Once cancer goes to the brain is it all over?

No: It is a bad sign, however, there are some people who do well for a long time. Now, unfortunately, this is the exception to the rule. I have several patients doing well a year or 2 after brain radiation. My partner has a lady who is 10 years out from brain metastases from breast cancer. So in summary, not a good situation but there are some long term survivors.

Brain Mets: Come in different varieties: it depends on where it comes from, how long from initial diagnosis, whther there is 1, 2 or multiple, general condidtion and how well the cancer is under control every place else. Multiple brain metastasis, poor control of other disease and spending most of the time in bed would be very poor prognosis.