Main Page | Risk Factors | Reducing Your Risk | Screening | Symptoms | Diagnosis | Treatment Overview | Chemotherapy | Radiation Therapy | Surgical Procedures | Other Treatments | Lifestyle Changes | Managing Side Effects | Living With Brain Tumors | Talking to Your Doctor | Resource Guide
This page discusses the management of side effects specific to brain cancer and its treatment. For a review of methods to manage side effects common to all cancers and their treatments, please see the monograph: Managing the Side Effects of Cancer and Cancer Treatment.
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your health care provider if you need to take any special precautions. Use each of these medications as recommended by your health care provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your health care provider.
Medications may help to either prevent or reduce side effects of treatment, or to manage certain side effects once they occur. Since you can develop these symptoms from the treatment and/or from the cancer itself, it is essential that you discuss them with your doctor when you notice and ask him or her if any of these medications are appropriate for you.
Some of the complications of brain cancer that may require supportive care include the following:
Many brain tumors cause swelling (also called edema) of the tissues surrounding them. This leads to brain irritation and diminished brain function. Corticosteroids, which are cortisone-like drugs, can decrease the volume of edema surrounding brain tumors and improve brain function.
Among the many corticosteroid drugs available, dexamethasone (Decadron) is the only one in common use for brain swelling, because it has the fewest side effects. It is given in divided doses of 12 to 20 milligrams a day or more, orally or through an IV. These doses are quite effective in reducing brain swelling and usually do not produce the major side effects associated with corticosteroids.
Side effects of corticosteroids include:
Brain tumors may cause seizures or convulsions. Seizures result when clusters of nerve cells in the brain, called neurons, communicate with each other abnormally. During a seizure, the neurons' normal pattern of activity is disturbed. This can cause strange sensations, emotions, and behavior; or convulsions, muscle spasms, and loss of consciousness.
Anticonvulsants are medications that can help prevent and/or manage seizures:
Common brand names include:
Carbamazepine prevents seizures by reducing the excitability of nerve fibers in the brain. This medication is taken as a tablet (regular or chewable) or liquid. It is best taken at the same time or times each day; taking it with food or liquid can help prevent stomach upset.
Possible side effects include:
More serious, but less common side effects include: bone marrow suppression, rashes, and heart failure.
Common brand name: Zarontin
Ethosuximide controls seizures by depressing nerve transmissions in the motor cortex, the part of the brain that controls muscles. The medication is taken in liquid or capsule form. It is best taken at the same time or times each day; taking it with food or liquid can help prevent stomach upset.
Possible side effects include:
Persistent fever or sore throat should be reported to your physician because these symptoms may indicate a low white blood cell count due to bone marrow suppression.
Common brand name: Neurontin
The mechanism by which gabapentin prevents convulsive seizures is unknown, but is thought to increase the brain concentration of a protein called gamma-aminobutyric acid (GABA), which calms the brain. This medication is taken in capsule form. Maintenance dosage varies among patients. It is best taken with food or liquid to prevent stomach upset.
Possible side effects include:
Common brand name: Lamictal
The mechanism by which lamotrigine prevents convulsive seizures is uncertain but it may be by stabilizing nerve membranes. The medication is taken in tablet (regular or chewable) form. Maintenance dosage varies among patients. It is best taken with liquid to prevent stomach upset.
When you are taking lamotrigine, contact your doctor immediately if you have the following symptoms:
Other possible side effects include:
Common brand name: Trileptal
Oxcarbazepine is believed to prevent convulsive seizures by altering the transmission of nerve impulses in the brain and thereby stabilizing the nerve membranes. This medication is taken in tablet or liquid form. Maintenance dosage varies among patients. It is best taken with liquid.
Possible side effects include:
Common brand name: Dilantin
Phenytoin prevents seizures by promoting sodium loss in nerve fibers. This inhibits nerve excitability and the spread of nerve impulses. This medication is taken in tablet (regular or chewable) or liquid form. It is best taken with liquid and at the same time each day.
Possible side effects include:
Common brand name: Mysoline
Primidone is believed to prevent seizures by inhibiting the repetitious spread of nerve impulses. This medication is taken in tablet or liquid form. It is best taken at the same time each day, and it is best taken with liquid or food.
Possible side effects include:
Common brand name: Depakene, Depakote
Valproic acid may prevent seizures by increasing concentrations of gamma-aminobutyric acid (GABA). This inhibits nerve transmissions in parts of the brain. This medication is taken in capsule or syrup form. It is best taken once a day, at the same time each day, and taking it with liquid or food can help prevent stomach upset.
Possible side effects include:
These two drugs of the large class of benzodiazepines are approved for use in various kinds of seizure disorder. Diazepam is far more frequently used than clonazepam and can be given orally, by injection, or by rectal gel. They are central nervous system depressants and are habituating.
Possible side effects of benzodiazepines include:
Contact your health care provider if:
Never discontinue or reduce your medications without first consulting your doctor.
Sources:
National Institute of Neurological Disorders and Stroke
The Merck Manual of Medical Information , 17th ed. Simon and Schuster, Inc.; 2000.
Complete Guide to Prescription & Nonprescription Drugs , 2002 ed. Berkley Publishing Group; 2001.
American Academy of Family Physicians
Dreifuss FE, Rosman NP, Cloyd JC, et al. A comparison of rectal diazepam gel and placebo for acute repetitive seizures. N Engl J Med. 1998;338:1869-1875.
Guidelines for the management of chemotherapy-induced nausea and vomiting. Cancer Care Ontario Web site.
Available at:
http://www.cancercare.on.ca/access_158.htm
.
Accessed November 2002.
Last reviewed February 2003 by Jondavid Pollock, MD, PhD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.