Headaches

When you have cancer, there are many reasons that you may develop a headache.

The type of cancer treatment you are receiving may lead to a headache. The type of cancer you have may be associated with headaches. Or, there may be medicines you are using that cause headaches as a side effect. Lastly, you’re human, and the emotions you experience during this time may cause stress and headaches.

If you develop regular headaches when you have cancer, it’s important to pay attention to several factors that may be involved with causing them. Noting this information may help you and your care team pinpoint the causes.

The good news is that there are many treatments and strategies that you may employ to prevent or treat headaches and feel better.

Headache as a side effect of cancer and cancer treatment

Cancer leads to changes in your body. The following health problems that may develop when you have cancer may also cause headaches:

• Anemia, a low number of red blood cells
• Dehydration, caused by vomiting and/or diarrhea
• Hypercalcemia, a high level of calcium
• Infections, including sinusitis (an infection of the sinuses) and meningitis (an infection of the membranes that cover and protect the brain and spinal cord)
• Thrombocytopenia, a low platelet count (platelets are cells in the blood that help stop or prevent bleeding)

Cancer treatments associated with headaches include:

• Certain types of chemotherapy 
• Immunotherapy
• Radiation therapy to the brain

Medications used when you have cancer may cause headaches as a side effect. Among these medications are:

• Antibiotics
• Antiemetics, a type of medication that helps prevent or treat vomiting
• Certain heart medicines
• Bisphosphonates, which are a type of medication used to protect the bones
• Pain medications taken in large doses, which may cause a “rebound headache,” indicating that your body wants more of that medicine; it’s also possible to develop a low-grade headache after using pain medicines for a long time

Finally, general emotional and physical side effects that are common with cancer may lead to a headache, such as:

• Anxiety and stress
• Fatigue
• Sleeping problems

Types of cancer typically associated with headaches

Certain types of cancer have a strong association with headaches. These include:

• Brain and spinal cord cancers
• Cancer that has spread to the brain
• Certain forms of lymphoma, a cancer of the lymph nodes (which help protect the body from viruses and bacteria)
• Nasopharyngeal cancer, a cancer of the upper throat
• Pituitary gland tumors

Headache symptoms and severity

The symptoms and severity of a headache when you have cancer may range from mild to severe. For example, a tension headache usually causes a dull ache, as if it wraps around your head. On the other hand, a migraine may have several other symptoms, including:

• Nausea
• Pulsing and throbbing sensation in the head (this may occur on just one side)
• Sensitivity to light and sound
• Vomiting

Additionally, an infection of the sinuses may cause a sinus headache.

Here are some factors to note and discuss with your care team:

• When the headaches occur (are they more common in the morning, afternoon or evening?)
• How often you get them
• How long they typically last
• Possible triggers (do the headaches occur after a certain treatment or medication, after eating certain foods or exposure to bright lights?)
• What the pain feels like. (is it dull, a feeling of pressure, a stabbing/piercing feeling or throbbing?)
• Where they occur (including the back of the neck, in the forehead or over the eyes)

Treating your headaches

If you experience headaches while you have cancer, there are several treatments you may be able to try. Always check with your care team first to make sure you’re able to use a specific treatment.

Over-the-counter options include pain relievers such as acetaminophen and ibuprofen. Inform your doctor if you’re using over-the-counter treatments for your headaches.

Prescription treatments for headaches include:

• Antibiotics (used if an infection is the cause of the headache)
• Narcotic pain relievers
• Steroid medications
• Tricyclic antidepressants (dosage is typically lower than that prescribed for treating depression)
• Triptan medications, such as sumatriptan

When you’re experiencing a headache, there are a few steps you may take to try and lessen the pain:

1. Use a cold washcloth and place it on your forehead or back of your neck
2. Rest in a darkened room
3. Do something relaxing (i.e., a warm bath or nap)

There are also healthy practices that may help you avoid or lessen headache pain over time:

• Get enough sleep
• Eat regularly
• Exercise regularly, but don’t overdo it
• Regularly relax your body and muscles throughout the day