Brain metastases are considered as the incurable disease as various complexities are attached with the complete removal of the tumor. The treatment strategy is usually to improve the quality of life and increase life expectancy.[1]
Life Expectancy For Brain Metastases
Life expectancy in patients with brain metastases depends upon the variety of factors. It depends upon the stage at which the cancer is diagnosed. It also depends upon the type of primary cancer and its spread in other body parts. The life expectancy also depends upon the number of brain metastatic sites.
The complications related to brain metastases further depends upon the neurological damage due to tumor.[2] Although various treatments are available for the management of brain metastases but none of the treatment completely cure the disease due to various reasons. Chemotherapy is rarely effective due to the fact that most of the chemotherapeutic drugs unable to cross the blood brain barrier at required concentration. Surgery of brain tumor is highly complicated and requires precision. Also, the patient and relative fears with surgery due to significant risk involved. Even if the risk of brain surgery is taken, most of the times the tumor cannot be completely removed due to its inaccessibility.[3]
The radiotherapy which is generally accompanied by surgery also causes severe neurological complications. The radiotherapy may cause short term and long term side effects. The prognosis of brain metastases is poor, and the approach of the oncologist is to improve the quality of life. The quality of life is improved by managing the symptoms such as dementia, seizures and gastric disturbances.[4] In some studies it has also concluded that the radiotherapy reduces the quality of life. If the patient does not receive the treatment, the survival is for 1 month while with the treatment the survival varies between 6 moths to 13 months.[5]
Treatment For Brain Metastases
Various treatment options are available for the management of brain metastases. The treatment strategy depends upon the stage at which cancer is diagnosed as well as on the number of sites of metastasis. Further the treatment should also be different for rapidly spreading cancer and slow spreading cancer. Brain metastasis is generally considered as incurable disease and thus the treatment is done to increase the life of the patient and for improving the quality of life. Following are the various treatment options available to the oncologists for treating brain metastases:
Chemotherapy. Cancer cells are rapidly dividing cells. Chemotherapy drugs are the drugs used to kill the cancer cells. Chemotherapy is the mainstay treatment in the management of the cancer however things are different when it comes to treating brain tumor. Brain is surrounded by blood brain barrier which allows only specific ingredients to pass through it. Thus, in brain tumor, the chemotherapeutic drugs are not able to pass this barrier in required concentration. Chemotherapy is generally not used in brain metastases.[6]
Radiotherapy. Radiotherapy if the process of killing cancer cells with the help of radiations. Radiotherapy is generally used along with surgery. There are two types of radiotherapy. Whole grain radiotherapy is used when the cancer has spread to various sites in the brain. The whole brain therapy does not differentiate the cancer cells and healthy cells and thus it has various long term and short term neurological effects. [7] Another type of radiotherapy is stereotactic therapy which is used when the cancer is at single site. As this technique differentiates between the cancer cells and healthy cells, it has fewer side effects as compared to whole brain radiotherapy.[8]
Surgery. Surgery is considered as the most effective method for brain metastases, but it also has certain limitations. The brain surgery has high risk and complexity. Further, even after the brain surgery, the tumor may not be completely removed either due to non-reachability to the site or due to its attachment to vital nerve.
Conclusion
Without any treatment, the mean life expectancy is 1 month, and the symptoms are managed through steroidal drugs. The mean life expectancy after the disease is diagnosed is approximately 6 months to 13 months depending upon the stage of cancer.
- https://www.mayoclinic.org/diseases-conditions/brain-metastases/symptoms-causes/syc-20350136#:~:text=Brain%20metastases%20occur%20when%20cancer,many%20tumors%20in%20the%20brain.
- https://education.eviq.org.au/rapid-learning/brain-metastases-and-associated-complications
- https://emedicine.medscape.com/article/1157902-treatment
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656565/
- https://www.cancer.org/content/dam/CRC/PDF/Public/6151.00.pdf
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/metastatic-brain-tumors
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457607/
- https://www.cancer.gov/publications/dictionaries/cancer-terms/def/stereotactic-radiation-therapy
Also Read:
