Malignant neoplasms sometimes behave extremely unpredictably. They can metastasize in a variety of organs and even in the head or bone marrow. With this spread of tumor cells, treatment is significantly complicated, because the localization of metastases in the brain structures adversely affects predictions.
Causes of
Various malignant neoplasms are capable of metastasizing to the brain structures, but more often such a spread of cancerous process is observed in such oncopathologies as:
- Adenocarcinoma or small cell lung cancer;
- Mammary carcinoma, with ductal form most dangerous;
- Melanoma;
- Cancerous lesions of the organs of the gastrointestinal system;
- Malignant prostate formation;
- Ovarian cancer.
For lung cancer
Most often metastasis in the brain structures is observed with pulmonary malignancies.
Usually, brain metastases appear within a year after the oncological process is actively progressing.
Most often, metastatic lesions are found in the parietal region of the brain.
Metastases can be formed latently, although more often nevertheless they are manifested by nervous systemic lesions like apathy and drowsiness, headaches, etc.
To treat such metastases, the whole brain is irradiated on the cancer, and chemotherapeutic treatment is also performed.
Often patients refuse such treatment, which is very dangerous, because life expectancy in the absence of treatment of metastases in the brain is only a few months.
Symptoms of
The clinical picture of cerebral metastasis depends on the specific localization of secondary malignancies.
All brain metastases are divided into cerebrospinal and bone marrow. This is a completely different localization, so the clinic in these secondary cancers is also different.
Symptoms of metastases in the brain
Brain metastasis is curved from the specific location of the tumor in the brain.
- If the metastasis is formed next to the innervation structures of the eyes, then the visual fields fall out, that is, the eye is not able to perceive certain areas of the vision.
- Approximately half of cancer patients with cerebrospinal metastasis complain of headaches. Often the degree of pain varies depending on the position of the head, but with further growth of metastatic tumors, soreness becomes constant and intense.
- About 20% of cancer patients with such metastases suffer from motor disorders and even a paresis of ½ body.
- One in six with cerebrospinal metastases has a violation of intelligence, so many are tormented by behavioral changes and gait disturbances.
- Significantly fewer patients are cramped.
If tissue around the metastasis swells, intracranial pressure increases, which provokes symptoms of cerebral injury, which is manifested by headaches with vomiting, double vision and dizziness, frequent attacks of hiccough and depression of consciousness.
Symptoms of bone marrow metastases
If the metastatic spread of the tumor has penetrated the bone marrow, then the clinical manifestations are reduced to such symptoms:
- Deterioration of general health and anemia, oncological concern frequent dizziness and weakness;
- Pain symptomatology. Usually affects the medullar structures of the ribs and lower back, and also in the pelvic bones. With the growth of metastases, pain only increases and becomes permanent;
- Headaches and nosebleeds, frequent drowsiness, which is associated with increased paraprotein.
If bone marrow metastasis is of a multiple nature, the patient begins to worry about bone pain and weight loss, spinal column curvature and thickening of the bones, a tendency to infectious diseases and a pathological decrease in the immune status.
Diagnostics
Diagnosis of cerebral metastasis includes such procedures as:
- MRI;
- Patopsihologicheskoe survey, which allows to identify verbal violations, problems with writing or reading, etc.;
- Neuro-ophthalmologic diagnosis - involves the detection of changes in the bottom of the eye;
- Echoencephalography - ultrasound of the brain;
- Otonevrological diagnostics - the auditory organs, as well as sensory and taste sensors are carefully examined, the vestibular apparatus is examined;
- Electroencephalography - examination of the activity of the external cephalic membrane;
- Gastrointestinal scintigraphy;
- CT with the introduction of fluid into the brain tissue;
- Laboratory analyzes of cerebrospinal fluid;
- Puncture biopsy.
Treatment of
If the patient does not receive the necessary treatment during brain metastasis, the duration of his life is unlikely to exceed 2-3 months. Hormonal exposure can increase life expectancy up to 4 months, and chemotherapy - up to six months.
Tactics of treatment are determined in accordance with the size and number of metastatic foci, as well as the response of primary education to the treatment being undertaken.
If the secondary cerebral formations are not technically removable, but differ in sensitivity to chemotherapeutic drugs, then a chemotherapy course is first conducted, and then the entire brain is radiated.
Irradiation always leads to an increase in swelling of the brain tissue, so radiation therapy is carried out in conjunction with dehydration. In the presence of resistance to diuretics and the presence of cerebrospinal displacement, radiation therapy is contraindicated.
In addition, irradiation is not performed in the presence of pronounced clinical signs of cerebral metastasis.
With contraindications to neurosurgical and radiotherapy, they resort to chemotherapy along with supporting symptomatic treatment.
How long does it take to live?
How long can a cancer patient survive if he has a brain metastasis?
Life expectancy depends on many factors - the type of primary education and the correctness of the therapy, the degree of malignancy of education, etc.
- With spinal metastasis , with proper treatment and operable metastases, life expectancy reaches decades. If metastasis to the brain is multiple, and the tumor itself is aggressive, then the cancer patient will live only a few days.
- Bone metastasis almost always has unfavorable prognosis. The only way to save the situation is transplantation. On average, patients live about 3-4 years, and if the secondary hemoblastosis has a solitary form, then the oncological patients may live longer, depending on the results of treatment of the primary focus.
With extensive multiple metastasis, whether it be cerebral structures or bone marrow, the predictions, unfortunately, are disappointing.
Video about the role of stereotaxic radiation therapy, with relapse of metastases to the brain: