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Metastatic Brain Tumors

‘Metastasize’ means to spread, grow or change form. In pathology (the science of disease), ‘metastasize’ describes the spread of cancer cells from the primary site of the disease to other parts of the body.  From primary sites such as the lungs, breasts, kidneys, bladder or skin, tumor cells can spread via the circulatory system (or, in the case of leukemia and lymphoma, can originate within it) to the brain.

Metastatic brain tumors (also referred to as brain metastases, secondary brain tumors or metastasis to the brain) are the most common type of brain tumor in adults. The majority of them are discovered after the primary cancer has already been diagnosed, when a cancer patient first experiences neurological symptoms and undergoes a CT or MRI scan. In rarer cases, a person with neurological symptoms (or requiring imaging for other medical reasons) and no history of cancer may undergo a brain scan that leads to the discovery of brain metastases. Over 80% of metastatic brain tumors arise as multiple lesions in the brain (with fewer than 20% manifesting as a single tumor), and over 80% of all lesions appear in the cerebrum (the uppermost, largest, most recently evolved part of the brain that receives the majority of blood flow).

The signs and symptoms of metastatic brain tumors are the same as any expanding intracranial (within the skull) lesion. They result from the pressure the metastases put on the surrounding tissue, from edema (fluid-based swelling) or from hemorrhage (bleeding). Symptoms vary based on the location of the tumor within the brain and include headaches, seizures, cognitive difficulties (loss of memory or changes in personality or behavior), weakness in an area of the body, decreased coordination or issues with vision, numbness, tingling or other sensation.

As cancer therapies have improved, an increasing number of cancer patients are living longer. Unfortunately, increased patient life expectancy gives cancer cells greater opportunity to spread from their primary sites, causing the incidence of metastatic brain tumors to rise as well. Thus, techniques for treating intracranial tumors, such as Gamma Knife radiosurgery, are vital components of the fight against cancer. Utilized by doctors at the Boston Gamma Knife Center at Tufts Medical Center to limit the growth of small or delicately situated metastases, Gamma Knife radiosurgery isn’t traditional surgery—no incisions are made. Instead, this state-of-the-art technology focuses 192 beamlets of gamma radiation on the tumor, delivering a high dosage at the site of convergence while saving the vital surrounding tissue from radiation’s harmful effects.

Doctors + Care Team

Carl B. Heilman, MD

Carl B. Heilman, MD

Title(s): Neurosurgeon-in-Chief; Chairman of Neurosurgery; Professor, Tufts University School of Medicine
Department(s): Neurosurgery
Appt. Phone: 617-636-5860
Fax #: 617-636-7587

Meningiomas, acoustic neuromas, skull base surgery, pituitary surgery, Chiari surgery

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John E. Mignano, MD, PhD

John E. Mignano, MD, PhD

Title(s): Radiation Oncologist; Clinic Director; Associate Professor, Tufts University School of Medicine
Department(s): Radiation Oncology, Pediatric Radiation Oncology
Appt. Phone: 617-636-6161
Fax #: 617-636-4513

Oncologic consultation for general radiotherapy and Gamma Knife, pediatric radiation oncology

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Julian K. Wu, MD

Julian K. Wu, MD

Title(s): Associate Chairman, Department of Neurosurgery; Chief, Division of Neurosurgical Oncology; Neurosurgery Residency Program Director; Professor, Tufts University School of Medicine
Department(s): Neurosurgery
Appt. Phone: 617-636-4500
Fax #: 617-636-7587

Neuro-oncology, Gamma Knife radiosurgery, meningiomas, pituitary tumors, gliomas, brain metastasis, trigeminal neuralgia

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Suriya Jeyapalan, MD, MPH

Suriya Jeyapalan, MD, MPH

Title(s): Neuro-Oncologist
Department(s): Neurology; Cancer Center
Appt. Phone:
Neurology: 617-636-5848
Hematology/Oncology: 617-636-6227
Fax #: 617-636-8199

Neuro-oncology, brain tumors, neurologic metastases

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Research + Clinical Trials


A Randomized, Placebo Controlled Phase 2b/3 Study of ABT-414 with Concurrent Chemoradiation and Adjuvant Temozolomide in Subjects with Newly Diagnosed Glioblastoma (GBM) with Epidermal Growth Factor Receptor (EGFR) Amplification (Intellance 1)

The main purposes of this study are to evaluate whether combining ABT-414 with usual RT and TMZ treatment controls GBM better than usual RT and TMZ without ABT-414, and whether ABT-414 makes patients live longer. This study will only include people whose tumors are tested and confirmed to have EGFR amplification.
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A221101: A Phase III Randomized, Double-Blind Placebo Controlled Study of Armodafinil (Nuvigil®) To Reduce Cancer-Related Fatigue in Patients with High Grade Glioma

The purpose of this study is to:  1) see if taking the study agent, armodafinil, at a dose of 150mg or 250mg, will improve problems with fatigue in subjects who have been diagnosed with cancer and are experiencing fatigue; and 2) see the effects (good and bad) of taking Armodafinil compared to placebo (an inactive agent) on cancer related fatigue. In this study, subjects will take either the study agent, armodafinil, or the placebo (inactive agent).  Subjects will not take both. Armodafinil (Nuvigil®) is a medicine that is currently FDA approved to promote wakefulness in people who have sleep disorders.   However, it is not been studied in people with cancer related fatigue.
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