When cancer that started elsewhere in the body spreads to the brain, it results in what we call brain metastases. This diagnosis can cause uncertainty and worry, but it’s important to understand that there are various therapeutic options designed to control symptoms, slow disease progression, and significantly improve the patient’s quality of life.
In our neurosurgical practice, we specialize in providing highly complex solutions for these cases, utilizing minimally invasive techniques that allow us to address secondary brain tumors with greater precision and less impact on the patient. Here are the different options available along with key considerations for each clinical situation.
What Are Brain Metastases and What Causes Them?
Brain metastases are tumors that form when cancer cells from other organs travel through the bloodstream to the brain. Lung, breast, kidney, colon cancers, and melanoma are the cancers that most commonly cause this kind of spread. Unlike primary brain tumors, these lesions represent an advanced stage of the original oncological disease.
Symptoms can vary depending on the lesion’s size and location. Early diagnosis with a brain MRI is crucial to determine the number, size, and location of the metastases, information that guides the most appropriate treatment strategy. The most common clinical signs include:
- Persistent headaches that do not respond to common painkillers
- Impaired coordination and balance
- Cognitive changes such as memory loss or difficulty concentrating
- New onset seizures
- Focal neurological deficits depending on the affected brain area
Brain Metastases Treatment Available in Costa Rica
Managing these secondary lesions requires a multidisciplinary approach considering the primary cancer type, the patient’s overall condition, the number of lesions, and their location. Our region has the technology and expertise to offer effective therapeutic options.
Neurosurgery
Surgical removal is a key option when there is one or a few accessible metastases, especially if they cause mass effect, brain swelling, or significant neurological symptoms. Using skull base surgery and endoneurosurgery techniques, we can remove the lesions with maximum precision and minimal damage to surrounding healthy brain tissue. Surgery allows for rapid symptom relief, obtaining tissue for pathological analysis, and in selected cases, improved survival and quality of life.
Radiotherapy
Stereotactic radiotherapy (radiosurgery) is a non-invasive alternative that delivers high doses of focused radiation to the tumor lesions, sparing normal brain tissue. It is especially useful for multiple metastases or those located in surgically difficult areas. Whole brain radiotherapy is reserved for cases with multiple scattered lesions.
Complementary Systemic Therapy
Chemotherapy, immunotherapy, and targeted therapies are an integral part of treatment, controlling both brain metastases and systemic disease. The chosen regimen depends on the primary cancer type and the tumor’s molecular characteristics.
Specific Indications for Metastasis Surgery
Surgical intervention is considered when the patient’s condition maximizes the benefit of the procedure. Main indications include single or up to three accessible metastases, good functional status, reasonable systemic disease control, and lesions causing mass effect with progressive neurological decline.
Surgery is also used when diagnostic confirmation through biopsy is needed, when the lesion is resistant to prior radiotherapy, or when secondary hydrocephalus requiring shunting is present. Each case is evaluated individually alongside the oncology team to determine the best strategy.
Expectations and Care After Treatment
Following treatment, whether surgical or radiotherapy, close follow-up is critical to monitor response and detect any recurrence early. Monitoring includes regular neurological assessments, serial imaging studies, and medication adjustments according to clinical progress.
Postoperative care involves neurological rehabilitation in the event of functional deficits, management of anticonvulsant and corticosteroid medications, and coordination with medical oncology to continue systemic therapies. Our goal is to optimize functional recovery and maintain the best possible quality of life.
Prognosis has improved significantly in recent years thanks to advances in neuroimaging, precision surgical techniques, stereotactic radiotherapy, and new systemic therapies. If you or a loved one is facing this diagnosis, receive cutting-edge care backed by expertise in highly specialized oncological neurosurgery. Request information about our specialized services and let us support you through this process with the care and technology your case deserves.
