Secondary brain tumours (The UCLH Brain Metastases Service) 

Secondary brain tumours (metastases) are cancers that have spread to the brain from primary cancers in another part of the body. This is more likely to happen with certain cancers such as lung, breast, bowel, kidney and melanoma (skin cancer). In some people, the brain secondary tumours may be the first sign they have cancer.

You will have several tests to diagnose brain metastases. You may have a brain CT (computerised tomography) and / or MRI (magnetic resonance imaging) scans. Sometimes it may be necessary to have a biopsy to make the diagnosis.

Most treatments for brain metastases are given with the aim of control rather than cure. Your doctor will explain what your treatment involves and what they hope it will achieve.

The UCLH Brain Metastases Service provides localised treatments for secondary brain cancers in fit patients who have controlled or no active cancer outside the brain. The service was the first of its kind in the UK and receives referrals from all over London as well as offering second opinions to patients from other centres in the UK.

Patients are discussed in the weekly neuro-oncology multidisciplinary team (MDT) meeting, and are seen in a weekly clinic at the University College Hospital Macmillan Cancer Centre.

Treatments used include surgery and radiosurgery (such as the Gamma Knife), and other advanced radiotherapy techniques.

Following treatment, you will be kept under regular surveillance and follow up with both The Brain Metastases Service and your primary cancer oncology team.

Depending on the area of the brain affected by the tumour, patients can have very different problems, such as issues with movement, speech, thinking skills, or vision. If you experience difficulties in any of these areas you may be seen by one, or more, of our specialist therapy services.


Dr Naomi Fersht, Consultant Clinical Oncologist

Dr Naomi Fersht

Dr Naomi Fersht coordinates care across brain tumour services at UCLH.

She is a consultant clinical oncologist at University College Hospital and the National Hospital for Neurology and Neurosurgery (NHNN). She specialises exclusively in the management of primary and secondary brain and spinal tumours. This involves the use of both conventional and innovative radiotherapy techniques and chemotherapy. 

Her special interests are: brain oligometastases; meningiomas; pituitary tumours; the management of teenagers and young adults with brain tumours (age 16-24); and advanced radiotherapy techniques including radiosurgery.

She qualified from the University of Cambridge and her specialist training was at the Royal Marsden and University College Hospitals. Naomi's doctoral thesis, supervised by Nobel Laureate Sir Paul Nurse, was in cell cycle checkpoints.

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Dr Jeremy Rees, Consultant Neurologist

Dr Jeremy Rees

Dr Jeremy Rees was appointed as a consultant neurologist at the National Hospital for Neurology and Neurosurgery (NHNN) in 1999 and has built a national and international reputation in neuro-oncology, seeing patients with brain tumours, particularly low-grade gliomas. His opinion is widely sought on the diagnosis and treatment of neurological problems related to cancer and cancer treatments. He was previously the Director for London Cancer Brain Tumour Pathway Board, involved in systematic improvements to patient pathways in North London.

He has been Education Lead for Neurology at UCL Medical School and is currently the Lead for the Special Study Module in Neurology. He lectures widely to different professional groups and has written chapters and a textbook in Neuro-oncology. He was the Chief Investigator for the UK in a major European trial of treatment options in Low Grade Gliomas.

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Mr Robert Bradford, Consultant Neurosurgeon

Mr Robert Bradford

Mr Bradford qualified in 1979 at University College Hospital Medical School followed by house jobs at Addenbrooke's and UCLH. He obtain his FRCS in 1983 following general surgical training. He spent two years conducting research in neuro-oncology at The Institute of Neurology which lead to the award of Doctor of Medicine (MD) in 1987.

He undertook clinical neurosurgical training at The National Hospital for Neurology and Neurosurgery (NHNN) and The Wessex Neurological Centre. He was appointed consultant neurosurgeon at the Royal Free Hospital in 1989 and also honorary consultant neurosurgeon at The Royal National Orthopaedic Hospital, Stanmore.

He is a past Chair Brain/CNS tumour board North London Cancer Network.

As well as an interest in neuro-oncology he has an extensive skull base practice.

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Prof Sebastian Brandner, Consultant Neuropathologist

Prof Sebastian Brandner

Sebastian Brandner is Professor of Neuropathology at UCL and Honorary Consultant Neuropathologist at the National Hospital for Neurology and Neurosurgery (NHNN) at UCLH. He leads the Division of Neuropathology and is specialised in brain tumour diagnostics including molecular diagnostics, and neurodegeneration.

He has authored and co-authored research publications on brain tumour models, book chapters in major neuropathology textbooks, and the 2016 WHO classification as well as guidelines for the Royal College of Pathologists. He serves on the National Institute of clinical excellence (NICE) guideline committee to establish guidelines for management and treatment of primary brain tumours and cerebral metastases

The Division of Neuropathology receives brain tumour referrals from the NHNN, and several major regional hospitals. The Division also provides a molecular pathology service for referrers across the United Kingdom.

