Current Perspectives in the Management of Brain Metastases

Abstract

Brain metastases (BMs) are diagnosed in 10%-40% of all patients with cancer, and the incidence continues to increase along with the number of long-term survivors. When BMs occur, they are often associated with a myriad of symptoms, including neurologic dysfunction and functional decline; both are difficult to manage and can be distressing for patients and their caregivers. Although clinically significant findings have not kept up with the rapid pace of scientific breakthroughs in understanding the mechanisms of BMs, novel approaches that affect the prognosis of patients with BMs have been introduced in clinical practice. At a Glance • Screening for brain metastases (BMs) is not routinely performed in patients with no neurologic symptoms. However, screening is indicated in lung cancer and possibly in the context of high-risk cancers. • Individual differences in patients warrant a personalized approach in the management of BMs. • Whole brain radiation therapy and steroids are considered to be the cornerstones of treatment for BMs.

Anxiety and Depression Associated With Burden in Caregivers of Patients With Brain Metastases

“…Distinctive characteristics of brain metastases shape the nature of the caregiving experience. Brain metastases symbolize the beginning of the terminal phase of cancer, which is often marked by progressive focal neurologic deficits and the presence of symptoms that can lead to profound psychosocial distress for the care recipient and the caregiver (Argyriou et al, 2006;Dhandapani et al, 2015;Saria et al, 2015). Cancer caregiving has been shown to increase burden, a concept frequently used in caregiving research, either as a dependent or independent variable that is often operationalized as stress, distress, or strain (Chou, 2000).…”

Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping

“…The rise in the prevalence of cancer consequently increases the population at risk for developing brain metastases, with the reported annual incidence estimated between 98,000 and 170,000 [2][3][4]. Brain metastases can lead to rapid deterioration in quality of life (QOL) brought on by progressive neurologic deficits which can be a daunting challenge for family caregivers [5]. Neurologic deficits that may be manifested as cognitive impairment may contribute to the challenges faced by caregivers of patients with brain metastases.…”

The effect of time delay for magnetic resonance contrast-enhanced scan on imaging for small-volume brain metastases

“…Brain metastases (BM) are the most common intracranial tumours in adults, accounting for up to 80 % of primary tumours in patients with BM from lung cancer, breast cancer, and melanoma ( Sacks and Rahman, 2020 , Kim and Kim, 2021 , Jablonska et al, 2022 ). Recently, the incidence of BM has increased due to improvements in tumour treatment efficacy and prolonged patient survival ( Saria et al, 2015 ). Approximately 30 %-50 % of patients with BM die of uncontrolled and recurrent intracranial lesions, and BM has become the main cause of death in patients with malignant brain tumours ( Achrol et al, 2019 ).…”