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  • Writer's pictureGregory Cannarsa, MD

Treatment Options for Brain Metastases: A Comprehensive Guide

Brain metastases are a significant medical concern and present unique challenges to healthcare professionals. They occur when cancer cells spread from their original site to the brain. If you or a loved one is dealing with brain metastases, it's essential to understand the various treatment options available. In this post, we will explore the most effective therapies for managing brain metastases.

1. Surgery

For patients with limited brain metastases, surgery might be the best course of action. The procedure aims to remove the tumor and alleviate symptoms. Advances in neurosurgery have made minimally-invasive "keyhole" approaches safer and effective, avoiding large incisions and long recovery times in the hospital. As well, I avoid using staples for skin incisions and instead use all absorbable sutures, so that nothing needs to be removed. The focus of surgery is to be as least disruptive as possible and set the patient up for the best and most rapid recovery possible.

2. Radiation Therapy

Radiation therapy is one of the most common treatment options for brain metastases. There are multiple types of radiation types and treatments available, but here I will give a brief description of two of the more well-known types.

Whole-Brain Radiation Therapy (WBRT): This method delivers radiation to the entire brain and is often used when multiple metastases are present. WBRT has become less favored due to the effects on the normal, unaffected brain.

Stereotactic Radiosurgery (SRS): A targeted approach, SRS delivers high doses of radiation to the tumor itself, sparing healthy brain tissue. Both neurosurgeons at Apex Brain & Spine are certified in Stereotactic Radiosurgery, in cooperation with nearby Radiation Oncologists in Naples, Florida.

The choice between these two will depend on factors like the number and location of metastases, but, currently, SRS can be used for metastases even when they are already numerous.

3. Chemotherapy

Chemotherapy can be employed, but it's worth noting that many chemotherapy drugs cannot cross the blood-brain barrier. However, some specially formulated drugs can be effective in treating brain metastases and might be combined with other therapies. Medical Oncologists are physicians who specialize in management of this type of therapy.

4. Targeted Therapy and Immunotherapy

Targeted Therapy: By targeting specific genes or proteins within cancer cells, this therapy can effectively treat tumors with known mutations.

Immunotherapy: This innovative treatment boosts the body's immune system to recognize and attack cancer cells. Similar to chemotherapy, Medical Oncologists are physicians who specialize in management of this type of therapy.

Both of these therapies have been promising in treating brain metastases in specific cancer types.

5. Supportive Care

Palliative care focuses on improving the patient's quality of life by managing symptoms and side effects. Medications for pain, steroids to reduce swelling, or antiseizure drugs might be prescribed.


The treatment of brain metastases is a complex process that requires a tailored approach. Collaborative care involving oncologists, neurosurgeons, radiation oncologists, and other healthcare professionals is essential for optimal outcomes.

If you or a loved one is facing brain metastases, it's crucial to consult with a specialized healthcare provider like a neurosurgeon to understand the best treatment plan. There are more options than ever for treating brain metastases, and continued research is expanding these possibilities.

For more information or to schedule a consultation with at our office in Naples, Florida, please contact us today at 239-422-2739.

Dr. Gregory Cannarsa is a Fellowship-trained Neurosurgeon who practices in Naples, Florida.


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