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Carcinomatous Meningitis Treatment

Also known as leptomeningeal metastasis or meningeal carcinomatosis, carcinomatous meningitis occurs in about five people out of every 100 cancer patients. Doctors are still struggling to find an effective treatment.

  1. The Facts

    • Carcinomatous meningitis occurs when cancer cells spread from primary tumors to the meninges that surround the brain and spine. It happens most often with breast and brain cancer, but can occur with any form of cancer that metastasizes. Symptoms include muscle weakness and loss of motor control, headaches, and impaired cognitive function. Without treatment, patients can live only two to three months after being diagnosed. Carcinomatous meningitis treatment options usually focus on controlling the symptoms of the disease rather than eradicating it. They include radiation, chemotherapy, and symptom management.

    Radiation

    • One course of treatment for carcinomatous meningitis is radiation therapy. It is usually performed in short courses and is comparatively well tolerated by patients. For treating carcinomatous meningitis, radiation therapy is usually directed at the brain and the meninges tissue around it. It is an effective choice to help control the symptoms of the disease. If radiation therapy is given in high enough doses to try to destroy the cells causing carcinomatous meningitis it could cause severe enough suppression of bone marrow production to interfere with continued treatment.

    Chemotherapy -- Intrathecal

    • When chemotherapy is chosen as a treatment for carcinomatous meningitis, it is usually delivered intrathecally. In order to inject the drug directly into the spinal canal, a doctor will perform a lumbar puncture. If repeated injections are planned, the doctor might implant an Ommaya reservoir to make the course of chemotherapy easier and less painful for the patient. Chemotherapy can alleviate the symptoms of carcinomatous meningitis and add months to a patient's life expectancy.

    Chemotherapy -- Intravenous

    • In searching for a more effective treatment for carcinomatous meningitis, doctors have begun to explore the possibilities to be found in chemotherapy delivered intravenously. This course of treatment eliminates the need for repeated injections into the spinal canal. Doctors have seen improved results in some patients when cancer fighting drugs were delivered both intrathecally and intravenously.

    Symptom Management

    • Because the prognosis for patients with carcinomatous meningitis is so poor even with aggressive radiation or chemotherapy treatments, many patients and their caregivers focus on symptom management. The goal is to relieve the symptoms brought on by carcinomatous meningitis and improve the time the patient has left. Drugs to eliminate pain or improve motor control are given, rather than drugs to try to cure the disease.

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