When Cancer Spreads to the Brain

By Kate McHugh, Ivanhoe Health Correspondent

MIAMI, Fla. (Ivanhoe Newswire) -- Brain metastasis -- when cancer spreads to the brain from another part of the body -- is the most feared complication of systemic cancer. Metastases accounts for about 40 percent of all brain cancers but no longer comes with the automatic death sentence of the past thanks to advances in radiology.

At the American College of Radiation Oncology’s 18th annual conference in Miami, Fla., John Suh, M.D., from the Cleveland Clinic, discussed the available options for treatment. Of particular interest: is traditional whole brain radiation treatment still a favorable option?

Whole brain radiation can cause alopecia, fatigue, headaches, memory loss and confusion. In a recent study, 11 percent of patients treated with whole brain radiation suffered severe dementia. Given these unfavorable side effects, many doctors feel the loss of the patient’s quality of life makes them look to other treatment options.

In recent years, radiosurgery has emerged as a viable option for these patients. “It gives us a method of delivering a much higher dose of radiation to the tumor,” Dr. Suh told Ivanhoe. “There is a concrete dose-response relationship where higher levels yield better results.” These devices, including Gamma Knife, Brain Lab and Cyber Knife, are minimally invasive and can be performed as an outpatient procedure.

Dr. Suh added some medications, including donepezil hydrochloride (Aricept), when taken in conjunction with whole brain radiation, improve the patient’s attention, concentration and memory performance after treatment.

But not all cancer treatments are right for brain metasteses. “Historically, we have not thought of chemotherapy as a good treatment option for a patient with brain metasteses,” Dr. Suh said.

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SOURCE: Ivanhoe interview with John Suh, M.D., the 18th annual meeting of the American College of Radiation Oncology, Miami, Fla., Feb. 21-23, 2008