Treatment for brain metastases focuses on easing symptoms, slowing tumor growth, and helping patients live longer, sometimes with durable cancer control. While treatment can be effective, some tumors may come back over time, so your care team will monitor you closely. Your treatment plan will be based on many factors, including the type, size, number, and location of the tumors, as well as your overall health, symptoms, and personal goals. Specialists from Brigham and Women’s Hospital and Dana-Farber Cancer Institute — including neuro-oncologists, neurosurgeons, radiation oncologists, and other experts — work together to create a plan that’s tailored just for you.
We take a personalized and team-based approach to your care. Treatment decisions may depend on where your cancer started, as different cancers respond to different treatments. For example, immunotherapy may be used for metastatic melanoma, targeted therapies may be used for mutated lung cancer, and hormone therapy may be used for breast cancer. Our team takes part in leading-edge research to bring the latest treatment options to our patients.
The Brain Metastases Program at Dana-Farber Brigham Cancer Center is one of the most comprehensive in the country, offering advanced treatment options and a patient-centered approach. As part of the Center for Neuro-Oncology, we combine the expertise of Brigham and Women’s Hospital and Dana-Farber Cancer Institute to deliver seamless, coordinated care. You may have appointments at both Brigham and Women’s and Dana-Farber, which are connected by a bridge, so you won't need to go outside when moving between buildings. Throughout your care, we will include you and your family in every decision, and we encourage you to ask questions and share your goals at any time.
Learn more about treatment related questions for metastatic brain cancer.
When surgery is needed to treat brain metastases, our expert neurosurgeons at Brigham and Women’s Hospital use the most advanced technologies available. The goal of surgery is to safely remove as much of the tumor as possible while protecting healthy brain tissue. This can help relieve pressure inside the skull—called "mass effect"—which is often the cause of symptoms like headaches, confusion, or trouble with movement or speech. Some patients may start to feel better within hours of surgery.
Doctors usually recommend surgery when the tumor is causing symptoms, the primary cancer is under control, and the tumor can be removed without harming important areas of the brain. Brain surgery is performed by a neurosurgeon with a team of trained medical experts, including an anesthesiologist who makes sure you are comfortable and pain-free during the procedure.
To make brain surgery safer and more accurate, your care team may use several advanced techniques:
One of the most advanced tools we use is the AMIGO Suite (Advanced Multimodality Image-Guided Operating Suite) at Brigham and Women’s Hospital. This special operating room combines surgery and imaging in the same space. It includes real-time MRI scanning, which lets the neurosurgeon see the tumor clearly while operating. The ability to take new MRI images during surgery helps the surgeon remove more of the tumor with greater precision and safety. It also helps lower the risk of damaging healthy brain tissue. The AMIGO Suite is one of only a few like it in the world and offers patients access to some of the most precise and personalized brain cancer surgery available. It’s one of the many ways we’re working to improve outcomes and provide leading-edge care for people with brain metastases.
Before surgery, patients with brain metastases will meet with their care team at the Hale Building for Transformative Medicine. During this appointment, important pre-operative tests will be done, and patients will receive instructions to help them prepare for the procedure. This is a good time to ask questions and make sure you understand what to expect. Planning ahead is important—be sure to arrange transportation to and from the hospital and prepare for recovery at home. A social worker is available to help with post-surgery care planning if needed.
On the day of surgery, a specialized team—including neurosurgeons, anesthesiologists, and nurses—will provide expert care in the operating room. After surgery, patients are moved to a post-surgical care unit where they are closely monitored by experienced staff. The length of the hospital stay depends on the type of surgery and how each person recovers, but most people who have a craniotomy stay in the hospital for a few days.
Recovery time after surgery for brain metastases varies based on the type of procedure and the individual patient. Common symptoms include fatigue and soreness at the incision site. Patients should avoid strenuous activities at first and will receive guidance on pain management from their care team. When it's safe to return to daily routines, including work, will depend on how the patient is feeling and their surgeon’s advice. The care team will stay in close contact to support each patient through recovery.
Some patients may benefit from neurological rehabilitation after surgery to help restore function and improve their quality of life. Rehab programs focus on managing symptoms, strengthening physical abilities, and helping patients regain independence.
The NeuroRecovery Clinic at Brigham and Women’s Hospital provides personalized support for patients recovering from brain metastasis surgery. Our team includes experts in physical medicine and rehabilitation, who work together to create a care plan that promotes healing, improves function, and supports a return to everyday life. We use the latest research and treatment approaches to help patients rebuild confidence and regain independence as they move forward in recovery.
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