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Dr Gary Hotton, Consultant Neurologist

Dr Gary Hotton

Dr Gary Hotton qualified from University College and Middlesex School of Medicine in 1995. His general medical training was undertaken at Dundee Royal Infirmary and the Royal Free Hospital. Following this he spent seven years in research at Kings College Hospital and Imperial College. He then returned to specialist training in London and joined the specialist register in May 2010.

Dr Hotton is a consultant neurologist and divides his time between the National Hospital for Neurology and Neurosurgery (NHNN) and The North Middlesex Hospital. At the NHNN he has a specialist neuro-oncology clinic and is a core member of the neuro-oncology multidisciplinary team.

At the North Middlesex Hospital he provides an in-patient and out patient general neurology service.

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Mr Neil Kitchen, Consultant Neurosurgeon

Mr Neil Kitchen

Mr Neil Kitchen is a consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery (NHNN) and lead neurosurgeon for neuro-oncology.

He studied medicine at Bart's Health, University College London Hospitals and at Addenbrooke's Hospital in Cambridge. Before moving to Cambridge he completed a BSc degree in the history of medicine at the Wellcome Institute.

Mr Kitchen has special clinical interest in brain tumour surgery, intracranial microsurgery, trigeminal neuralgia, cavernoma and radiosurgery (Gamma Knife).

Mr Kitchen has also worked at Bart's, Charing Cross Hospital, the Royal Free, Atkinson Morley's, Southend Hospital, and the National Hospital for Neurology and Neurosurgery.

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Mr Hani Marcus, Academic consultant neurosurgeon

Mr Marcus is an academic consultant neurosurgeon, and was among the first cohort of trainees to be selected for a Walport Integrated Academic Training Pathway, with rotations at the University of Cambridge, Imperial College London, and University College London.

His clinical interest is in “keyhole” endoscopic neurosurgical approaches. To this end, he completed fellowships in endoscopy and anterior skull base surgery (including pituitary surgery) at the Klinik Hirslanden, Zurich and the National Hospital for Neurology and Neurosurgery. His research interest, and the subject of his doctoral thesis under Prof Lord Darzi, is the development and evaluation of new devices that makes these keyhole approaches more safe and effective, including augmented reality, robotics, and artificial intelligence. 

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Mr Andrew McEvoy, Consultant Neurosurgeon

Mr Andrew McEvoy

Andrew McEvoy is a world-leading consultant neurosurgeon at The National Hospital for Neurology (NHNN) and Neurosurgery and Institute of Neurology (ION).

Listed in The Times 2010 top UK doctors for his epilepsy and brain tumour surgery,
Mr McEvoy’s specialist neuro-oncology service has a particular interest in the prediction and preservation of function during large resective neurosurgical procedures and the reorganisation of brain function around brain tumours. This multidisciplinary approach integrates facilities such as 3T MRI, FMRI for language and motor function, DTI, MEG, neurophysiology and neuropsychology.

As a result of this expertise, he performs probably the largest number of ‘awake’ craniotomies presently in the UK. This enables the largest possible resection of brain tumours while minimalising neurological deficit Gamma Knife and Cyberknife ensure that patients have access to the most extensive treatment options available at any centre throughout the world.

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Mr George Samandouras, Consultant Neurosurgeon

Mr George Samandouras

George Samandouras has been trained in Oxford at the Radcliffe Hospitals NHS Trust and has completed a fellowship in Paris in 2008.

At Queen Square he directs the education and training of neurosurgical trainees and fellows.

His clinical interests include brain tumours, minimally invasive surgery and spine surgery. Surgical oncology techniques employed include fluorescent-guided resection, cortical mapping and intraoperative MRI.

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Miss Huma Sethi, Consultant Neurosurgeon

Miss Huma Sethi

Miss Sethi is a Consultant Neurosurgeon at The National Hospital for Neurology and Neurosurgery (NHNN).

Training programme director (ST1-ST3) for North Thames Neurosurgical training programme, which is the biggest training rotation in the UK. Her specialist clinical interest include Neuro-oncology, Intraventricular Endoscopy, Radiosurgery (Gamma Knife), Peripheral Nerve Surgery & Degenerative Spine Surgery

Mr Lewis Thorne, Consultant Neurosurgeon

Mr Lewis Thorne

Mr Lewis Thorne is a consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery (NHNN) at Queen Square.

He graduated from Edinburgh University in 1995 and completed his postgraduate training in London, becoming a consultant in 2007. He has a specialist interest in the management of brain tumours, utilizing a range of techniques including: awake surgery, intraoperative MRI, fluorescence guided resection and Gamma Knife. He works in a multidisciplinary clinic offering long term follow up with both surgeon and specialist oncologist, along with a clinical nurse specialist (CNS).

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 Clinical Nurse Specialists (CNS)

Orla McKee, Clinical Nurse Specialist (CNS)

Orla McKee

Orla qualified as a registered nurse in 1993 and has worked in many specialist areas of neurosciences since 1993. She has experience as a ward sister for 7 years looking after a variety of patients with brain and spinal issues. She has specialised as a clinical nurse specialist in both benign and malignant brain tumours since 2008.

"I enjoy working within a multidisciplinary team who focus on the complex needs of this group of patients."