Battling Brain Metastases: Whole-Brain Radiation vs. Gamma Knife

For many years, whole-brain radiation was a mainstay in treating brain cancer metastases — when cancer from another area of the body, such as lung cancer, breast cancer or melanoma, spreads to the brain. Because the long-term survival rates were generally poor, the long-lasting treatment side effects of whole-brain radiation, like memory loss, lack of coordination and loss of urinary control, weren’t likely to impact whether someone pursued this treatment option. Additionally, tumors were sometimes too large or numerous to be treated with alternative methods like stereotactic radiosurgery, which includes Gamma Knife treatment.

Advances in Cancer Diagnosis and Treatment

Today, cancer survival rates and outcomes are improving. Why? Two reasons: Technological advancements are enabling physicians to detect tumors earlier (when they’re smaller), and cancer treatments have advanced. While this is great news in the fight against cancer, it also means that longer-term side effects of treatment have a greater impact on the treatments chosen. For this reason, recent studies have highlighted the diminishing role of whole-brain radiation, instead supporting the use of stereotactic radiosurgery, such as Gamma Knife.

Gamma Knife uses targeted radiation to help spare healthy tissue, preserve cognitive function and alleviate brain tumor symptoms. In contrast, because whole-brain radiation treats the entire brain, its cognitive side effects make it a less favorable choice when the patient’s prognosis is good. In addition, recent studies have found stereotactic radiosurgery without whole-brain radiation therapy effective for patients with up to 10 metastatic lesions. It’s also been reported that stereotactic radiosurgery has a better outcome compared to whole-brain radiation therapy alone. That’s why it’s important to explore all available options when considering treatment for brain metastases.

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