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What Are the First Signs of Brain Cancer?

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Ask a Doctor

My sister had persistent headaches she thought were migraines. She finally got a CT scan because the medication wasn’t effective, and doctors found she had a type of brain cancer and it was already grade III. What are some warning signs of brain cancer? How do you know you have brain cancer?

Doctor's Response

Seek care from a health-care provider right away, probably emergently, if a person develops any of the following symptoms:

  • Unexplained, persistent vomiting
  • Double vision or unexplained blurring of vision, especially on only one side
  • Lethargy or increased sleepiness
  • New seizures
  • New pattern or type of headaches, especially early morning headaches

Although headaches are thought to be a common symptom of brain cancer, they may not occur until late in the progression of the disease. If any significant change in a person's headache pattern occurs rapidly, health-care professionals may suggest that he or she go the emergency department. If a person has a known brain tumor, any new symptoms or relatively sudden or rapid worsening of symptoms also warrants a trip to the nearest hospital emergency department. Be on the lookout for the following new symptoms:

  • Seizures
  • Changes in mental status, such as excessive sleepiness, memory problems, or inability to concentrate
  • Visual changes or other sensory problems
  • Difficulty with speech or in expressing oneself
  • Changes in behavior or personality
  • Clumsiness or difficulty walking
  • Nausea or vomiting (especially in middle-aged or older people)
  • Sudden onset of fever, especially if the patient is receiving chemotherapy treatments.

Not all brain tumors cause symptoms, and some (such as tumors of the pituitary gland, some of which cause no symptoms) are found mainly after death, with the death not caused by the brain tumor. The symptoms of brain tumors are numerous and not specific to brain tumors, meaning they can be caused by many other illnesses as well. Many people have no awareness that they have brain cancer. The only way to know for sure what is causing the symptoms is to undergo diagnostic testing. Early symptoms may not occur; if they do, they occur for the following reasons and are listed below:

  • The symptoms are caused by the tumor pressing on or encroaching on other parts of the brain and keeping them from functioning normally.
  • Some symptoms are caused by swelling in the brain primarily caused by the tumor or its surrounding inflammation.
  • The symptoms of primary and metastatic brain cancers are similar in men, women, and children.

The following symptoms and warning signs are the most common:

  • Headache, especially in the early mornings, which may become persistent or severe
  • Muscle weakness, which is often more evident on one side of the body than another
  • Paresthesias, like feeling pins and needles or reduced touch sensations
  • Clumsiness, problems with coordination, and/or a balance disorder
  • Difficulty walking, with weakness and/or fatigue of arms and legs
  • Seizures

Other nonspecific brain cancer symptoms and signs include the following:

  • Altered mental status: changes in concentration, memory, attention, or alertness and/or mental confusion
  • Nausea, vomiting: especially early in the morning with possible dizziness and/or vertigo
  • Abnormalities in vision (for example, double vision, blurred vision, loss of peripheral vision)
  • Difficulty with speech (impaired voice)
  • Gradual changes in intellectual or emotional capacity; for example, difficulty or inability to speak or understand, personality changes

In many people, the onset of these symptoms is very gradual and may be overlooked by both the person with the brain tumor and the person's family members, even for long time periods. Occasionally, however, these symptoms appear more rapidly. In some instances, the person acts as if he or she is having a stroke. In some patients, the symptoms may be more pronounced if the cancer is located mainly in a specific brain lobe that is usually responsible for certain body functions. For example, behavioral changes may predominate in frontal-lobe cancers while difficulty with speech or movements may predominate in cancers within the parietal lobe.

The following factors have been proposed as possible risk factors for primary brain tumors, but whether these factors actually increase an individual's risk of a brain tumor is not known for sure.

  • Radiation to the head
  • A hereditary (genetic) risk
  • HIV infection
  • Cigarette smoking
  • Environmental toxins (for example, chemicals used in oil refineries, embalming chemicals, rubber industry chemicals)

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Reviewed on 8/6/2018
Sources: References