It's not usually possible to get rid of secondary brain cancer, but treatment can shrink the tumours, slow their growth or control symptoms. Your treatment will depend on your general health, the size and number of brain tumours, and the type of primary cancer. Treatment may include steroids, radiotherapy, surgery, anti-cancer drugs and anticonvulsants.
Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about treatment benefits and disadvantages. They will also explain the risks and side effects.
You will have time to talk this through with them before you make any treatment decisions. You may be given a choice of treatment options. Let your specialist know if you need more information or time.
Steroids
Doctors prescribe steroid drugs to reduce the swelling around brain tumours. They reduce the symptoms caused by increased pressure and make you feel better. They may be given before or after surgery, and during or after radiotherapy. For some people, steroids are the main treatment.
It’s important to take the steroids exactly as your doctor has explained. Your pharmacist or nurse will give you a steroid card. You should carry the card at all times so that in an emergency a doctor will know you are having steroid treatment. A card is not necessary if you are only having a short course of steroids.
Never stop taking your steroids suddenly, as this can make you very ill. Your doctor will gradually reduce the dose.
Possible side effects include:
- Indigestion. Take them with food and tell your doctor if you have stomach problems. They can prescribe a drug to help with this.
- Increased appetite and weight gain. This is more common when steroids are taken over a longer time. It will improve when your steroids are reduced.
- Difficulty sleeping. Avoid taking your steroids after 6pm.
- Feeling restless or agitated. Let your doctor know if this is a problem.
- A higher level of sugar in the blood. You will have blood or urine tests for this.
Taking higher doses of steroids for a longer period of time may cause more side effects. These can include mood changes or feeling low, swollen feet and legs, and raised blood pressure. It can make you more likely to get an infection too. Your muscles may also get weaker, so it is important to do some regular, gentle exercise.
Talk to your doctor or specialist nurse if you’re worried about any side effects. These will go away gradually as your doctor reduces your steroid dose.
Radiotherapy
Radiotherapy treatment uses high-energy rays to destroy the cancer cells. You may have this to slow the tumour growth and control symptoms.
You normally have radiotherapy in the hospital radiotherapy department as a series of short daily sessions. Treatment is usually given from Monday to Friday, with a rest at the weekend. The length of your treatment may vary from a couple of days to up to two weeks.
Radiotherapy has to be carefully planned to make sure it’s as effective as possible. On your first visit to the radiotherapy department, you’ll be asked to have a CT scan or lie under a machine called a simulator, which takes x-rays of the area to be treated. Your radiotherapy team use this scan to plan your treatment.
At the beginning of each treatment session, you lie in the same position but under the radiotherapy machine. The treatment itself only takes a few minutes. You’ll be left alone in the room but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful, but you have to be very still for a few minutes during the treatment.
Stereotactic radiotherapy and radiosurgery
Stereotactic radiotherapy is a specialised type of radiotherapy sometimes used to treat secondary brain cancer. Several beams of radiation are given from different angles, overlapping at the tumour. This gives a high dose to the tumour and very low doses to surrounding healthy tissue so helps to reduce side effects.
Sometimes, people with fewer than four small brain tumours have stereotactic radiotherapy in one session of high-dose treatment. This is called stereotactic radiosurgery, which is also known as gamma knife treatment. Stereotactic radiosurgery doesn’t involve any surgery.
Stereotactic radiotherapy is only available in some hospitals and may not be suitable for everyone. Your cancer doctor can give you more information and talk to you about possible side effects and risks.
Side effects of radiotherapy
You may develop side effects over the course of your treatment. These usually disappear gradually over a few weeks or months after treatment finishes. Your doctor, nurse or radiographer will discuss this with you so you know what to expect. Let them know about any side effects you have during or after treatment so they can help.
Side effects of radiotherapy may include hair loss, skin reactions, feeling sick, tiredness and feeling drowsy. Your hair will usually grow back after treatment and the other side effects should gradually improve. Always tell your doctor or nurse about your side effects and let them know if any side effects get worse.
Surgery
In some cases, surgery may be used to treat secondary brain cancer. This is usually when there is only one secondary tumour and you are feeling well except for any symptoms caused by the tumour.
You will be referred to a neurosurgeon (brain surgeon) to see whether surgery is suitable for you. Surgery aims to remove all of the tumour or as much as possible. After the operation, you may have radiotherapy to treat any remaining cancer cells or to reduce the risk of the tumour returning.
Your surgeon will explain what your operation will involve. They will talk to you about the possible complications and risks.
It can take a while to recover after surgery, so it’s important to take good care of yourself. Get plenty of rest, try to eat well and follow the adviceyour doctor and specialist nurse give you.
Anti-cancer drugs
Depending on the type of primary cancer, you may be given anti-cancer drugs such as:
Your cancer doctor will be able to tell you more about the types of drugs that are suitable for you. They will explain the 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.