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When a headache signals a brain tumor

June 30, 2014
Headaches, especially those that strike in the early morning or on waking up, can signal a brain tumor, according to a UCI Health brain specialist.

Everyone gets the occasional headache, which usually responds to rest and over-the-counter pain relievers. But sometimes, a throbbing head signals a more serious problem.

In fact, a headache is the most common early symptom of a brain tumor. UCI Health brain tumor expert Dr. Daniela Bota says you should be concerned if you begin waking up with headaches, or if your headaches have changed in type and severity.

"It’s important to pay attention when you start having headaches all of a sudden, at different times of the day or having different kinds of headaches," the neuro-oncologist says. "If a headache comes in the morning, especially if it is a recurring event, see your doctor right away."

When to be concerned

Be especially worried if your headache is accompanied by another symptom or symptoms, such as:

  • Numbness in the arms or legs
  • Vision problems
  • Nausea or vomiting
  • Difficulty speaking or finding the right words

“That’s when I recommend going to your primary care doctor or asking to be examined by a neurologist,” says Bota, co-director of the UCI Health Comprehensive Brain Tumor Program.

“Only imaging can determine whether you have a brain tumor — a CT scan or, better yet, an MRI (magnetic resonance imaging).”

Risk increases with age

The chances of developing brain tumors increases as we grow older. While children and young people do develop brain tumors, the highest incidence occurs in people between ages 65 and 70.

Among this group, the tell-tale signs of a brain tumor may be problems with memory, speech and even singing — symptoms often associated with Alzheimer’s disease or dementia.

“So many times I see people in my clinic who have come to medical attention because people close to them thought they were developing dementia,” Bota says. “They may not be remembering things very well or they are having problems finding the words to express themselves. Or they may be depressed and lose their will to do anything. If you see that in a loved one or in yourself, always ask to be evaluated with brain imaging.”

Brain tumors vary in type, location and severity. Some are benign, or noncancerous, but they can have serious, even debilitating effects, depending on where the tumor forms, Bota says.

“You know the saying, ‘We use only 10 percent of our brain’? Well, in that 10 percent, there are some 30 important hubs in the brain. If your tumor forms in one of those very important hubs, the symptoms are usually immediate."

“If the tumor forms in the rest of brain, those areas are involved in much finer and harder to differentiate tasks such as memory, attention, the ability to sing, vision. This is called the silent area of the brain.”

Innovative treatments

Treatment for brain tumors has come a long way in recent years, Bota says. Advances in diagnostic and surgical techniques have made it possible to remove many low-grade tumors. “If they are in places deep in the brain that we cannot reach — or if they are in important hub areas — we may try targeted radiation or targeted chemotherapy.”

The best treatment depends on an accurate diagnosis, which requires a level of specialty usually found only in academic medical centers with dedicated brain tumor programs.

“Studies show that brain tumor patients seen at academic medical centers live six months longer than do brain tumor patients treated in community cancer centers,” Bota says. “For some of the most aggressive tumors, patients survive 18 months longer.”

Leaders in research

Academic medical centers also are more likely to be participating in leading-edge research. “We have a  unique portfolio of clinical trials that are only available at UCI Health, including a unique vaccine cocktail,” Bota says. “We are also working on opening a new clinical trial to target the most aggressive glioblastoma cells.”

UC Irvine also is one of the few centers in the nation to offer the Novo-TTF (Novocure) device, which uses electrodes worn on the head to produce an electrical field that prevents tumors from dividing. The device, approved by the U.S. Food & Drug Administration, has been shown to be as effective as chemotherapy in some cases of glioblastoma multiforme, and without chemotherapy’s side effects.

“It requires careful mapping and planning,” says Bota, who is certified in the use of the device along with her colleague, Dr. Jose Carrillo. “You can’t get this treatment anywhere else in Orange County, Riverside or San Bernardino counties.”

The first step to effective treatment is an early and accurate diagnosis. Not long ago, an acquaintance told Bota about her college student son, who for the first time in his life suddenly began having severe headaches, accompanied by facial numbness that didn’t go away.

“I told her to get him an MRI immediately,” she recalls. “Lo and behold, it showed he had a small brain tumor. It was a low-grade tumor and we were able to treat it and stop it before it became a problem.”

— Kristina Lindgren, UCI Health Marketing & Communications