Stereotactic Radiosurgery for Brain Metastases (Podcast)

Why it remains the mainstay for newly diagnosed metastases and tumors

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“Brain metastases are about 10 times more common than primary brain tumors in adults, so it is really important that medical oncologists and primary care doctors are tuned into the possibility of their patients with cancer developing brain metastases,” says neurosurgeon Gene Barnett, MD, MBA, Director of Cleveland Clinic’s Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center. “The treatment options are better if we get to these metastases when they are smaller and/or asymptomatic.”

One treatment option is stereotactic radiosurgery, a minimally invasive intervention that uses targeted radiation beams to treat brain tumors and other abnormalities. In a recent episode of Cleveland Clinic’s Cancer Advances podcast, Dr. Barnett discusses the evolution of traditional surgical approaches for treating patients with brain metastases and the ability of stereotactic radiosurgery to deliver superior outcomes. He provides insight on the following:

  • Presenting symptoms of brain metastases
  • The range of treatment options, from surgical interventions to medication and radiation therapies
  • A step-by-step look at the stereotactic radiosurgery procedure
  • The emergence and promising results of neoadjuvant stereotactic surgery
  • The importance of combining systemic therapies with radiosurgery for tumor control

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt.

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Excerpt from the podcast

Podcast host Dale Shepard, MD, PhD: What does [stereotactic radiosurgery] look like from a patient perspective, in terms of what their experience is as they undergo the treatment and how well they’re likely to do? When I see patients in clinic and I tell them they have a lung met or a liver met, they’re not nearly as frightened as when I tell them they have a brain met. So how do we reassure patients?

Dr. Barnett: Well, I think that’s totally understandable because people understand the brain is who we are and allows us to do what we want to do. Many people know, or know of, people who have had brain tumors and have not done well. I think the point of reassurance is that we can actually do a really good job of controlling brain metastases these days with radiosurgery, to the extent that most people who have brain metastases don’t die from them — rather, they die of their systemic disease and their brain disease is under control. For the vast majority of brain metastases, the control rate is upwards of 90% to 95%. And with the staged technique, the control is typically durable. So, I think that giving patients the facts should be consoling. You don’t want to sugarcoat things, but the facts are that the outcome is actually probably a lot better than what they were thinking.