Cancer that begins in other parts of the body can sometimes spread to the brain.
Our 'Living well with advanced cancer' booklet is available now.
What is advanced cancer?
Advanced cancer (also called secondary cancer or metastatic cancer) is cancer that has spread from the part of the body where it started (the primary cancer), to another part of the body.
Although the cancer is growing in a different part of the body, it is still named after the primary cancer. For example, if melanoma has spread to the brain, it is called advanced melanoma.
Advanced cancer that has spread to the brain
Cancer that begins in another part of the body can sometimes spread to the brain.
This is called advanced cancer that has spread to the brain.
Your treatment team may use different words to describe cancer that has spread to the brain.
You may hear it called:
- metastatic brain cancer (brain mets)
- secondary cancer in the brain
- stage 4 (IV) cancer.
Symptoms of cancer that has spread to the brain
Having any of the following symptoms does not always mean that cancer has spread to the brain, but it is important to get any changes checked by your GP or whānau doctor.
Signs that cancer may have spread to the brain include:
When cancer that has spread to the brain starts to grow, it takes up more space in the skull and pushes on the brain. This can cause headaches. Some people find that the headache is worse in the morning.
Cancer that has spread to the brain can press on the brain. This can make you feel sick (nausea) and you might be sick (vomit).
Cancer that has spread to the brain can change how messages (electrical impulses) move from your brain to your nerves and muscles. A seizure is a sudden change in electrical activity in the brain.
There are two main types of seizure:
- Focal seizure - These are also called partial seizures and affect one part of the body, such as an arm or a leg. The symptoms depend on which part of the brain is affected.
- Generalised seizure - These seizures usually affect the whole body and are known as tonic-clonic seizures. You might lose consciousness or stop responding to people around you for a few minutes. Your muscles may become tighter, and your arms and legs can make jerky or twitching movements.
Cancer that has spread to the brain can change how messages move from the brain to your nerves and muscles. This can cause weakness and numbness. You may also have problems with balance or walking.
Cancer that has spread to the brain can affect the parts of the brain that control speech, vision and understanding. You may also experience confusion, or have personality changes.
Finding out if cancer has spread to the brain
If your GP or whānau doctor is concerned that any symptoms you may be experiencing could be caused by cancer that has spread to the brain, they will recommend further tests (investigations).
These tests may include:
The doctor will do some neurological (brain) tests to check your:
- muscle strength
- balance and movement
The doctor will also ask you some questions to check your thinking and memory. Sometimes, they may shine a light into your eye to check if there is any sign of swelling in your brain (raised intracranial pressure).
A CT scan creates a 3D picture of the inside of your brain. It can show smaller cancers than an x-ray.
An MRI uses magnets and radio waves to make a detailed picture of your brain.
A PET-CT scan uses a radioactive dye injected into your arm that will show up in areas of your body affected by cancer. You may have to travel to a different hospital for this scan.
A biopsy takes a small sample of the abnormal cells to check if they contain cancer.
Managing cancer that has spread to the brain
Cancer that has spread to the brain is often managed with more than one type of treatment.
Your treatment may include:
- Hormone treatment – most commonly used in cancer that has spread from the breast or prostate
- Radiation treatment
- Specialist palliative care
- Steroids – medication to help reduce the swelling in the brain caused by the cancer or treatments such as radiation treatment
- Supportive care
- Targeted treatments
- Traditional healing or complementary therapy
The goals of any treatments are to control the cancer for as long as possible, improve any symptoms you may be experiencing, and to maintain your quality of life.
Sometimes treatments for cancer, such as radiation, may no longer work, but you will always benefit from supportive care.
Supportive care includes the management of physical symptoms, emotional and spiritual support, and guidance to help you plan for the future.
Supportive care will mostly be provided by your primary health care team, Cancer Society support workers, and specialist palliative care services.
If the symptoms you are experiencing are difficult to manage, you and your whānau may be referred to a specialist palliative care service.
Specialist palliative care helps with the physical and emotional needs of advanced cancer, and can help you to access practical support. Care can be provided at home or in a hospital, rest home, or hospice by doctors, nurses, social workers, spiritual care workers, and cultural health services.
Living well with advanced cancer
Looking for ways to stay as well possible can help reduce stress and improve your wellbeing.
The following suggestions may be helpful:
- Eating well, keeping active and relaxing can help your overall health and improve sleep.
- Keeping in touch with whānau and friends can be an important support. You may choose to keep working if you can - talk to your employer about reduced hours or lighter duties if you need.
- Some people find that prayer or talking to a spiritual advisor/tohunga is a way to find strength and meaning in times of stress.
- Setting goals for things you have wanted to do but have not yet had the chance can give a sense of structure and purpose.
Learning to manage uncertainty is another important part of staying healthy.
These tips may help:
- It is important to ask for support. Talk with your treatment team about support and resources available to help you if you are struggling.
- Accept that there are things you can control and things you cannot.
- Talk to the Cancer Society or your GP/whānau doctor about counselling services.
- Try a local support group or talk with a social worker at the hospital.
- Talk with family/whānau and friends. Tell them how you are feeling and how they can help.
- Learn as much as you can about the cancer and its treatment. Having the right information can help you know what to expect.
- Maintain your usual interests, friendships, and activities that give you time out from cancer.