Metastases in the brain occur as a result of the spread of cancer antibodies from the original lesion. The movement of oncogene cells is carried out through the circulatory and lymphatic systems.
Metastasis is characterized by the following symptoms:
- pain in the head;
- appearance of seizures of epileptic etiology;
- increased pressure inside the skull;
- intoxication of the body, fainting.
Tomographic diagnostics is performed for differential diagnosis of adjacent conditions.
Symptoms
The manifestation of the disease depends on where it was formed. Metastases should be divided into brain and bone marrow.
Symptoms of brain metastases depend on the location of the focus, and on the rate of spread of cancer:
- If the formation occurred in the area where the nerve endings of the eye are located, then the patient has visual impairment.
- One of the main symptoms is considered to be pain in the head. Initially, it may appear with an uncomfortable position of the head. But over time, the tumor grows, painful sensations appear morebrightly and disturb the patient regularly.
- Motor activity is disturbed.
- The gait becomes uneven, the intellect is affected, and the very behavior of a person changes.
- May have seizures or signs of epilepsy.
- Dementia develops with multiple metastases.
- The patient may experience vomiting without any signs of nausea. This usually happens in the morning.
- If the frontal area is affected, then the activity of the musculoskeletal system is disrupted, the patient shows aggression.
- If the tissue around the malignant tumor near the temple swells, the patient has increased internal cranial pressure, headache, dizziness, vomiting, double vision occurs, the patient is depressed.
Mechanisms of brain metastasis
Metastasis is a very complex process that goes through several stages of development. First, cancer cells need to attach to the connective tissue, close to large veins and arteries, in order to actively feed and spread their influence throughout the body.
The second stage is the disclosure of pathological foci. They begin to grow actively, filling the free space and displacing he althy radicals. Part of the destructive elements finds additional places of settling and attachment (according to the principle of daughter and mother cells).
The third stage is considered the final one - it is marked by a rapid, intensive growth of the neoplasm, a violationmany mental functions, malfunction of other internal organs.
After overcoming the third, final stage, the patient is diagnosed with "4th stage of brain cancer", in which almost nothing can be done. Even with a favorable outcome of the surgical operation, the degree of CNS damage is very high. The probability that intellectual abilities will return in full is zero. The residual effect of a deep lesion is a persistent neurological profile, malfunctions of many internal organs, and a short life expectancy.
Diagnosis
In order to detect metastases, the following studies are carried out:
- Magnetic resonance imaging, therapy.
- CT of the brain.
- They take a cerebrospinal fluid test.
- Echoencephalography.
- Electroencephalography, which helps identify abnormalities.
- A biopsy is performed in a secondary neoplasm by examining cells in tissues. With primary tumors, the metastases of which spread to the head, it also helps to explore the process. If there are suspicions of metastases in the spinal cord, then they resort to osteodensitometry and skeletal scintigraphy.
- Pathological examinations that help analyze if there are problems in speaking, writing, etc.
- Neuro-ophthalmic studies that show if there are changes in the fundus.
- Otoneurological examination of the auditory organ,vestibular apparatus and also on the sensors of taste and smell.
- Computed tomography, during which fluid is injected into the brain tissue.
- Laboratory analysis of CSF, where cerebrospinal fluid is examined.
Drug therapy
Drug treatment of brain metastases is combined with classical methods of therapy - chemical, radiation.
Depending on the formation of pathological focal changes, the patient may be prescribed:
- Hormone-active drugs that stabilize the production of biological agents and support the work of higher nervous activity.
- Antineoplastic antimetabolites. A cancerous tumor is a clot of connective tissue that is fueled by free he althy brain cells. To interrupt this process, antimetabolites are prescribed, medicinal substances that stop the blood supply to neoplasms and their growth. The most common of them are Ftorafur, Methotrexate, Hydroxyurea, Xeloda.
- Molecular blockers of a new type. Almost every year, pharmaceutical companies release more and more new drugs to stop cancer cells. And one of them are molecular blockers. These drugs can stop the growth of small-sized neoplasms for a fairly long period of a person's life.
Chinese drugs
Treatment with Chinese drugs is advisable for people who have a hugethe number of contraindications to the use of anticancer drugs. Chinese medicines made from natural ingredients help to get rid of multiple symptoms of brain cancer. The list of substances allowed for use is as follows: Fufang Banmao, Zhuhe San Jie Pian, Xiaoaiping or Anticancerlin. These drugs are quite effective in metastases of melanoma of the brain.
Surgical treatment
Delaying treatment when brain areas are affected by malignant tumors leads to the progression of the disease and death. Surgical treatment is carried out only in combination with chemotherapy and radiation therapy.
Using radiosurgical removal techniques
"Gamma Knife". Surgical intervention "Gamma Knife" is a modern way to remove areas affected by metastases. The size of the tumor with brain metastases can be from four to five centimeters, and the number of lesions from three to six, the use of this method contributes to the deep and thorough removal of all formations.
Surgical intervention is performed in the presence of a single focus of localization, while the entire part of the neoplasm is subject to removal, which helps prevent the reappearance of the tumor and will significantly alleviate the pathogenic symptoms of the patient.
Surgical intervention involves the introduction through the artery of drugs containing a substance that prevents the appearance and developmentneoplasms of a malignant nature, and then the introduction of implants with a radionuclide into the thickness of the tissue. This avoids trepanation of the skull for manipulation.
Radiation therapy for brain metastases
Radiation therapy in cancer centers has become very popular and is an effective method of fighting for the life and he alth of the patient.
Radiation therapy for metastases is used on a small neoplasm (up to twenty millimeters) and located in such a way that there is a chance to bring a linear accelerator without causing any harm to good tissue radiation. The ionizing beam is able to destroy the metastatic cancer cell, but also provide maximum protection to the he althy cell. Irradiation of a cancer tumor with brain metastasis can last five to thirty-five times with a duration of half an hour. With this particular radiation, it is necessary to ensure the absolute immobility of the patient; for this purpose, an individual fixing device (thermoplastic mask and vacuum mattress) is used. In combined treatment, cyberknives are used for metastasis, radiation IMRT therapy using Electa Synergy linear accelerators.
The general exposure rate is thirty to thirty-five dimensions (fourteen fractions are used - two and a half dimensions each or three whole dimensions each - ten fractions). This method is used to reduce the likelihood of radiation complications.
Prognosis for brain metastases
A patient with a tumor in the brain and his relatives are worried about how long a person can live with such a disease.
This question is quite difficult to answer as the answer depends on many factors such as:
- Age of the patient.
- Type of tumor disease.
- How many foci of infection are there and so on.
If the brainstem, cerebellum is affected, then the result for such a patient is disappointing. If there are many foci and the tumor is aggressive, then the life expectancy for brain metastases is two weeks. If the metastases were eliminated, then the chance for life is given much more than in the first case.
