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Botox for Brain Tumour Headaches?

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Botox has become so connected to migraine treatment over the last few years, that we may be forgetting its possible value for other headaches.

Two patients with cancer were recently treated at the MD Anderson Cancer Center. Both had brain tumours, though of different types.

After Botox injections both patients experienced fewer headache days, shorter headaches, and less intense headaches. There were no complications, and quality of life improved.

Dr. Alexander Mauskop of the New York Headache Center comments:

It is not surprising that Botox could help headaches caused by a brain tumor. The brain itself is not pain-sensitive – neurosurgeons can cut it in an awake patient without causing any pain. Most of the pain originates in the brain covering called meninges which are innervated by the trigeminal nerve and which can be stretched and irritated by a tumor. The trigeminal nerve also provides sensation over the face and the anterior part of the head. Botox works by reducing pain signals sent from the trigeminal nerve endings to the brain.

Botox for brain tumor headaches?

The end of the story is that doctors can explore the use of Botox (onabotulinum toxin A) for headache and migraine symptoms that may have a variety of causes. The authors of this study conclude: “With careful dose and injection site adjustment based on tumor location, use of Onabotulinum toxin A injections is a safe practice in patients with diagnosis of brain tumor headaches.”

For the study abstract, see Use of Onabotulinum Toxin A as Ambulatory Treatment of Brain Tumor Headaches in 2 Ambulatory Patients at MD Anderson Cancer Center: A Retrospective Chart Review (bottom of page).

Also see: Brain Tumor or Migraine?

Women, Migraine, and Serious Disease

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A study published this year in the Journal of Headache and Pain confirms our previous concerns about migraine and heart disease – but also gives us surprising clues about cancer risk.

Take care of your heart!

It was hard to come up with a title for this post, and in fact this is a complex study with no easy answers. But let’s start with an overview.

This research comes from the Women’s Health Study, a study of 27,844 women. They were 45 and older at the start of the study, which followed the women over the next two decades or so.

The study was looking for some big clues or general trends when it comes to headache and migraine and death rates. Simply put, do we see women with migraine dying at a higher rate than the general population? If so, what are they more likely to die of?

The perhaps comforting short answer is – no, women with migraine are not more likely to die sooner than women in general. But there’s more to it than that. (And in some ways, we would like to start seeing women with migraine dying later than the general population – because often times they are more aware of their health and may start taking better care of themselves!)

But there was one cause of death that was higher among women with migraine with aura specifically – that was cardiovascular disease. As we’ve noticed in other studies, migraine, and especially migraine with aura (as in this case) does seem to increase risk of cardiovascular disease.

Although some have questioned the role of migraine medication in this link, it’s interesting that, in this study, it was only migraine with aura that increased risk.

The moral of the story is the same as what we’ve been saying for years – if you have migraine, treat it. And be aware of other risk factors you may have for stroke and heart attack et cetera.

Now, for those of you who are mathematically minded, you may be asking – if there is an increased risk for cardiovascular disease, why weren’t women with migraine in general more likely to die earlier? The surprising answer – those with migraine with aura were also at a slightly decreased risk for cancer – especially female-specific cancers. So that balanced out the numbers.

Why would this be? Remember, this study was just looking for some overall clues, it doesn’t give us a lot of specific information. But researchers believe the answer could be related to hormones, which do affect both migraine and cancers.

For more on this study, see Women With Migraine, Aura Have Increased Risk of Cardiovascular Death. For all the details of the study, go to Migraine, headache, and mortality in women: a cohort study.

Chemotherapy Headache

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Chemotherapy headache is very common in cancer patients, although the chemo itself is not always the cause, or only cause, of the pain. Today we’re going to take a look at what may cause the headaches, and what you can do to fight them.

Chemotherapy and headachesIf you’re experiencing headaches during or after chemotherapy, you probably don’t need to be told that your body is already going through a lot of unwelcome changes. There are a huge number of things that can lead to head pain – the chemotherapy itself, other medications (including “painkillers”!) that you take along with the chemo, the cancer itself, changes in schedule and eating habits, and the many other changes that are happening in your body that are directly or indirectly related to your treatment.

In light of this reality of chemotherapy headaches, here are some important things to remember:

  1. Always mention headaches, related symptoms, and especially any changes in your headache symptoms, to your doctor. Do not assume that this is just another symptom you just have to “live with”. Even if the headaches are temporary (and will go away after the treatment is over), there are may be things you and your doctor can do to alleviate the pain. And alleviating the pain may help your overall treatment be more effective. But some headaches can be signs of ongoing and serious problems that need more attention.
  2. Pay attention to the timing and intensity of the pain, and any related symptoms. It can be hard to keep track when you already feel so tired and sick, but if you notice anything it can help your doctor diagnose your pain. For example, are headaches waking you up in the night? Are they worse in the morning? Is nausea worse when the headache is present? Any clues might help you find a good treatment.
  3. Make sure your doctor knows your headache history. Have you been prone to migraine attacks in past years? Or regular, mild tension-type headaches?

