Brain metastases are the condition caused when the cancer cells from other organs spread to the brain and causing various neurological symptoms. The condition is said be almost incurable due to various reasons and the treatment is done to increases the life of patient and improving the quality of life.[1]
Why Reversal of Brain Metastases is Not Possible?
Brain metastases are caused due to the spread of cancer from other part of the body to brain. It is almost impossible to reverse the brain metastases due to the complexity of the situation.[2] As brain is the central controlling region of the body and is composed of nerves controlling the body, aggressive treatment may damage the brain. Thus, the primary goal of the surgeon or the oncologist in cases of brain metastases is to slow the growth of the tumor and prolong the life of the patient. The approach of the doctors is also to increase the quality of life of the patient. Therefore, other than providing the main treatment, the doctors also provide supportive treatment to the patient.[3]
Unfortunately, the reversal of brain metastases is highly unlikely due to various underlying features related to the brain as well as the location of tumor. For instance, the flow of nutrients and other chemicals to the brain is regulated by the blood brain barrier.[4] This makes difficult for the chemotherapeutic drugs to reach the tumor in an effective concentration. Thus, the highly reliable therapy for cancer, chemotherapy, fails to provide any significant benefit in these patients. Further, as the brain is highly sophisticated organ and itis not always possible to reach at the tumor in order to completely remove it. Thus, again, if any part of the tumor remains, it will develop in to large tumor.[5]
Radiotherapy is also used for the treatment of brain metastases, but it has some serious side effects especially in children. This includes dementia, nausea, dizziness, otitis media and mental retardation.[6] Historically, brain metastases was a disease with no management therapy; however, due to the aggressive therapy such as surgical resection, immunotherapy and stereotactic radiosurgery, the life of the patient gets prolonged and due to the supportive treatment, the patient lives quality life. But the disease cannot be reversed and the prognosis is poor.
Brain Metastases Causes
Brain metastases are caused when the cells of cancer escape the organ in which they have originated and reached the brain. In the brain they start growing abnormally causing brain tumor. This tumor creates pressure inside the brain and causes headache. Further, the pressure created on the brain tissues leads to various symptoms such as nausea, vomiting, vision changes, difficulty in swallowing and speech problems. Cancers that generally metastasize to brain includes Lung cancer, kidney cancer, colon cancer, breast cancer, head and neck cancer, osteosarcoma, and melanoma.[7] The occurrence of primary brain tumor is less as compared to tumors due to brain metastases. It is believed that the cancer metastasizes to brain in almost 15%-20% of the cancer cases. The highest incidence of brain metastases is found in case of lung cancer where almost one-fourth of the patients suffer with brain metastases.[8]
Brain Metastases Diagnosis
Metastatic brain tumor is diagnosed after the diagnosis of primary tumor. For instance, if the lung tumor is diagnosed, the oncologists look for other parts of the body to evaluate the spread of the disease. For this reason, the brain imaging is done. The imaging of the brain and the neurological assessment are important parameters to define the extent of damage caused by the brain tumor. Various imaging techniques are used to diagnose the disease. The most commonly used imaging techniques are Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). These techniques are used to identify the number of tumors, size and site of tumor. Another technique used to differentiate the cancerous and healthy tissue is Positron Emission Tomography. Magnetic Resonance Spectrometry can also be used for the diagnosis of brain metastases.[9]
Conclusion
Brain metastases cannot be reversed due to the lack of any curative therapy. The therapy which works on other tumors does not effectively works on brain metastases due to various reasons. The prognosis of brain metastases is poor.
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/metastatic-brain-tumors
- https://www.cancerresearchuk.org/about-cancer/brain-tumours/living-with/cant-be-cured
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087313/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292164/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383356/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656558/
- https://www.ncbi.nlm.nih.gov/books/NBK470246/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909497/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620494/
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