Life After Metastatic Brain Tumor

Subsequent treatment 

  • Treatment depends on the size and type of the tumor, from where in the body it spread, and your general health. The goals of treatment may be to relieve symptoms, improve functioning, or provide comfort. 
  • In hospital (chemo, radiation)
    • Radiation to the whole brain is often used to treat tumors that have spread to the brain, especially if there is more than one tumor. 
    • Surgery may be used when there is a single tumor and the cancer has not spread to other parts of the body. Some tumors may be completely removed. Tumors that are deep or that extend into brain tissue may be reduced in size (debulked). Surgery may reduce pressure and relieve symptoms in cases when the tumor cannot be removed. 
    • Chemotherapy for metastatic brain tumors is usually not as helpful as surgery or radiation. Some types of tumors, though, do respond to chemotherapy. 
    • Stereotactic radiosurgery may also be used. This form of radiation therapy focuses high-power x-rays on a small area of the brain. 
  • After discharge: 
    • Medicines for brain tumor symptoms include: 
    • Antacids or antihistamines to control stress ulcers 
    • Anticonvulsants such as phenytoin or levetiracetam to reduce or prevent seizures 
    • Corticosteroids such as dexamethasone to reduce brain swelling
    • Osmotic diuretics such as urea or mannitol to reduce brain swelling 
    • Pain medicines

Follow-up 

  • Brain metastases tend to recur so long-term follow-up examinations are advised.
  • Following surgery, an MRI scan is performed to determine the extent of tumor removal and to help plan further treatment. Repeat MRI scans are also done on an ongoing basis after radiation therapy and chemotherapy. 
  • Physical examinations are done frequently to detect tumor recurrence or side effects of treatment. It is important to report any new symptoms, such as headache, to your doctor right away, since they may indicate cancer recurrence or side effects of treatment. 
  • If your brain tumor recurs, or if other brain tumors are seen on subsequent scans, a new course of treatment will be planned for you. 
  • Treatment for a recurrent metastatic brain tumor begins with updated scans, an evaluation of the person’s overall health and the status of their primary cancer, and their response to previous treatments. Options may include another surgery, another course of radiation therapy, a different form of radiation therapy, a course of chemotherapy, or perhaps a clinical trial.

Providing support

  • When the cancer has spread, treatment may focus on relieving pain and other symptoms. This is called palliative or supportive care. 
  • Comfort measures, safety measures, physical therapy, occupational therapy, and other treatments may improve the patient's quality of life. Some people may want to seek legal advice to help them create an advance directive and power of attorney for health care. 
  • Integrative health care brings the physical, mental, emotional and spiritual components of health into the treatment plan, and beyond. Integrative therapies support the health and healing of the whole person. Treatment and supportive areas may include diet, exercise, stress reduction, lifestyle enhancements, massage, acupuncture, herbs, mind-body therapies and spiritual growth, among others. 

Emotional 

  • A brain tumor diagnosis can be frightening and confusing physically and emotionally, as well as financially. The confusion of a new diagnosis is overwhelming yet it is very important to gather all the information you can, organize it in your mind, and therefore be better able to effectively communicate with your caregivers. 
  • Knowing your potential plan of care allows you to organize your life, your thoughts and your means of support appropriately. It also helps to identify which questions to ask your caregivers. Your caregivers are your greatest source of support on every level and knowing that you can utilize them while feeling comfortable doing so is incredibly valuable. 
  • In addition to your direct care team (doctors, nurses, therapists) who are well equipped to meet many of your physical needs, YNHH has a Social Work Department. Your social worker will meet with you, upon request, to assist you in understanding your body and mind’s reaction to your diagnosis. He or she can help you identify areas in which you might need assistance and provide connections for the best type of support for you. 

Financial 

  • While our social workers are able to provide you with referrals for financial support YNHH also has a number of financial assistance programs. 
  • https://www.ynhh.org/patients-visitors/billing-insurance/financial-assistance.aspx 
  • Financial Assistance Programs
    • Yale New Haven Health understands that it can be difficult for some patients to afford paying their hospital bills. That is why we have a variety of financial assistance programs designed to help. Patients are required to complete a financial assistance application and provide requested documents to verify financial need. 
    • To learn more, obtain a free copy of our Financial Assistance Policy and application, or for help completing an application contact Patient Financial and Admitting Services or go to www.ynhhs.org/billpay or visit us in our Admitting offices at: Yale-New Haven Hospital 20 York Street, New Haven, CT; Bridgeport Hospital 267 Grant Street, Bridgeport, CT; or Greenwich Hospital, 5 Perryridge Road, Greenwich, CT. 
  • Free Care Program 
    • You may be eligible for free care if your family earns less than 2½ times the Federal Poverty Level, you apply for State Assistance (Medicaid) and receive a valid written decision from the State; and you complete a Yale New Haven Health financial assistance application. 
  • Discounted Care 
    • You may be eligible for discounted care if you do not have any type of health insurance and you complete a Yale New Haven Health financial assistance application. 
    • These programs cover medically necessary care and cover ONLY Yale-New Haven Hospital, Bridgeport Hospital & Greenwich Hospital bills. Patients eligible for financial assistance will not be charged more than the amount generally billed to patients with insurance for emergency or other medically necessary care. Yale New Haven Health will respond to each application in writing. If your application is rejected, you can re-apply at any time. Additional free bed funds become available every year. 
  • Financial Counseling 
    • Additional programs are available to help patients and families in need of financial assistance. We can often help you find out if you qualify for federal or state funds to cover your hospital costs. Our agency coordinators are also available to help patients apply for Medicaid benefits. Call to speak with or schedule a free, private and confidential appointment with one of our patient account representatives.