Controlling symptoms of brain tumours

Brain tumours can cause symptoms. These include:

• headaches
• feeling sick (nausea) or being sick (vomiting)
• seizures (fits)

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

One way of managing your symptoms is with surgery, radiotherapy or chemotherapy. These treatments can 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 the pain

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 if you have troubling symptoms.  Palliative treatment might also help you live longer and more comfortably, even if you can't be cured.

Your brain tumour team will have expertise in managing the symptoms of your brain tumour. Your doctor might also refer you to the palliative care team. This team can support people with with a range of issues, both in and out of the hospital setting.

Drugs to help control seizures

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).

Types of seizures

There are different types of seizures, including:

• focal onset - this only affects one part of the brain and usually one part of the body
• generalised onset - this affects both sides of the brain at the same time and you can become unconscious for a short time, have whole body shaking, lose bladder function or bite your tongue
• unknown onset - it’s not known where they started
• nocturnal seizures – these only happen at night and don't necessarily stop you driving a car

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

• motor onset which involves shaking or jerking - these include partial seizures (usually one arm, leg or body side) or generalised (involves your whole body, and is also called tonic-clonic or convulsive seizure)
• non motor onset when you become unaware of what is around you (vacant), or have a feeling of having done something before, or experience odd smells or tastes

Medicines to control seizures

You might have a drug such as levetiracetam, lamotrigine, or topiramate to control seizures. Other drugs include sodium valproate, phenytoin, carbamazepine, or clobazam. These are all called anti epileptic drugs. You might take more than one of these drugs.

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 climbing high ladders
• 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
• telling a swimming pool lifeguard that you have seizures if you use a public swimming pool

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. 

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.

Other symptoms

Your brain tumour might cause other problems. You can get support from your healthcare team to manage some of 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. And for many people, fatigue improves in the months or year after your finish your treatment.

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 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

Your healthcare team might suggest:

• talking therapies such as counselling
• joining support groups with others going through the same thing
• medicines such as antidepressants

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.

 If the changes are caused by temporary problems such as swelling in your brain, it might improve as your recover after treatment. And your healthcare team might be able to alter your medication dose if they think the drugs might be making problems worse.

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