Metastatic Brain Tumours (Secondary Brain Tumours)
Metastatic brain tumours, also called secondary brain tumours or brain metastases, occur when cancer cells from a tumour elsewhere in the body spread to the brain via the bloodstream.
What are Metastatic Brain Tumours?
Metastatic brain tumours, also called secondary brain tumours or brain metastases, occur when cancer cells from a tumour elsewhere in the body spread to the brain via the bloodstream. They are the most common type of tumours in adults, occurring far more frequently than primary brain tumours.
Almost any type of cancer can spread to the brain, but the most common ones are lung cancer, breast cancer, melanoma, bowel cancer, and kidney cancer. Brain metastases may be single (solitary), a small number, or multiple.
A diagnosis of brain metastases can be very distressing. At One Brain and Spine, our Melbourne neurosurgeons work compassionately within a comprehensive multidisciplinary team to offer the best possible treatment tailored to each patient's individual condition.
Which Cancers Spread to the Brain?
The most common primary cancers causing brain metastases in Australia are:
- Lung cancer – the most common cause. Both non-small cell (NSCLC) and small cell (SCLC) lung cancers frequently metastasise to the brain.
- Breast cancer – particularly certain subtypes. Brain metastases may occur even years after initial breast cancer diagnosis and treatment
- Melanoma – the highest propensity to metastasise to the brain of any cancer.
- Colorectal cancer – less commonly causes brain metastases compared with other common cancers.
- Renal cell carcinoma – highly vascular brain metastases are characteristic
- Unknown primary – in some patients, brain metastases are discovered before the primary tumour is identified. In these cases, further tests are needed to find the source.
Symptoms of Brain Metastases
Symptoms depend on the number, size, and location of metastases, as well as the degree of associated brain swelling. Common presentations include:
- Headache – often gradually worsening, and sometimes worse in the morning, with nausea or vomiting.
- New weakness, numbness, or difficulty speaking – depending on which part of the brain is affected.
- Seizures – particularly with lesions involving the cerebral cortex.
- Cognitive or personality change – memory problems, confusion, behavioural change.
- Balance and coordination problems – from cerebellar metastases.
Urgent Symptoms
If symptoms come on suddenly, if there's a rapid change in how you're feeling or functioning, or if you lose consciousness, seek emergency medical attention immediately.
How are Brain Metastases Diagnosed?
- MRI brain with contrast – the best test for brain metastases. This demonstrates number, size, and location of metastases.
- CT scan – often the first investigation performed in acute or emergency settings.
- Full-body staging CT (chest/abdomen/pelvis) – helps identify the primary tumour and assesses the extent of systemic disease. This is essential for treatment planning.
- PET scan – may be used to assess overall disease burden and guide treatment planning.
- Tissue diagnosis – biopsy is performed when the primary tumour is unknown or when histological confirmation is needed to guide targeted therapy choices
Treatment of Brain Metastases
Treatment is highly individualised based on the number and location of brain metastases, the type and status of the primary tumour, systemic disease burden, patient performance status, and goals of care.
Corticosteroids
Steroid medication called dexamethasone can quickly reduce swelling around the tumour, often improving symptoms rapidly. It's usually used as a short-term measure while more definitive treatment is arranged.
Stereotactic Radiosurgery (SRS)
This treatment delivers a precise, high dose of radiation to individual tumours, usually over a single or a small number of sessions. SRS is often the main treatment for patients with a number of brain metastases, particularly when surgery isn't suitable or when the tumours are in delicate parts of the brain. The suitability of SRS depends on the total number and size of the tumours, and your radiation oncologist will determine whether this approach is right for your specific situation.
Surgery — Craniotomy and Resection
Surgery is usually recommended for larger tumours causing significant symptoms, solitary or oligometastatic disease with good systemic control, when tissue diagnosis is required, or when there is haemorrhage into a metastasis. Surgery provides immediate relief of mass effect and allows definitive histological diagnosis. At One Brain and Spine, our neurosurgeons use advanced navigation and monitoring technology to make surgery as safe as possible.
Whole-Brain Radiotherapy (WBRT)
This treatment delivers radiation to the entire brain, and is used when there are many tumours that aren't suitable for targeted radiation or surgery, for symptom relief, or sometimes after surgery in certain cases. Modern practice increasingly favours SRS over WBRT to preserve cognitive function.
Systemic Therapy
Targeted therapies and immunotherapy have shown activity against brain metastases in selected patients and have transformed the management of some tumour types. Systemic treatment is coordinated with the treating medical oncologist.
Frequently Asked Questions — Brain Metastases Melbourne
Can brain metastases be cured?
For many patients, the aim of treatment is to control brain metastases, relieve symptoms, and maintain quality of life rather than cure. However, some patients, particularly those with just one tumour and well-controlled cancer elsewhere in the body, can achieve long-term control with surgery and/or targeted radiation. Outcomes continue to improve as cancer treatments advance.
Is surgery safe for brain metastases?
In appropriately selected patients, surgical resection of brain metastases is safe and effective. At One Brain and Spine, our neurosurgeons use intraoperative navigation and monitoring to maximise safety. Whether surgery is recommended depends on your overall health, how much the cancer has spread, the specific tumour, and your own preferences.
What is the prognosis for brain metastases?
Prognosis varies widely depending on the primary tumour type, systemic disease extent, performance status, and response to treatment. Modern targeted therapies and immunotherapy have significantly improved outcomes for some tumour types. Your treatment team will give you personalised information based on your specific situation.
Why Choose One Brain and Spine for Metastatic Brain Tumours in Melbourne?
One Brain and Spine is a specialist neurosurgical group practice in Melbourne, bringing together extensive expertise in brain, spinal, and peripheral nerve surgery. Our team has particular strength in neuro-oncology surgery, delivering multidisciplinary care using the latest technology available in Australia. We are committed to providing comprehensive, patient-focused treatment through:
- Specialist neuro-oncology neurosurgeons – internationally fellowship-trained with subspecialty cranial surgery expertise
- Advanced technology – including intraoperative navigation, neuromonitoring, and state-of-the-art microsurgical techniques
- Multidisciplinary care – close collaboration with oncologists, radiation oncologists, neurologists, and allied health teams to ensure optimal outcomes
- Patient-centred approach – compassionate care with clear explanations of your diagnosis and all available treatment options
- All major health funds accepted