Chemotherapy headache, and this includes chemotherapy and migraine headaches (and other migraine symptoms) can be difficult to treat. You may or may not be able to conquer all the pain, but there are some things that you and your doctor might want to consider:

  • Stay Hydrated. If you’ve been told to drink more water and you’re having trouble getting it down, you’re not alone. But drinking lots of water has helped some people lessen their headaches. If you can’t drink much water, but find other liquids more appealing, talk to your doctor. She can help you choose something that will be easier for you to drink. Another option is to drink one thing, and then something else, rather than sticking to one thing all the time.
  • Adjusting medications. Medications may trigger headaches during chemo treatment. This may be nausea medication (such as ondansetron (Zofran)), or the chemo drugs themselves. Your doctor might be able to adjust the level of your chemo drugs, or give you a different medication for nausea, for example. Even “painkillers” may lead to more headaches. If the dosis isn’t right for you, for example, a drug treating the pain may start “rebound headaches” – as if your body is starting to ask for more and more of the drug. Adjusting the dose, changing the medication, or even alternating meds, may help.
  • Fighting chemo headache with medication. Taking any extra medication during chemo is common, but as you probably know, it’s a tricky balance. Your doctor will want to avoid NSAIDs (like ibuprofen or aspirin), but might want to try paracetamol/acetaminophen, or a prescription medication.
  • Keep a regular “schedule” as much as you can. Those with migraine often find changes to schedule and meals especially difficult, and there’s only so much you can do about it. But if you can try to eat/sleep/wake up/take a short walk at a more regular time, it might help lessen the headache pain.
  • Complimentary treatment. As with medications, complimentary treatments will vary depending on the patient. A cold compress or ice pack in a towel may help some people, but it may or may not help you. But it’s worth a try. Two options that may be helpful include the ICEKAP and the ThermaZone Continuous Thermal Therapy Device. Massage can also help. A warm foot bath, or foot massage, may also help alleviate headache symptoms.

It can be overwhelming juggling many symptoms and treatments at the same time. But if you can lessen your chemotherapy headache, it can help your overall treatment. If you’ve experienced chemotherapy headache and have found something that helped, leave a comment!

More about chemotherapy headache and cancer related headache from the American Society of Clinical Oncology here.

Helicobacter Pylori and Migraine

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Helicobacter pylori, or h. pylori, is the sneaky bacteria known for causing ulcers. Usually, ulcers are caused either by this bacteria, or long term use of NSAIDs, such as ibuprofen.

Helicobacter Pylori and MigraineFor many years researchers have been asking the question – does an h. pylori infection lead to more migraine attacks? And if so, could treatment lead to a better quality of life for migraine patients?

The research has been somewhat conflicting. But overall, it does seem more likely that migraine patients will have an h. pylori infection.

There are two sets of patients that may be tested – first, those who actually have ulcers. They are the ones who can benefit most from testing and treatment.

Second, those who are at high risk or who have had gastric cancer.

Now for the majority of the rest of us, testing and treatment has never been recommended. The fact is that many, many people seem to have the h. pylori bacteria, but most do not have any symptoms.

On top of that, the conflicting results of studies have not yet shown us exactly who may benefit, among migraine patients. It could be, for example, that h. pylori is more of a problem in patients who otherwise are at low risk of migraine (for example, they have no relatives with migraine – but h. pylori may be connected with the triggering of migraine symptoms).

A recent Mexican study into the gastrointestinal disorders related to migraine suggested that, in spite of the somewhat confusing past studies, there was at least enough evidence to support further research, and even testing of migraine patients (see Gastrointestinal disorders associated with migraine: A comprehensive review).

At the very least, if you’re a migraine patient at high risk for gastric cancer, or with ulcers, or you seem to be otherwise at low risk for migraine, you may want to ask your doctor about testing and treatment of h. pylori. Otherwise, it may not be a major factor for you, and you’re probably better to focus on other possibilities for the time being.

If you have been treated for h. pylori, have you seen any improvement in your migraine symptoms?

For more on treatment, see Helicobacter Pylori Infection Treatment & Management

Brain Tumor or Migraine?

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Brain Tumor or Migraine?

Brain Tumour or Migraine?

Headaches are a symptom of both migraine and brain tumour.  Symptoms alone can’t diagnose a tumour, but there are “warning signs” that should send you to a doctor.

See a doctor right away if:

  1. Headache attacks get worse and/or more frequent
  2. The pattern of headaches changes
  3. New symptoms include changes in behaviour, weakness, confusion or dizziness

… and headache treatments aren’t helping.

Tell your doctor if:

  1. Headaches worse in the morning or after a nap
  2. Headaches worse with coughing, sneezing or straining
  3. You’re experiencing vision and/or hearing problems
  4. You smoke or have a history of cancer

Good news?

  • Most people with headaches (even severe ones) don’t have a brain tumour (brain tumor)
  • More brain tumours are non-cancerous than cancerous
  • Brain tumours are very serious, but there are treatments available

For more information:

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The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.