Controlling symptoms of brain tumours

Having symptoms when you have a brain tumour

The symptoms you have depend on where in the brain the tumour is, and the size of the tumour.

Ways of managing symptoms include surgery, radiotherapy and chemotherapy. These treatments may help to reduce the size of the tumour and help you feel better.

You might also have drugs to:

• help control seizures (fits)

• reduce the swelling inside your brain

• control headaches and pain

Find out more about the symptoms of a brain tumour

Supportive care

The aim of supportive care treatment is to relieve symptoms and improve your quality of life. It is also called palliative care. You can have palliative care at any stage of an illness. This can help make you more comfortable, even when treatment is not aimed at curing the tumour.

Your healthcare team has expertise in managing the symptoms of a brain tumour. Your doctor may also refer you to the palliative care team. These teams can support you and your family emotionally and practically. Both in hospital and at home.

Drugs to help control seizures (fits)

Seizures are bursts of electrical activity in the brain. They are a common symptom of brain tumours. If you have a seizure, you are required by law to stop driving for a period of time. You must tell the Driver and Vehicle Licensing Agency (DVLA). In Northern Ireland, you contact the Driver & Vehicle Agency (DVA) Northern Ireland.

Types of seizures

There are different types of seizures, including:

• focal onset seizure- this only affects one part of the brain and usually one part of the body

• generalised onset seizure - this affects both sides of the brain. During some types of generalised seizure, you may lose awareness or consciousness. You may have stiffening or jerking movements involving the whole body. Some people may lose bladder function or bite their tongue

• unknown onset - it’s not known where they started

Seizures can happen at any time. Seizures that happen when you are awake are called awake seizures. If they happen while you are asleep, they are called asleep or nocturnal seizures.

If your doctor does not have enough information about the seizure, it may be called an unclassified seizure.

Seizures are also grouped based on whether they involve movement or not. They can be:

• motor onset seizures - these cause changes in movement. This includes shaking, jerking, and muscle spasms. The seizure might affect one arm, leg, or one side of the body. Or it may affect your whole body. One type of motor onset seizure is a tonic-clonic seizure (also called a convulsive seizure). This causes the body to stiffen and jerk

• non motor onset seizures - you may be unaware of what is happening around you. Or you might have a feeling that something is familiar when it's not. You might also notice unusual smells or tastes or changes in your vision such as flashing lights

Medicines to control seizures

There are several drugs to control seizures. You might have levetiracetam, lamotrigine, or topiramate. Other drugs include sodium valproate, phenytoin, carbamazepine, or clobazam. These are all called anti epileptic drugs or anti convulsants. You may need to take more than one drug.

You usually have them as tablets or liquids that you swallow every day. Your doctor or pharmacist will give you instructions about how to take the drugs. It's important you follow these and that you don't suddenly stop taking the drugs.

Staying safe

Your healthcare team might advise you to take some precautions if you are at risk of having a seizure. These include:

• not locking the bathroom door during a bath

• taking showers instead of baths if that is possible

• not cooking with gas unless you have supervision

• telling friends or family your plans if you are going out

• not climbing high ladders

Read about living with brain tumours

Drugs to reduce the swelling inside your brain

Some brain tumours cause swelling (oedema). This can increase the pressure inside the brain and cause symptoms. Symptoms can include:

• weakness

• headaches

• speech problems

Certain treatments can also increase the swelling in the brain at first. For example, surgery and radiotherapy.

Steroids are naturally made by our bodies in small amounts. They help to control many functions. This includes reducing swelling. You can take steroids as a treatment to help reduce swelling. Steroid drugs are stronger than the amount of steroid your own body makes.

The type of steroids you might have as part of your treatment are called corticosteroids. You usually have a steroid called dexamethasone. Other steroid drugs include prednisolone and methylprednisolone. 

Find out more about steroids, how you have them and the possible side effects

Drugs to control the pain

Brain tumours can cause headaches if they are pressing in areas of the brain that are sensitive to pain. These areas include blood vessels and nerves.   

Certain treatments can also cause headaches at first. For example, radiotherapy, chemotherapy and surgery.

You usually have painkillers to help with headaches. There are many types and strengths of painkillers. Your treatment team will work with you and your GP to find the right type and strength of painkiller. It’s important that you take your painkillers regularly, exactly as your doctor prescribes.

Find out more about what painkillers are and which types of painkillers you might have

Other symptoms

Your brain tumour might cause other problems. You can get support from your healthcare team to manage these.

The following symptoms might cause you problems:

Feeling very tired

Many people with a brain tumour feel very tired. Fatigue means feeling very tired, exhausted and lacking energy. You might find it one of the most disruptive side effects of having a brain tumour.

Unfortunately there isn’t a cure for fatigue. But there are some things you can do that might help, for example gentle exercise.

Read more about fatigue and what you can do to manage it

Changes in your mood and behaviour

Brain tumours can cause changes in your mood, behaviour and personality. Changes can include feeling:

• irritated or aggressive

• confused or forgetful

• low in mood or depressed

• impulsive and being direct or forward

Tell one of your healthcare team if you notice these changes. Or if you are worried about somebody with a brain tumour. There are some things that might help. How helpful these are will depend on your situation and how severe your symptoms are.

There are things that you can try to help yourself feel better. These can help even though you may feel low and as though you can't do anything. For example relaxation, exercise or getting support from other people who have had a brain tumour.

Read more about what might help you manage your emotions

Your healthcare team might suggest:

• talking therapies such as counselling

• joining support groups with others going through the same thing

• medicines such as antidepressants

Read some general information about mental health and cancer

Feeling or being sick

Some people with a brain tumour feel sick (nausea) or are sick (vomiting). This may be caused by the tumour increasing pressure in the brain. It can also be a side effect of treatments such as chemotherapy or radiotherapy. Your doctor may prescribe anti sickness medicines. You may also have steroids to help reduce swelling in the brain. Other ways that may help control sickness include:

• complementary therapies, such as acupuncture

• changes to what you eat and drink

It is important that you speak to your doctor or specialist nurse before you start any complementary therapies. Some may affect your treatment or cause side effects.

Difficulty thinking, decision making and concentrating (cognitive changes)

Cognitive changes refer to changes in your memory, concentration and ability to be able to think clearly. Symptoms can include:

• memory loss – forgetting things that you normally remember

• difficulty thinking of the right word for a particular object

• difficulty following the flow of a conversation

• trouble concentrating or focusing on one thing

You might have cognitive changes because of where the tumour is in your brain. These changes can also be a side effect of brain tumour treatments such as surgery or chemotherapy. Some medications can also affect your cognition. For example, medicines to control fits.

There isn’t a treatment for these cognitive impairments. But there might be ways to improve your cognition. And your team might have advice about ways of coping with the changes.

Some changes can be caused by temporary problems, such as swelling in the brain. These may get better as you recover from treatment. Your healthcare team may also change your medicines if they think they are making the symptoms worse.

We have some general information about cognitive changes and how you can manage these.

Read about cognitive changes