How serious is metastatic brain tumor

Lung metastases

Lung metastases usually show no symptoms as long as they are not very advanced. That is why the cancer specialists at the University Hospital Mannheim take the follow-up examinations for cancer diseases very seriously and regularly carry out comprehensive diagnostics for the spread of cancer. If the lungs are already damaged by metastases, patients often feel pain in the chest and suffer from an urge to cough with often bloody sputum. Pneumonia and shortness of breath can also indicate lung metastases.

Diagnosis of lung metastases

A chest x-ray will show if a possible ulcer in the lungs is calling for space. A lung function test checks whether the bronchial system is compromised. After inhaling an air mixture with metacholine, there is then an increase in airway resistance due to narrowing of the airways. If the lungs are healthy, the patient will not respond to this pulmonary function test. Further imaging procedures are often necessary to confirm the diagnosis and to plan therapy. With computed tomography (CT), magnetic resonance tomography (MRT), positron emission tomography (PET) or a combination of PET and CT, the radiologists at the Mannheim University Hospital can precisely record the location, size and number of lung metastases.

Laser surgery for lung metastases

With a precision laser, the surgeons at Mannheim University Hospital can operate on lung metastases in a particularly gentle manner. Because the laser removes the tumor cells with millimeter precision, more healthy lung tissue remains. As a result, the lung function is better preserved and this also improves the patient's quality of life after the operation. Thanks to the tissue-friendly laser technology, another operation on the lungs - if necessary - is easier. When using the precision laser, there is only very little blood loss, as the tissue closes again immediately.

An additional advantage is that the removed tumor tissue is retained and can be examined. With this high-quality tissue sample, the doctors can find the original tumor from which the lung metastases arose. As a result, the therapy for the original tumor can begin more quickly and in a more targeted manner, which has a positive effect on the course of the disease.

Surgery with CT for lung metastases (CATS)

An operation for lung metastases is most successful when the surgeon knows exactly where the individual metastases are in the lungs. Computed tomography (CT) is therefore essential before the operation. With CT-assisted thoracic surgery (CATS), however, patients do not need a separate appointment in the radiology department. The University Hospital Mannheim has hybrid operating theaters with integrated CT technology. There, the radiologists perform a CT in 360-degree rotation while the patient is already under anesthesia and without having to be moved again. The CT images the structures of the lungs very precisely, so that a radiologist can precisely mark the lung metastases in preparation for the operation.

Operation with camera for lung metastases (VATS)

If the metastases are on the surface of the lungs, the surgeons no longer have to open the chest to operate on the lung metastases thanks to video-assisted thoracic surgery (VATS). This minimally invasive keyhole surgery only requires three small incisions of one centimeter each for the surgical instruments and the camera. The VATS enables the surgeon to see a much larger view of the lung tissue on a monitor with modern microscopes. This body navigation function is supplemented by further CT images during the operation - for control purposes. Video-assisted thoracic surgery (VATS) enables faster healing, a good cosmetic result and less pain during wound healing after the procedure. As a result, the patient can leave the hospital bed more quickly and, with the support of physiotherapy, can soon be able to cope with everyday life again.

Pain therapy for lung metastases

In order to reduce the patient's pain, surgery works closely with anesthesiology (anesthetic medicine and pain therapy). The anesthetists provide the patient with painkillers after the operation and, if necessary, carry out other methods of pain therapy. If the chest had to be opened for the operation of the lung metastases, the patients are given special pain catheters (peridural anesthesia, paravertebral block catheter), which enable them to be largely free of pain after the operation.

Radiation for lung metastases

Irradiation of the lung metastases is completely painless. This is useful if there are only a few small metastases whose location could be precisely determined. Then the radiation oncologists can direct the radiation dose precisely at the cancer cells and destroy it - the surrounding tissue remains intact except for a small safety margin. Breathing during irradiation of the lung metastases poses a particular challenge: for a highly precise irradiation, the patient must not move during the irradiation. In order to ensure targeted radiation therapy, a computer-aided procedure with the Active Breathing Coordinator ™ was developed. The device calculates the required lung volume during a planned respiratory stop for reliable irradiation. The radiation oncologists practice holding the breath with the patient before the irradiation so that he knows when, how deeply and for how long to hold his breath. A gating interface (Response ™) starts and stops the irradiation automatically as soon as the patient reaches or leaves the specified lung volume.

Chemotherapy for lung metastases

Radiation for lung metastases can also be used to reduce the size of the metastases before an operation (downsizing). Chemotherapy can also be used for this. It is also the method of choice when there are multiple tumor foci in different locations, as chemotherapy affects the whole body. Its purpose is to prevent the various tumors and metastases from growing further.

Further support with lung metastases

Together with the original tumor, lung metastases can be very stressful for the patient both physically and mentally. During the entire course of the disease, not only excellent doctors but also psycho-oncologists, oncological nurses and a social service are at your side at the Mannheim University Hospital.