Lung Cancer Metastasis to the Brain: Symptoms, Diagnosis, Treatment, and Prognosis
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What to Know About Lung Cancer That Has Spread to the Brain

What to Know About Lung Cancer That Has Spread to the Brain
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Updated on June 18, 2025
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Lung cancer is one of the kinds of cancer that is most likely to spread to the brain. Approximately 20 percent of lung cancer patients develop brain metastases.

 And roughly 10 to 20 percent of people with non-small cell lung cancer already have brain metastases at the time of diagnosis, and up to 50 percent of them will eventually develop brain tumors over the course of the disease.

 While metastatic lung cancer can rarely be cured, improvements in the detection and treatment of brain metastases are allowing people to live longer, with a higher quality of life. Standard treatments for brain metastases, such as surgery and radiation, have gotten better and more precise. And newer, systemic therapies can also target brain metastases in many people.

Brain Metastasis

Lung cancer metastasis to the brain occurs when cancer cells break off from the tumor in the lungs and enter the bloodstream or travel through the lymph system to the brain, where they multiply.

 This type of tumor consists of lung cancer cells and is not considered brain cancer. Brain cancer originates in the brain and consists of brain cancer cells.

The specific location of these tumor cells in the brain determines which symptoms a person will likely experience, and it may also impact their treatment options.

Signs and Symptoms of Lung Cancer Metastasis in the Brain

As metastatic tumors in the brain grow, they can directly damage cells or affect the brain indirectly by compressing parts of it or causing swelling and increased pressure within the skull. Early warning signs can be subtle and may be attributed to other causes, including chemotherapy, says Jonathan Goldman, MD, a clinical instructor of hematology and oncology at UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles.

Illustrative graphic titled Signs and Symptoms of Lung Cancer Metastasis to the Brain shows Headaches Cognitive Problems or Memory Loss Personality or Behavior Changes Speech Problems Blurred Vision Balance Problems Nausea or Vomiting
Symptoms of brain metastasis can vary. It’s important to let your oncologist know right away if you consistently experience any of these symptoms.Everyday Health
Symptoms vary by where the metastases are in the brain, but they often include:

  • Headaches
  • Fatigue
  • Nausea or vomiting
  • Seizures
  • Blurred vision
  • Balance problems
  • Loss of sensation or weakness along one side of the body
  • Difficulty walking
  • Loss of coordination (such as reaching for a door handle and missing)
  • Speech problems
  • Cognitive problems or memory loss
  • Personality or behavior changes
If you consistently experience any of these symptoms, it’s important to alert your cancer care team as soon as possible. If you experience sudden signs of a stroke or seizures, seek emergency medical care.

Diagnosing Brain Metastasis

To diagnose brain metastases, your doctor will most likely perform a neurological exam (which may include checking your vision, hearing, balance, coordination, strength, and reflexes) and order a magnetic resonance imaging (MRI) scan of your head. An MRI can detect cancer and precisely identify the location and size of each brain lesion. An MRI uses magnets and radio waves to create images of your brain, and you might also have dye injected into your arm to help aid the imaging process.

Other imaging tests your doctor may use include positron emission tomography (PET) and computed tomography (CT) scans. A PET scan uses a small amount of radioactive tracer, which is injected into a vein. Cancer cells absorb a large amount of the tracer, which is detected on the scan.

 A CT scan creates many X-ray images as the machine scans around your body.

A biopsy may also be done to confirm the diagnosis and help determine the best course of treatment. Tumor tissue from the brain is removed either as part of a surgery to remove the tumor or during a procedure in which a small sample is taken with a needle. The tissue is then viewed under a microscope to determine whether it’s cancerous. If it is, the biopsy can also determine if it’s a primary or metastatic tumor.

Your doctor may also run blood tests to look for tumor markers. Depending on the results, you may be eligible for targeted treatments.

Treatment Options for Lung Cancer With Brain Metastasis

If diagnosed and treated early, brain metastases usually respond to therapy. Your treatment plan will depend on your tumors (size, number, location in the brain, and genetic characteristics), the extent of disease outside the brain, and your overall health.

Surgery

Surgery may be an option for people with only one or two brain metastases that are easy to access and remove. It may also work for people who have a larger tumor that’s causing compressive symptoms, in cases where removing even a portion of the tumor may help alleviate symptoms. Surgery is commonly followed by radiation therapy.

Radiation

Radiation therapy uses X-rays or other high-energy beams to kill cancer cells. Different methods of radiation are used to treat brain metastases.

People who have smaller tumors or ones that are either not surgically accessible or are too advanced for neurosurgery may be good candidates for stereotactic radiosurgery, in which MRIs, CT scans, and computer guidance are used to deliver large doses of radiation directly to tumors.

 “This approach can effectively treat metastases with little radiation exposure to other parts of the brain and with minimal side effects,” says Dr. Goldman.
If you have many tumors throughout your brain or a large tumor deep in the brain, your doctor may recommend whole-brain radiation, in which radiation is applied to the entire brain to kill tumor cells.

 “This method treats the whole area but, unfortunately, comes with more side effects, such as headache, fatigue, nausea, hair loss, and some slowed cognition,” says Goldman.

Systemic Therapy

With systemic therapies, such as chemotherapy, immunotherapy, and targeted therapy, drugs travel through the bloodstream to reach cancer cells throughout the body.

Because many chemotherapy drugs are unable to cross the blood-brain barrier — a network of capillaries that keeps certain substances from reaching the brain — targeted therapy is the primary form used to treat brain metastases.

Targeted therapies can identify and attack specific cancer cells with minimal harm to normal cells. For people with lung cancer cells that have specific mutations (such as EGFR and ALK), these therapies can be highly effective.

But if your lung cancer doesn’t carry these specific mutations or has spread elsewhere in the body, your doctor may consider other systemic therapies, such as immunotherapy (which uses medicine to activate your own immune system to recognize and kill cancer cells) or chemotherapy.

Palliative Care

This type of specialized medical care can include pain management, mental health counseling, spiritual support, and stress management techniques. It’s a key component of treatment for patients with metastatic lung cancer.

Palliative care can help mitigate the side effects of both the cancer and its treatment and significantly improve quality of life.

Prognosis and Outlook

After radiation, surgery, or systemic treatment for brain metastases, your doctor will most likely order an MRI to determine how much of the tumor is gone and then follow up with MRIs every few months.

The prognosis for people with lung cancer that’s metastasized to the brain is highly variable, so it’s important to keep in mind that statistics don’t necessarily describe your outcome. While the outlook was traditionally poor for people with lung cancer and brain metastases, advancements in treatment are continually improving survival rates.

Clinical trials are regularly being conducted to find ways to improve treatment for people with lung cancer that’s metastasized to the brain. Ask your doctor whether you may be a candidate for such a trial. You can also search for a clinical trial in your area at ClinicalTrials.gov.

“Brain metastasis has traditionally been an area that was difficult to study,” Goldman says. “But, thankfully, more and more studies are focused on exactly this problem.”

The Takeaway

  • Lung cancer that has metastasized to the brain is rarely curable, but there are many treatment options that can slow cancer growth and provide symptom relief.
  • Imaging tests, biopsies, and blood tests for tumor markers are used in the diagnosis process, and they may continue to be used afterward to monitor cancer progression.
  • Surgery, chemotherapy, radiation, and targeted therapies are common treatments for brain metastases.
  • New technologies and treatments are improving the outlook for people with brain metastases.

Resources We Trust

Additional reporting by Erica Patino.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Brain Metastasis From Lung Cancer. American Lung Association. October 1, 2024.
  2. Wang S et al. Lung Cancer With Brain Metastasis — Treatment Strategies and Molecular Characteristics. Journal of Clinical Medicine. December 3, 2024.
  3. Brain Metastases. Cleveland Clinic. April 16, 2024.
  4. Brain Metastases: Symptoms and Causes. Mayo Clinic. November 20, 2024.
  5. Metastatic Brain Tumors. Cleveland Clinic.
  6. Brain Metastases: Diagnosis and Treatment. Mayo Clinic. November 20, 2024.
  7. PET Scan. Cleveland Clinic. October 19, 2022.
  8. CT (Computed Tomography) Scan. Cleveland Clinic. June 13, 2023.
  9. Nelson TA et al. Targeting Lung Cancer Brain Metastases: A Narrative Review of Emerging Insights for Anaplastic Lymphoma Kinase (ALK)-Positive Disease. Translational Lung Cancer Research. February 3, 2023.
  10. What Is Stereotactic Radiosurgery? Memorial Sloan Kettering Cancer Center.
  11. Myall NJ et al. Management of Brain Metastases in Lung Cancer: Evolving Roles for Radiation and Systemic Treatment in the Era of Targeted and Immune Therapies. Neuro-Oncology Advances. November 27, 2021.
  12. Supportive Care. Memorial Sloan Kettering Cancer Center.
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Conor E. Steuer, MD, is medical oncologist specializing in the care of aerodigestive cancers, mesothelioma, and thymic malignancies and an assistant professor in the department of hematology and medical oncology at the Emory University School of Medicine in Atlanta. He joined the clinical staff at Emory's Winship Cancer Institute as a practicing physician in July 2015. He currently serves as chair of the Lung and Aerodigestive Malignancies Working Group and is a member of the Discovery and Developmental Therapeutics Research Program at Winship.

Dr. Steuer received his medical degree from the New York University School of Medicine in 2009. He completed his postdoctoral training as a fellow in the department of hematology and medical oncology at the Emory University School of Medicine, where he was chief fellow in his final year.

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Steuer's work has been published in many leading journals, such as Cancer, the Journal of Thoracic Oncology, and Lung Cancer, and has been presented at multiple international conferences.

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