The Humor in Tumor

Headaches

The joke is inevitable.

A headache has been throbbing inside your skull for hours, resistant to everything in your medicine cabinet. Then a loved one says in a calm, reassuring voice: "Don't worry. It's probably just a brain tumor."

Yes, they're kidding. But what if there is something horribly wrong inside your head? How do you tell a garden-variety headache from one that signals an impending tumor, aneurysm, or other life-threatening ailment?

The key warning sign is change, says Marc Simard, M.D., Ph.D., a neuroscience professor at the University of Maryland. We all get headaches on occasion, whether from stress, sinus pressure, or too much beer the night before. But a sudden change in the frequency, severity, or pattern of headaches warrants further investigation.

One cause for concern is frequent morning headaches. Tension headaches usually occur at the end of a stressful day. But since blood flow to our head increases when we're horizontal, headaches from intracranial tumors that are impinging on a blood vessel are most common when we first awake. (While sinus headaches can strike early in the day, they're usually accompanied by sinus pressure or tenderness.)

A particularly ominous sign of trouble: suspicious headaches accompanied by other symptoms. Weak or numb limbs, vomiting, dizziness, and speech or vision problems suggest the tumor is interfering with brain function, and demand immediate attention.

Because the brain itself feels no pain, a tumor generally causes headaches only when it affects a nerve or blood vessel.

On the other hand, you're unlikely to suffer a brain aneurysm without realizing it. The most obvious symptom is "the sudden onset of the worst headache you've ever had," says Seymour Solomon, M.D., director of the Montefiore Medical Center Headache Unit in New York.

The prognosis for brain cancer, while grim, is better than many may think. The American Cancer Society estimates that of the 17,000 new brain cancers this year, 26 percent of patients will survive at least five years. Simard emphasizes that early diagnosis will raises the odds, "If the tumor is found early enough, treatment can be very effective. Almost all of the vascular lesions and many of the tumors can be treated quite successfully and permanently."

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