October 5, 2014 | by Denise Heady
More and more people are surviving cancer, thanks to advanced cancer treatments and screening tools. Today there are nearly 14.5 million cancer survivors in the United States.
But in up to 20 percent of cancer patients, the disease ultimately spreads to their brain. Each year, nearly 170,000 new cases of brain metastasis are diagnosed in the United States, sometimes years after an initial cancer diagnosis. The cancers most likely to spread to the brain are melanoma and cancers of the lung, breast and colon.
Neurosurgeon and scientist Rahul Jandial, M.D., Ph.D., assistant professor in the Division of Neurosurgery at City of Hope, says that recognizing symptoms and seeking medical attention as early as possible is vital.
“The warning signs are important not to ignore because it gives us the opportunity to catch potential complications. Early detection gives us a better chance to help patients recover the brain or nerve function that was affected by the cancer,” Jandial said.
Here, Jandial highlights four common symptoms of brain metastasis that are often ignored but that warrant immediate medical attention when occurring in cancer survivors.
1. Progressive headaches
“Common headaches can arise for lots of reasons that aren’t necessarily dangerous," said Jandial. “You can’t overreact and respond to every headache with a brain scan. So the question becomes how do you identify which headaches to take very seriously if you are a cancer patient."
The key to recognizing a headache that can be potentially dangerous is knowing when a headache is out of character and falls into the category of a progressive headache.
"Progressive headaches are not a typical headache or migraine that we are accustomed to. These types of headaches get worse, continue for days and won’t go away. If your headache gets progressively worse and doesn’t start to fade even with time, rest and medicine, call your doctor’s office,” said Jandial.
This includes any type of seizure. Any twitching of the lip, twitching of the hand, falling to the floor, difficulty speaking or anything even perceived as a seizure requires medical attention in a cancer survivor, Jandial said.
“If you have a history of cancer and are doing well, do not ignore a seizure – even if it’s partial and only involves one part of the body and you remain awake and aware throughout.”
Significant weakness — not associated with pain — in any extremity such as the arm or leg should be a cause for concern, Jandial said.
“Injury by cancer spreading to the brain doesn’t cause pain in your arms and legs; it causes weakness in your arms and legs, “ said Jandial. “When people get a heart attack, they go to the doctor because they are in so much pain. They are there because it hurts. When you have a brain tumor, you may not have leg or arm pain, but your left leg may just not respond. I’ve seen people who use their pants to swing their leg to get in and out of car. It’s weakness, not fatigue or pain, that you’re looking for.”
4. Balance problems
Many cancers that spread to the brain occur in the back of the brain (cerebellum), which controls balance. This can affect simple tasks that you may not consider alarming.
For example, you try to grab the doorknob, but you keep missing the target. You stand up, but you fall over. Again, you may not get hurt, but if something is clearly off with your coordination, it needs to be brought to a physician's attention, Jandial said.
“The warning signs of brain metastases are not always painful and so unfortunately we see a lot of people who ignore them or come in days later and our window to help them recover neurological function sometimes closes,” said Jandial. “The brain is extremely delicate and complex, and there are limited treatment options for the brain compared to treating cancer in other parts of the body. That’s why early detection is crucial for any cancer that may have spread to the brain – brain metastases.”
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