If left untreated, brain metastases is commonly associated with fatal results. It is a form of cancer which spreads to the brain from another location in the body. Symptoms are not usually obvious and can take the form of various common neurological conditions. In most cases, patients will not be aware of the cancer until it has already spread to the brain. While the diagnosis has a poor prognosis for cure, with the right treatment plan this condition can be a manageable one. The emergency nature of this requires rapid intervention to prevent further harm.
Our specialists use their expertise and experience to target the blood-brain barrier for the preservation of neurological and cognitive functions as well as the optimisation of brain control. A common treatment plan will use a combination of stereotactic radiosurgery, intra-operative navigational systems and new systemic agents. As with all other services, our overall aim is to improve our patient’s quality of life.
Patients with spinal metastases generally face several critical needs:
1) Pain control from the tumor invading into the spinal vertebral
2) Stability of the skeletal structure after the tumor had weakened the bony structure
3) Preservation of neurological function as the tumor often sits within small distances to the spinal cord and the spinal nerves.
Cord compression occurs when the tumor invades into the spinal canal and encroaches onto the spinal cord, leading to symptoms such as limb weakness or bladder and bowel disturbance. New advances in treatment strategies allow us to combine the expertise of each field to achieve the best results: Durable pain control, Durable tumor control, Spinal stability and Neurological Preservation.
Depending on the extent of the tumor, various modalities can be combined such as the use of spinal instrumentation to stabilise the spine; using minimally-invasive techniques, followed by radiosurgery ablation of the tumor. Such an approach allows the surgeon to minimize exposure and reduce the risk of operation and yet achieves tumor ablation through the use of stereotactic radiosurgery. Our specialists are all trained and experienced in the latest developments in these fields which have only emerged over the past decade.
The oligo-metastatic state is one whereby the tumor has already spread beyond the primary site of the cancer, but is limited to only a few sites, usually less than 5. This means that there is an intermediate state between localised cancer, and full-blown stage 4 cancer which invariably leads to death. Aggressive treatment of these sites with the use of ablative radiation therapy, surgery and chemotherapy may possibly lead to a cure for the patient.
This is significant for the treatment of cancer as patients with limited numbers of metastasis who were previously thought to be incurable by some clinicians might be cured with cancer treatments such as radiotherapy.
While it is still not possible to determine which of these patients may be totally cured, the specialised multi-disciplinary management of the oligometastatic patient utilising minimally invasive techniques such as stereotactic body radiation therapy and other ablative methods in conjunction with carefully selected systemic therapy will ensure that patients get the best chance with least side effects when doing so.
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