How are metastatic brain and spine tumors treated?

Metastatic brain and spine tumor (secondary brain and spinal cord cancer) treatment depends on the size, location and number of tumors, as well as your health status.

Your care team at Miami Cancer Institute may recommend surgery, radiation therapy or other therapies to target your cancer or treat your symptoms.


Our neuro-oncology surgeons use sophisticated brain surgery techniques to carefully remove brain tumors. They use fMRI to create a detailed plan before your surgery and surgical navigation (computer-assisted surgery) to operate tools more precisely during your procedure. At times, they may use fMRI or MRI to visualize the tumor during the procedure. These technologies ensure effective, efficient tumor removal. In some cases, you may be a candidate for minimally invasive brain surgery through neuroendoscopy or awake craniotomy, during which you are awake, but sedated.

Radiation therapy

This treatment uses ionizing radiation to kill cancer cells and shrink tumors. Doctors prescribe radiation therapy when metastatic brain tumors are 4 centimeters wide or smaller or when surgery isn’t possible. Our radiation oncology specialists use intensity modulated radiation therapy, image-guided radiation therapy, stereotactic radiosurgery or whole-brain radiation therapy to deliver precise doses of radiation to metastatic brain tumors and protect healthy tissue. In some cases, proton therapy is used. Miami Cancer Institute is one of only a few cancer centers in the nation to offer this advanced form of radiation therapy, which is more precise than traditional forms of radiation therapy. Learn more about proton therapy and if it could benefit you.

  • Tumor treating fields – This is used to treat some types of metastatic brain tumors. Devices taped to the head send low-intensity electrical fields through the skull. These electrical fields may inhibit tumor growth without causing side effects.
  • Medicines – Your doctor may prescribe a corticosteroid to relieve swelling in the brain or anti-seizure medicines if you are having seizures.
  • Neurocognitive evaluation – This assesses your brain function and is done before you begin treatment. If you experience complications from radiation therapy, another evaluation will be done to check for any changes in your cognitive abilities.
  • Rehabilitation – You could require rehabilitation after treatment to strengthen affected physical or cognitive functions. This can include physical therapy, occupational therapy or speech therapy. Rehabilitation at the Institute is guided by a physiatrist who specializes in treating patients with brain tumors.
(Current Radiation Treatment Approaches for Brain Metastases w-PU Bug)

Interventional Oncology

Our interventional oncologists use minimally invasive procedures that can help with pain management, including:

  • Injecting medication into the area around the spinal cord (epidural injections)
  • Injecting pain medication into the abdomen (celiac plexus neurolysis).
  • Performing procedures, such as vertebroplasty, kyphoplasty and tumor ablation, for spinal fractures caused by osteoporosis or tumors. These procedures effectively control pain.
  • Using nerve blocks to reduce or relieve pain and improve your quality of life.
"Dr. Kotecha and his team are awesome. They answer all your questions and explain everything to you in a language you can understand."

Tumor Board

A multidisciplinary team of cancer experts including surgeons, medical oncologists, radiation oncologists, plastic reconstructive surgeons, pathologists, radiologists, genetic counselors, medical geneticists, social workers, patient navigators and clinical trials staff meet weekly to discuss select complex cases and determine the best course of care.

Clinical Trials

Clinical Trials

Miami Cancer Institute can provide access to clinical trials not widely available elsewhere. Clinical trials find new ways to treat and diagnose cancer and are ongoing. If an appropriate trial is available, we will talk to you about the benefits and risks.

South Florida's First Proton Therapy Center

Proton therapy is a highly specialized treatment that directs high-energy proton particles toward tumors. They destroy cancer cells while sparing healthy tissue and decreasing side effects. This sophisticated treatment is used only for certain types of cancers and in a limited number of individuals.

Language Preference / Preferencia de idioma

I want to see the site in English

Continue In English

Quiero ver el sitio en Español

Continuar en español