastases can progress very rapidly, which may at times crowd the surrounding brain tissue, destroying it. A person may have a single or multiple metastatic tumors in different parts of the brain. 
Is There A Surgery For Brain Metastases?
A person with brain metastases usually has the following options for treatment- medications, radiotherapy, chemotherapy, immunotherapy, surgery, radioactive surgery etc. These may be used singularly or in combination with each other.[3]
Surgery can be an option that provides a quick relief from the pressure that the growing tumor is exerting upon the surrounding tissue in the brain. This is called as ‘mass effect’. If the mass effect is the reason for the severe symptoms of the brain metastases patient, then surgery can provide relief within hours after.[4] The surgery focuses mainly on debulking, by minimizing the amount of the space that the tumor is taking up inside the skull. It focuses on the removal of as much tumor as possible, while keeping the person’s neurological function unharmed. On general terms, a brain metastases surgery is recommended in the following conditions-
- If it is found that the neurological dysfunction is due to the location of the brain metastases tumor
- If the primary cancer of the patient is treatable and is presently under control
- If the person has tumors that can be safely removed, or a few tumors that are located near to each other, or they are only one or two in number[5]
The surgery most commonly used to remove the metastatic brain tumor is craniotomy. There are a variety of approaches by which craniotomy can be performed. Keyhole craniotomy can be one of them. The surgeon may also decide upon a microsurgery with the use of newer tools; like the image-guided surgery, minimally invasive endoscopy etc. The surgeon will decide on the surgery procedure keeping in mind the best outcome and improvement of the brain metastases prognosis.[6] Whether to perform a surgery or not, will entirely depend upon the condition of the person, the extent of the spread and the location of the tumor. Surgery cannot be performed on each and every person having brain metastases. Some may benefit from the surgery, while others may not. This varies from person to person. An individually tailored treatment plan is what is needed to achieve best outcome. A surgeon is the best person to judge this and provide you with a treatment plan suitable for you. Brain metastases can be treatable and can be controlled well with the help of a diagnosis that is made early and an efficient treatment that is started promptly. The treatment will reduce the symptoms and slow down the progression of the disease. It is therefore necessary to consult the oncologist at the earliest and report any signs or symptoms that you may encounter. Brain metastases treatment usually varies from person to person and is therefore tailored according to the needs of the patient. It largely depends upon the location, size and the number of tumors, the stage of the diagnosis of the condition and the extent of the spread of the disease, along with the age and general health of the person. The treatment also depends on the type of the primary cancer that the patient has and how is he responding to the treatment. The treatment also depends upon the signs and symptoms of the patient.
- https://www.mayoclinic.org/diseases-conditions/brain-metastases/symptoms-causes/syc-20350136#:~:text=Brain%20metastases%20occur%20when%20cancer,many%20tumors%20in%20the%20brain.
- https://www.sciencedirect.com/topics/nursing-and-health-professions/brain-metastasis
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087313/
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/metastatic-brain-tumors#:~:text=Metastatic%20brain%20tumors%20are%20five,different%20areas%20of%20the%20brain.
- https://www.uclahealth.org/neurosurgery/brain-metastases
- https://www.cancer.gov/publications/dictionaries/cancer-terms/def/craniotomy
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