Secondary brain cancer

What is secondary brain cancer?

Secondary brain cancer is cancer that starts somewhere else in the body and spreads to the brain. It may also be called brain metastases or secondary brain tumour. It is a type of advanced cancer.

Some types of primary cancer are more likely to spread to the brain. The primary cancer is where the cancer first started. These include:

Sometimes, secondary brain cancer is found before the primary cancer has been diagnosed. For a small number of people it is not possible to find the primary cancer. This is called secondary brain cancer from an unknown primary.

We also have other information about primary brain tumours.

Symptoms of secondary brain cancer

Secondary brain cancer can cause similar symptoms to primary brain tumours.

As a tumour grows, it can press on or grow into nearby areas of the brain. This can cause symptoms because it stops that part of the brain from working normally.

The first symptoms may be due to the tumour causing a build-up of pressure inside the skull. This is called raised intracranial pressure.

Symptoms depend on where the tumour is in the brain. They can include:

headaches
feeling or being sick
seizures (fits)
changes in personality or being confused
numbness or weakness on one side of the body
problems with speech.

Some people might not have any symptoms. Instead, the tumour may be found during tests to find out more about the primary cancer.

Diagnosis of secondary brain cancer

A doctor may suspect secondary brain cancer if you have symptoms, and:

you have had cancer before, even a long time ago
a secondary cancer has been found in other places, such as the liver or bones
there is more than one tumour in the brain – this is because primary brain tumours usually only affect one area of the brain.

Your doctors will need to do some tests to diagnose secondary brain cancer. You will have one of the following:

Brain CT scan

A CT scan makes a three-dimensional (3D) picture of the brain. You may have an injection of a dye into a vein in your arm. This is called a contrast. It helps show certain areas of the brain more clearly.
Brain MRI scan

An MRI scan uses magnetism to make a detailed picture of the brain. It can also be used to check your spine. It takes about 30 to 60 minutes and does not use any radiation. You may have an injection of a dye into a vein in your arm during the scan. The dye is called a contrast. It helps show certain areas of the brain more clearly.

Your doctor may also:

do a neurological examination
arrange blood tests to check your general health and how well your kidneys and liver are working.

Rarely, if scans have found any tumours, you may have a biopsy. Your doctor or nurse will explain more about this.

Waiting for test results can be a difficult time. We have more information that can help.

Getting support

Finding out you have secondary brain cancer can be very difficult. You may feel shocked and find it hard to understand or accept. Talking about how you feel to close family and friends may help. Your doctor and specialist nurse can also give you support.

Macmillan is also here to support you. If you would like to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00
Chat to our specialists online
Visit our secondary brain cancer forum to talk with people who have been affected by brain tumours, share your experience, and ask an expert your questions.

You may also want to get support from a brain tumour charity, such as:

Driving and secondary brain cancer

If you are diagnosed with a secondary brain tumour, you must stop driving straight away.

You may not be allowed to drive for a time after diagnosis. Your doctor, surgeon or specialist nurse will tell you if this applies to you. This change can be upsetting and frustrating. But you must follow the advice they give you.

If you have a driving licence, you must tell the licencing agency you have been diagnosed with secondary brain cancer. If you live in England, Scotland or Wales, contact the Drivers and Vehicle Licensing Agency (DVLA) on 0300 790 6806. If you live in Northern Ireland, contact the Driver and Vehicle Agency (DVA) on 0300 200 7861.

You could be fined if you do not tell them. You could also be prosecuted if you have an accident.

If you have to stop driving, the DVLA or DVA will tell you when you are allowed to start driving again. This depends on:

how many tumours there are and where they are in the brain
whether you have had any seizures
your treatment
the type of driving license you have.

Treatment for secondary brain cancer

Secondary brain cancer cannot usually be cured. But treatments can shrink the tumours, slow their growth and control symptoms. Your treatment will depend on:

your general health
the size, position and number of brain tumours
the type of primary cancer.

Treatment may include steroids, radiotherapy, surgery, anti-cancer drugs and anticonvulsants.

A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and disadvantages of different treatment types. They will also explain the risks and side effects.

You may be given a choice of treatment options. You will have time to talk this through with your hospital team before you make any treatment decisions.

You will need to give giving your consent for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist if you need more information or more time to decide on a treatment.

Steroids

Doctors prescribe steroids to help reduce symptoms of a tumour in the brain. They reduce the symptoms caused by increased pressure. This can help you feel better. They may be given:

before or after surgery
during or after radiotherapy.

For some people, they will be the main treatment.

Radiotherapy

Radiotherapy uses high-energy rays to destroy cancer cells. It can slow tumour growth and control symptoms. The type of radiotherapy you have will depend on the size, position and number of tumours. Your doctor will explain what treatment is best in your situation.

A type of radiotherapy called stereotactic radiotherapy (SRT) can be used to treat some secondary cancers in the brain. SRT aims to give a higher dose of treatment, without damaging nearby areas of the brain. It is possible to treat a number of small brain tumours with SRT in one session of high-dose treatment. This is called stereotactic radiosurgery (SRS). It does not involve any surgery.

Sometimes, if there are a lot of brain tumours or they are large, radiotherapy is used to treat the whole brain.

Your specialist doctor or nurse will explain your treatment and possible side effects. Most side effects are short term and will improve gradually when the treatment is over. We have more information about coping with the side effects of radiotherapy for a primary brain tumour.

Surgery

In some cases, surgery may be used to treat secondary brain cancer. This is usually when there is only one secondary brain tumour and you are well except for any symptoms caused by the tumour. The operation you have is similar to the type of operation used to treat a primary brain tumour.

You will be referred to a brain surgeon, called a neurosurgeon. They will decide whether surgery is suitable for you. Surgery aims to remove all of the tumour. If your surgeon cannot remove all of the tumour they will remove as much as they can. After the operation, you may have radiotherapy to treat any remaining cancer cells.

Your surgeon will explain what your operation will involve. They will talk to you about the possible complications and risks.

Anti-cancer drugs

Depending on the type of primary cancer you have, you may have anti-cancer drugs. Only a few drugs can pass through to brain tissue. Your cancer doctor will be able to tell you more about the types of drugs that might be suitable for you.

You may have:

chemotherapy – drugs that destroy cancer cells
targeted therapies – drugs that interfere with how cancer cells to grow and survive
immunotherapy – drugs that use the immune system to find and attack cancer cells
hormonal therapies – drugs that change the effect of hormones on cancer cells.

Your doctor will explain any side effects you may have and how they can be managed.

Anticonvulsants

If you have had seizures (fits), you may be given drugs called anticonvulsants to help prevent them. Side effects will depend on the type of drug you take.

Treatment for other symptoms of secondary brain cancer

Your doctors and nurses will ask about any other symptoms or side effects you may have. It is important to talk to them about these so they can give you the right help. They may refer you to a palliative care team. They are experts in managing symptoms. There are palliative care teams based in hospitals and the community. Your GP or cancer specialist can refer you to a palliative care team. We have more information about advanced cancer.

After secondary brain cancer treatment

You may be seen at the hospital for check-ups. Some people will see their GP or community palliative care nurse.

Always tell your doctor or nurse if you have symptoms or side effects that do not improve. There are different ways that your symptoms can be managed.

You can use your follow-up appointments to talk to your doctor about any worries or problems you have. Many people find they get very anxious before appointments. This is natural. It can help to get support from family, friends or a specialist nurse.