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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about secondary brain tumours.
We also have information about primary brain tumours|.
The place where a cancer first starts is known as the primary tumour. Some cancers spread from this place (the original site).
A secondary brain tumour occurs when cancer cells break away from the primary tumour and travel through the blood system to the brain. When cancer cells spread to another part of the body they are called secondaries or metastases.
Some types of cancer are more likely to spread to the brain. The most likely are cancers of the lung|, breast|, bowel|, kidney| (renal) and skin| (malignant melanoma|).
Secondary brain tumours can look like, and cause the same symptoms as, primary brain tumours|. It's important to know if a tumour in the brain is a secondary or a primary as the two are treated differently.
Factors your doctor may consider include:
If there is only one growth in the brain (a solitary brain tumour) and if tests have shown there has never been a diagnosis of cancer elsewhere in the body, it may be difficult to tell whether the growth is a primary or a secondary one. In such situations, a sample of cells from the tumour (biopsy) will need to be taken. You will be referred to a neurosurgeon for this.
When the cells from the biopsy are examined under a microscope, they may look like cells from a cancer from another part of the body. For example, if a lung cancer has spread to the brain, the affected cells would look like lung cells rather than brain cells.
The most common symptoms of secondary brain tumours are headaches, weakness in areas of the body, mood swings and changes in behaviour, fits (seizures), feeling or being sick, confusion and listlessness.
A doctor may suspect a secondary brain tumour if there has been a previous diagnosis of cancer and you have any of the above symptoms.
Some people with secondary brain tumours have no signs or symptoms and their secondaries are discovered during the investigations of their primary tumour.
Sometimes secondaries are found before the primary cancer has been diagnosed. In a small number of cases it may not be possible to find the original cancer. In this situation, the tumour is known as a secondary brain tumour from an unknown primary|.
To diagnose a secondary brain tumour, the doctor will examine you thoroughly. The doctor may also test the power and feeling in your arms and legs, and will test your reflexes.
Your doctor will look into the back of your eyes using an ophthalmoscope. They can see if the optic nerve at the back of the eye is swollen. This can be caused by oedema (swelling of the tissues within the brain), which may occur due to an increase in the amount of fluid in the brain.
CT or MRI scans can sometimes show the difference between secondary and primary tumours.
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes 10-30 minutes. CT scans use small amounts of radiation, which will be very unlikely to harm you or anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
You may be given a drink or injection of dye which allows particular areas to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine or have asthma you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.
This test is similar to a CT scan, but uses magnetism instead of x-rays to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure it's safe for you to have an MRI scan.
Before having the scan, you'll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan show up more clearly. During the test you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable and some people feel a bit claustrophobic during the scan. It's also noisy, but you will be given earplugs or headphones to wear.
Occasionally it is necessary to take a sample of cells (biopsy) from the tumour to confirm the diagnosis. The cells are examined under a microscope. The biopsy operation is done by a neurosurgeon. Your doctor will discuss whether this is necessary in your case, and exactly what the operation involves.
Being told you have secondary cancer in the brain will be a tremendous shock. It is important to discuss any questions, fears and treatment options with your doctor. It is not usually possible to get rid of a secondary brain tumour completely, but treatment can sometimes shrink the tumour, slow its growth and control symptoms.
Before you have any treatment, your doctor will give you full information about the aims of the treatment and what it involves. They will usually ask you to sign a form saying that you give your permission (consent|) for the hospital staff to give you the treatment. No medical treatment can be given without your consent.
Treatment can be given for different reasons and the potential benefits will vary for each person. When a cure is not possible and the treatment is to control the cancer for a period of time, it may be difficult to decide whether or not to go ahead.
If you feel that you can’t make a decision about the treatment| when it is first explained to you, you can always ask for more time to decide.
You are free to choose not to have the treatment and the staff can explain what may happen if you do not have it. You don’t have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.
Steroids| are chemicals naturally produced in the body that help control and regulate how the body works. Steroids can be given as tablets or by injection, and can reduce the swelling that often surrounds secondary brain tumours. Although steroids do not treat the tumour itself, they are very useful in improving symptoms and making you feel better. They may be used before, during or after radiotherapy or before or after surgery.
Radiotherapy| is the use of high-energy x-rays and similar rays (such as electrons) to treat disease. Beams delivered from outside the body (external radiotherapy) is the most common treatment for secondary brain tumours. It's normally given as a series of short, daily treatments using equipment similar to a large x-ray machine.
The length of your treatment can vary from a couple of days to up to two weeks.
Side effects of radiotherapy to the head include hair loss|, skin reaction, tiredness| and feeling drowsy. Your hair will usually grow back after treatment and the other side effects should gradually improve.
In some cases surgery| may be used as a treatment. This is usually if the scans show that there is only one secondary tumour in the brain and the person is well enough for the operation (apart from symptoms caused by the pressure from the tumour).
You will be referred to a neurosurgeon to see whether surgery is suitable for you. After the operation, radiotherapy treatment may be given to reduce the chances of the tumour returning. Surgery is not usually recommended when there are two or more brain secondaries, although it may be used to relieve pressure.
Some people with only one or two secondary tumours may have stereotactic radiosurgery|. This is a new technique that delivers a very accurate high dose of radiation to the tumour and causes less damage to surrounding tissue. Only one session of radiotherapy is needed. This treatment may also be used for a secondary tumour that persists after previous radiotherapy to the whole brain.
Stereotactic radiosurgery is available only in specialist hospitals and is not suitable for all patients. You can discuss with your clinical oncologist whether it is appropriate for you.
If chemotherapy| is given, it has to be a type that is able to cross the membranes that protect the brain and spinal cord (the blood brain barrier). In certain cancers that have spread to the brain, hormonal therapy| or immunotherapy may be used.
If you experience seizures you may be given a medicine called an anticonvulsant| to help prevent them.
You may find the idea of a secondary cancer affecting your brain extremely frightening. You may have many emotions| including anxiety|, anger| and fear. These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition.
Many people find it helpful to talk things over with their doctor or nurse, or with one of our cancer support specialists|. Family members and close friends can also offer support.
The Drivers and Vehicle Licensing Association (DVLA) will not allow you to drive for 1-2 years after diagnosis of a secondary brain tumour, depending on the grade of the tumour. If you have also had epilepsy, the DVLA will not allow you to drive for a year after your last fit.
You may not be allowed to drive some vehicles, such as a large goods vehicle or a passenger-carrying vehicle.
The hospital will not contact the DVLA, but it is your responsibility to do so and your doctor will advise you how to do this. You can contact the DVLA by calling 0300 790 6806 or at dvla.gov.uk|
This information is based on our secondary brain tumours fact sheet and has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.