Brain Metastases Clinic

What We Do

The Brain Metastases Clinic is dedicated to managing brain metastases. Cancer experts on your team work closely with you to ensure you get the best care possible. 

• See also: CNS Site Group at Princess Margaret Cancer Centre​​

About Brain Metastases

Brain metastases are tumours that form in the brain when cancer cells spread there from another place in the body. For example, take a patient with lung cancer. If cancer cells spread to the brain from the lung(s), the tumours are known as brain metastases. Many types of cancer can spread to the brain. The most common cancers that spread to the brain include lung, breast, melanoma (skin), kidney, and colon cancers.

• Note: Brain metastases (sometimes called "brain mets") are different than brain cancers that start in the brain ("primary brain cancer"). Treatment for cancer that starts in the brain is different from treatment for brain metastases.

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What to Expect

Brain Metastases

Treatment for brain metastases can include many areas of medicine. For this reason, you will meet a few types of health care team members, including:

• Neurosurgeons (brain and spine surgeon)
• Radiation oncologists (cancer doctor who helps provide radiation treatment)
• Nurses
• Radiation therapists

Your health care team works with your medical oncologist (cancer doctor) to talk about treatment options for your brain metastases.

Your health care team plans your treatment for brain metastases to work with any other treatments you may be getting.

Your health care team at the Brain Metastases Clinic has a team approach. This means you may see different doctors and specialists each time you visit the clinic. But all of the clinic's doctors will know about your unique case and health history. The team members review your files as a group before each of your visits.

Clinical Trials: There may be options for brain metastases patients to take part in clinical trials in this clinic. Please ask a member of your care team if you are interested in hearing more about clinical trials.

​Patient Resource Guide

The Team

Treating and caring for people with cancer takes a well-coordinated team. Your team at the Brain Metastases Clinic is made up of world-class medical professionals working for you and with you. Your team includes neurosurgeons, radiation oncologists, nurses, radiation therapist and many others dedicated to helping you and your family.

Leadership

How to Get Referred

​You need a referral from your doctor to become a patient with the Brain Metastases Clinic.
Download the Brain Metastases Clinic referral form [PDF, opens in new window] »

When making a referral, your doctor will include:

• A letter of referral
  
• Patient demographics (full name, gender, address with postal code, telephone number, health card number)
• Pathology reports
• Surgical reports
• Previous radiation reports
• Most recent clinical notes
• Most recent brain diagnostic imaging reports (within one month of referral)
• Most recent brain diagnostic imaging films sent to: 700 University Ave – Toronto, ON M5G 1X6 – DRO 7^th floor, Attention: Brain Metastases Clinic Coordinator

How Long Does a Referral Take?

We try our best to see you within a week of your referral. This may sometimes be delayed to coordinate your care with your other treatments. There may also be a delay to ensure that we have all your information (including brain imaging) for your consultation.

Usually the doctor who referred you to the Brain Metastases Clinic will contact you with your appointment time.

Please call the doctor’s office if you do not receive information about your appointment within a week.

Referral Information for Physicians

Your doctor can get the necessary referral information in our guide for physicians referring to the Brain Metastases clinic »

Treatment for Brain Metastases

The treatment recommended by your health care team is planned just for you. The type of treatment you get is based on:

• The type of primary cancer (place in the body where the brain metastases have spread from)
• The number of brain metastases found
• The size and place of your brain metastases
• The kind of symptoms you have
• How well controlled the primary cancer is in the rest of your body

Treatment can involve one or more of the following:

• Surgery to remove the tumours
• Radiation treatment (to the whole brain)
• Radiosurgery (or Gamma Knife surgery)
• Medical treatment (like chemotherapy, targeted drugs, immune therapy)

The use of chemotherapy in helping treat brain metastases is changing. New targeted chemotherapy drugs are being made and can be useful in the treatment of some brain metastases.

Read Know About Brain Metastases and Treatment (PDF) for more details on each treatment option.

What to Expect with Radiosurgery

Your treatment can involve radiosurgery (also called Gamma Knife surgery). The videos below can help you learn what to expect when having radiosurgery.

After Treatment

After your first treatment, you will return to Princess Margaret's Brain Metastases Clinic for ongoing follow-up. Your first follow-up appointment will be 2 to 4 months after you finish treatment.

Your follow-up visit will involve:

• Repeated brain imaging (pictures of the brain). This will include:
  • MRI Scan
  • CT scan if you are not able to have an MRI scan
• Clinic appointments to meet with your radiation oncologist and/or neurosurgeon

You will do follow-up imaging of your brain and visit with your health care team every 2 to 4 months. This time frame can change based on your symptoms and overall cancer care.

In some cases, your brain imaging may get booked after your clinic appointment. If this happens, call 416 946 2901 so that the clinic can re-book your appointments.

If you live far from Princess Margaret, your team can work to schedule follow-up brain imaging closer to your home.

Leptomeningeal Disease

Leptomeningeal disease occurs when your cancer has spread to the meninges. The meninges line the spinal cord and brain. If you would like to learn more about Leptomeningeal Disease, you can read the brochure 'Learn about leptomeningeal disease' in the Patient Resource Guide and watch the video below.