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What are the side effects of treatment for brain cancer?

Cancer treatment often causes side effects. These side effects occur because treatment to destroy cancer cells damages some healthy cells as well.

The side effects of cancer treatment vary. They depend on the type of treatment used and on the area being treated. Also, each person reacts differently. Attempts are made to plan the patient's therapy to keep side effects to a minimum. Patients are very carefully watched so that any problems which occur can be addressed.

A craniotomy is a major operation. The surgery may damage normal brain tissue, and edema may occur. Weakness, coordination problems, personality changes, and difficulty in speaking and thinking can result. Patients can also have seizures. In fact, for a short time after surgery, symptoms may be worse than before. Most of the side effects of surgery lessen or disappear with time.

Most of the side effects of radiation therapy go away soon after treatment is over. However, some side effects may occur or persist long after treatment is completed.

Some patients have nausea for several hours after treatment. Patients receiving radiation therapy may become very tired as treatment continues. Resting is important, but doctors usually advise their patients to try to stay reasonably active. Radiation therapy to the scalp causes most patients to lose their hair. When it grows back, the new hair is sometimes softer and may be a slightly different color. In some cases, hair loss is permanent.

Skin reactions in the treated area are common. The scalp and ears may be red, itchy, or dark. These areas may look and feel sunburned. The treated area should be exposed to the air as much as possible but should be protected from the sun. Patients should not wear anything on the head that might cause irritation. Good skin care is important at this time. The doctor may suggest certain kinds of soap or ointment, and patients should not use any other lotions or creams on the scalp without the doctor's advice.

Sometimes, brain cells killed by radiation form a mass in the brain. The mass may look like a tumor and may cause similar symptoms, such as headaches, memory loss, or seizures. Doctors may suggest surgery or steroids to relieve these problems. About 4 to 8 weeks after radiation therapy, patients may become quite sleepy or lose their appetite. These symptoms may last several weeks, but they usually go away on their own. Still, patients should notify the doctor if they occur.

Children who have had radiation therapy for a brain tumor may have learning problems or partial loss of eyesight. If the pituitary gland is damaged, children may not grow or develop normally.

The side effects of chemotherapy depend on the drugs that are given. In general, anticancer drugs affect rapidly growing cells, such as blood cells that fight infection, cells that line the digestive tract, and cells in the hair follicles. As a result, patients may have a lowered resistance to infection, loss of appetite, nausea, vomiting, or mouth sores. Patients also may have less energy and lose their hair. These side effects usually go away gradually after treatment stops.

Some anticancer drugs can cause infertility. Women taking certain anticancer drugs may have symptoms of menopause (hot flashes and vaginal dryness; periods may be irregular or stop). Some drugs used to treat children and teenagers may affect their ability to have children later in life.

Certain drugs used in the treatment of brain tumors can cause kidney damage. Patients are given large amounts of fluid while taking these drugs. Patients also may have tingling in the fingers, ringing in the ears, or difficulty hearing. These problems may not clear up after treatment stops.

Treatment with steroids to reduce swelling in the brain can cause increased appetite and weight gain. Swelling of the face and feet is common. Steroids can also cause restlessness, mood swings, burning indigestion, and acne. Patients should not stop using steroids or change their dose without consulting the doctor, however. The use of steroids must be stopped gradually to allow the body time to adjust.

Loss of appetite can be a problem for patients during therapy. People may not feel hungry when they are uncomfortable or tired. Some of the common side effects of cancer treatment, such as nausea and vomiting, can also make it hard to eat. Yet, good nutrition is important because patients who eat well generally feel better and have more energy. In addition, they may be better able to withstand the side effects of treatment. Eating well means getting enough calories and protein to help prevent weight loss, regain strength, and rebuild normal tissues. Many patients find that eating several small meals and snacks during the day works better than trying to have three large meals.

Patients being treated for a brain tumor may develop a blood clot and inflammation in a vein, most often in the leg. This is called thrombo-phlebitis. A patient who notices swelling in the leg, leg pain, or redness in the leg should notify the doctor right away.

Doctors, nurses, and dietitians can explain the side effects of cancer treatment and can suggest ways to deal with them.