Understanding Brain Metastases Surgery vs. Gamma Knife Radiosurgery

While Gamma Knife radiosurgery is a minimally invasive treatment option available for brain metastases, many patients still choose traditional surgery. Below, we’ll detail what you should expect during recovery, as well as the risks and side effects associated with brain metastases surgery.

  • Brain metastases surgery happens in a hospital and requires a stay of approximately three days.
  • Expect activity restrictions for 4-8 weeks following brain metastases surgery.
  • Risks and side effects include reactions to anesthesia, bleeding, pain, infection and neurological deficits.
  • Minimally invasive treatment options (like Gamma Knife radiosurgery) are available to patients in the tri-state area as an alternative.

Brain Metastases Surgery and You

Learning you have metastatic brain cancer can be hard to process. Taking the time to understand more about your condition and treatment options is a great way to provide peace of mind, helping reduce some of the stress you may be feeling. Developing your knowledge and becoming familiar with the terminology will help you in conversations with your medical team and allow you to play a more active role in your care.

The following information will help you better understand brain metastases surgery, including what to expect during the recovery period and the risks and side effects of the procedure. This information can be helpful whether you are still in the treatment planning phase or already have surgery scheduled.

Overview of Brain Metastases

Brain metastases differ from other brain tumors because they arise from sites outside of the brain, such as the lung or breast. That means they are secondary tumors, as opposed to primary brain tumors like glioma. Sometimes, doctors discover them before the primary cancer, and you may need to undergo a biopsy to determine the origin of your brain metastases. Your doctor will make treatment recommendations based on the type of cells present, as well as the size and location of your tumor, how many tumors you have and your health factors.


Not all patients will require brain metastases surgery. However, your doctor may recommend surgery if:

  • Your tumor is in an accessible area.
  • You are a good surgical candidate.
  • Your tumor is large, and doctors can’t treat it by other methods alone.

Sometimes a doctor will only remove a portion of the brain metastases because complete removal risks damaging delicate structures. Even if your doctor is able to remove all of the metastases, you will still need to undergo radiation therapy to ensure all the cancer cells have been eradicated.

The Procedure

The surgery takes place in a hospital, and you will be asleep and comfortable through the entire procedure. The surgery involves two distinct steps. First, the neurosurgeon will perform a craniotomy, removing a small section of bone to provide access to your brain metastases. Once surgeons remove the metastases, they replace the bone and close the soft tissues with sutures or staples. The hospital will move you to the intensive care unit to begin your recovery when the procedure is complete.

Your Recovery

The initial stage of your recovery begins immediately following surgery. As you wake up from anesthesia, your care team will monitor your recovery in the recovery room. Once your vital signs stabilize, the hospital will transfer you to the ICU. You will spend a day or two in the ICU and spend the rest of your stay on a general floor. Most patients spend approximately three days recovering in the hospital following brain metastases surgery, though this will depend on your exact condition.

As you begin your recovery at home, you will be placed on activity restrictions, limiting things like exercise and lifting heavy objects. You may also have driving restrictions for some time, often between four to eight weeks, though, your recovery will be a very individual process.

Risks & Side Effects

Your doctor will consider all risks and side effects before recommending any treatment and only recommend surgery if the benefits outweigh the risks. Your doctor will discuss all risks and side effects related to your case during the treatment planning process. Risks and side effects to be considered include:

General surgical risks:

  • Complications from anesthesia/surgery (such as pneumonia or blood clots)
  • Bleeding
  • Infection
  • Pain

Brain metastases surgery risks:

  • Temporary or permanent neurological damage
  • Bleeding and blood clots, leading to stroke
  • Seizures
  • Local recurrence or recurrence distal to the operative site

Minimally Invasive Alternatives

In addition to surgery, there are minimally invasive treatments available for NJ patients with brain metastases. These include Gamma Knife radiosurgery and whole brain radiation therapy. Gamma Knife radiosurgery is an advanced form of radiation treatment that can destroy tumor cells with fewer side effects than whole brain radiation. Gamma Knife radiosurgery uses almost 200 individual beams of low-dose radiation, which combine to effectively treat cancer cells without damaging healthy tissues. Whole brain radiation, targets the entire brain and is typically used in select cases where Gamma Knife radiosurgery is impossible.

Many NJ patients who are candidates for surgery can also be treated using Gamma Knife radiosurgery. Your doctor will consider your specific condition and determine whether or not Gamma Knife radiosurgery would be an effective treatment option for your particular case. Gamma Knife radiosurgery can also be a great option for patients who are not eligible for surgery due to complicating health conditions or an inaccessible tumor.

The Right Treatment for You

Now that you have a deeper understanding of brain metastases surgery, it is important to continue the discussion with your personal doctor. They will be the best person to relate the information you have learned here to your specific condition. As you move through the treatment process, keep educating yourself and developing your understanding of your condition. Knowledge can promote calmness during a stressful time, helping you remain focused on the healing process when your body needs it most.

Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

Patient liaisons explain Gamma Knife surgery cost, outcomes, etc.