Management of brain metastases has come a long way from even as short as five years ago. Improvements in neurosurgical techniques, advances in radiosurgery and also in systemic treatments mean that patients with brain metastases are surviving longer. However, this also means that these patients may also have to live longer with long-term complications of their treatments, such as hydrocephalus (depending on location of metastases and resection) and cognitive impairment from brain irradiation. In this talk, I will cover some of these complications, as well as some of the systemic treatments that are used in this setting.
However, there is no denying that overall this patient population have poorer prognoses and heavier symptom burden. Loss of independence and autonomy, whenever it may occur in their disease trajectory, is a terrible blow to every patient in this situation. The gradual loss of a patient’s mental capacity and personality as his or her disease progresses inevitably causes much grief and suffering to his or her family and friends. In this talk, I will present a couple of case studies and talk about how to manage symptoms that may be seen in patients specifically with brain metastases.