diagnosing and treatment of primary brain tumor like glioblastoma and brain metastases

2. Brain metastases: cancer that started elsewhere in the body (e.g. lung or breast) and spread to the brain Brain primary: a normal brain cell (glial cell) becomes malignant and is called a glioma

3. Brain Function

9. The most common causes of brain metastases in adults with their approximate frequency are: Lung — 50 percent Breast — 15 to 20 percent Unknown primary 10 percent Melanoma — 10 percent Colon and rectum 5 percent The distribution of metastases roughly follows the relative weight of and blood flow to each area. Cerebral hemispheres — 80 percent Cerebellum — 15 percent Brain stem — 5 percent

10. SYMPTOMS OF BRAIN METASTASES Symptom Patients % Headache 42 Focal weakness 27 Mental change 31 Seizure 20 Gait ataxia 17 Sensory disturbance 6 Speech problems 10

11. Brain Imaging

12. Whole brain irradiation

13. Whole brain radiation

14. The response or benefit from whole brain radiation takes several weeks to months

15. Typical response for whole brain radiation

16. Typical response for whole brain radiation

17. Typical response for whole brain radiation Small tumors may be gone completely by two months

18. Radio resistant cancer (renal cell) MRI appearance two months after whole brain radiation (small lesions gone and large lesion much smaller)

19. Cyberknife Radiosurgery for Brain Metastases

21. Typical time interval to regression after radiosurgery Cyberknife or Gamma Knife)

24. Radiation prescription for # Diagnosis: # External radiation: # Internal radiation: #