Approved by the Cancer.Net Editorial Board, 02/2016

Almost everyone gets a headache from time to time. There are two main types of headaches:

  • Primary headaches. Primary headaches include migraines, cluster headaches, and tension headaches. Tension headaches are also called muscle contraction headaches.

  • Secondary headaches. Secondary headaches are caused by another medical condition or underlying factor, including a brain tumor, head injury, infection, or medicines.

Primary headaches and secondary headaches are common in people with cancer.

Relieving side effects is an important part of cancer care and treatment. This is called symptom management or palliative care.

Symptoms of a headache

Not all headaches are the same. There are several ways to describe headache symptoms:

  • Timing. This is the time of day when you develop a headache. Sometimes, the timing of a headache provides a clue to its cause. For example, headaches that occur later in the day are often tension headaches.

  • Frequency. This is how often you have a headache, such as occasionally, weekly, or daily.

  • Triggers. These are the factors that bring on a headache. Triggers can include exposure to cold, blinking lights, loud noises, or specific foods.

  • Duration. This is how long the headache lasts, ranging from minutes to hours to days. Some headaches start and end very suddenly. Others come and go over several hours or days.

  • Location. This is where the pain is occurring. For example, pain may occur over the eyes, in the forehead or temples, at the back of neck, or on one side of the head.

  • Severity. This is the degree of pain, ranging from mild to severe and incapacitating. Incapacitating means that you have difficulty moving or speaking during the headache. Some headaches start with mild pain that gradually becomes more severe. Other times, the severity of the pain remains constant.

  • Quality. This is type of pain experienced, such as throbbing, stabbing, piercing, pressure, or a dull ache.

In addition to the headache itself, you may experience symptoms related to the headache:

  • Nausea and vomiting

  • Dizziness

  • Blurred vision

  • Sensitivity to light or noise

  • Fever

  • Difficulty moving or speaking

  • Pain that increases with activity

Causes of headaches

The following factors can cause a headache:

  • Cancer. Sometimes, the cancer itself can cause a headache, particularly the following types:

    • Cancers of the brain and spinal cord

    • Pituitary gland tumors

    • Cancer of the upper throat, called nasopharyngeal cancer

    • Some forms of lymphoma

    • Cancer that has spread to the brain

  • Infections. Sinusitis and meningitis can cause headaches. Sinusitis is an infection of the hollow passages in the bones of the head, called the sinuses. Meningitis is the swelling of the protective membranes covering the brain and spinal cord.

  • Cancer treatment. The following cancer treatments can cause headaches:

    • Some types of chemotherapy, such as fluorouracil (5-FU, Adrucil) and  procarbazine (Matulane)

    • Radiation therapy to of the brain

    • Immunotherapy, a treatment that boosts the body's natural defenses to fight cancer

  • Other medicines. Medicines for other conditions or cancer-related symptoms and side effects can cause headaches. These include antibiotics for infections, drugs called antiemetics to prevent or treat vomiting, and heart medications.

  • Cancer-related side effects or other conditions. The symptoms or side effects related to cancer or cancer treatment can also cause headaches:

    • Anemia, a low red blood count

    • Hypercalcemia, a high level of calcium

    • Thrombocytopenia, a low platelet count

    • The loss of too much water from the body, called dehydration, from severe vomiting or diarrhea

  • Other factors. Stress, fatigue, anxiety, and sleeping problems may also cause an increase in headaches.

Diagnosing a headache

It is important to tell your health care team if you are having headaches with the following features:

  • Frequent or severe

  • Waking you at night

  • Changes in the pattern or frequency

  • New and with other symptoms

Your doctor determines the type and cause of a headache based on your symptoms, medical history, and a physical exam. A complete description of your symptoms can help your doctor make an accurate diagnosis. Keeping a headache diary to track your symptoms can be helpful.

Your doctor may also order tests to help diagnose the cause of your headaches, including:

  • Blood tests

  • A computerized tomography (CT) scan, which makes a three-dimensional picture of the inside of the body

  • Magnetic resonance imaging (MRI) of the brain, which uses magnetic fields to produce detailed images of the body

  • Other tests based on the pattern and symptoms

Treating and managing headaches

When possible, headaches caused by an underlying condition are managed by treating the condition that causes the headache.

Medicines can help treat headaches or reduce the pain. But, it is important to get your doctor's approval before taking some over-the-counter pain medicines. Common medicines to treat and prevent headaches include:

  • Over-the-counter pain relievers, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)

  • Prescription narcotic pain relievers, such as codeine

  • Tricyclic antidepressants

  • Triptan medications, such as sumatriptan (Alsuma, Imitrex, Zecuity)

  • Steroid medications, especially to treat headaches caused by the spread of cancer to the brain

  • Antibiotics, if an infection is causing the headache

Getting enough sleep, eating well, and reducing stress may also help reduce the number and severity of headaches.

In addition to treatments prescribed by your doctor, some patients have found that complementary medicine helps relieve and prevent headaches.

Complementary medicine techniques include:

  • Acupuncture, which is the use of fine needles in specific points of the body to relieve pain

  • Massage

  • Visual imagery

  • