Brain metastases are cancers that have spread to the brain from somewhere else in the body, most often from the lung, breast, melanoma, kidney or colon. They are about ten times more common than cancers that start in the brain. Headaches, seizures, weakness, vision changes or confusion can be signs, and an MRI scan finds them best. A diagnosis of brain metastases once meant only months to live. Today, precise radiation, surgery and drugs that cross into the brain allow many people to live for years. This article explains the options and the integrative research.
Precise Radiosurgery Instead of Whole-Brain Radiation
Stereotactic radiosurgery focuses many thin beams of radiation precisely on each tumor, sparing the healthy brain around it. In the Japanese JLGK0901 study of 1,194 patients, people with five to ten brain metastases treated with radiosurgery alone lived as long as people with two to four, showing that radiosurgery can treat more tumors than once thought.1 Avoiding whole-brain radiation matters, because in an American trial, radiosurgery alone caused much less decline in memory and thinking than radiosurgery with whole-brain radiation.2
Protecting memory when whole-brain radiation is needed. Shielding the hippocampus, the brain’s memory center, and taking the dementia drug memantine during treatment reduced memory and thinking problems in the NRG Oncology CC001 trial.3
Surgery
A single large metastasis, or one causing pressure or swelling, is often removed surgically, followed by radiosurgery to the area where it was.
Drugs That Now Reach the Brain
For years, most cancer drugs could not cross the blood-brain barrier. Many newer drugs can.
Lung cancer. Osimertinib for EGFR-mutated lung cancer and lorlatinib for ALK-positive lung cancer control brain metastases in most patients and often prevent new ones. See our article on lung cancer.
HER2-positive breast cancer. In the DESTINY-Breast12 trial, led by Nadia Harbeck of Ludwig Maximilian University in Munich, trastuzumab deruxtecan shrank brain metastases in about seven in ten patients.4 Tucatinib also helps. See our article on HER2-positive breast cancer.
Melanoma. In the CheckMate 204 trial, nivolumab with ipilimumab controlled brain metastases in about half of patients without symptoms, and many were still alive years later.5 See our article on melanoma.
Because brain metastases can differ genetically from the original tumor, testing tissue removed from the brain, or spinal fluid, can reveal new targets. See our articles on tumor DNA and RNA sequencing and preventing metastasis.
Integrative Research in Brain Metastases
Boswellia for brain swelling, from Germany. Swelling around brain tumors is usually treated with steroids, which have many side effects. In a German placebo-controlled trial at the University of Freiburg of people receiving radiation for brain tumors, Boswellia serrata, frankincense, reduced brain swelling by more than 75 percent in 60 percent of patients, compared with 26 percent with placebo, which may reduce the need for steroids (Kirste and colleagues, Cancer, 2011).
Melatonin, from Italy. In an Italian randomized trial of 50 people with brain metastases from solid tumors, those given melatonin with supportive care were significantly more likely to be alive at one year and had less disease progression than those given supportive care alone (Lissoni and colleagues, Cancer, 1994). The trial was small. See our article on melatonin.
These are some of the natural and integrative options studied in brain metastases, and others have promising research as well. Which may fit your situation depends on your tumor testing, your current treatment and possible drug interactions. In a consultation, Dr. Silver, MD, educates you on these options and the research behind them. Request a consultation.
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Frequently Asked Questions
What are brain metastases?
Cancer that has spread to the brain from another part of the body, most often from the lung, breast, melanoma, kidney or colon.
Is whole-brain radiation still needed?
Much less often. Precise radiosurgery can treat many tumors while sparing memory, and Japanese research showed it works for up to ten metastases.
Can drugs treat brain metastases?
Yes. Targeted drugs such as osimertinib, lorlatinib and trastuzumab deruxtecan, and immunotherapy for melanoma, now cross into the brain and control many brain metastases.
Can Boswellia help with brain swelling?
In a German placebo-controlled trial, Boswellia serrata reduced swelling around brain tumors during radiation in most patients, which may reduce the need for steroids.
About the author. Dr. Silver, MD, graduated from Temple University School of Medicine, trained as an interventional cardiologist, and has practiced medicine for nearly fifty years. A lymphoma survivor of about twenty-five years, he is co-author, with Dr. Lindmeier, DHSc, of The New Reality of Cancer: The Science of Recovery. Read more about Dr. Silver, MD.
Research by Dr. Lindmeier, DHSc, cancer educator and co-author of The New Reality of Cancer.
This article is for general education only and is not individual medical advice. Always consult your own doctor before making any changes to your care.
© 2026 Lovely LYF LLC. All rights reserved. This article draws on the research in The New Reality of Cancer and may not be copied, republished or distributed without written permission.
For more in-depth information on this topic and many others, get our book, The New Reality of Cancer: The Science of Recovery.
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References
- Yamamoto M, Serizawa T, Shuto T, et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. The Lancet Oncology. 2014;15(4):387–395.
- Brown PD, Jaeckle K, Ballman KV, et al. Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases. JAMA. 2016;316(4):401–409.
- Brown PD, Gondi V, Pugh S, et al. Hippocampal avoidance during whole-brain radiotherapy plus memantine for patients with brain metastases (NRG Oncology CC001). Journal of Clinical Oncology. 2020;38(10):1019–1029.
- Harbeck N, Ciruelos E, Jerusalem G, et al. Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases (DESTINY-Breast12). Nature Medicine. 2024.
- Tawbi HA, Forsyth PA, Hodi FS, et al. Long-term outcomes of patients with active melanoma brain metastases treated with combination nivolumab plus ipilimumab (CheckMate 204). The Lancet Oncology. 2021;22(12):1692–1704.
This article is for education only. It is not medical advice and does not diagnose or treat any condition. Cancer Expert MD has no financial relationship with any laboratory, drug maker, supplement company, clinic or hospital.
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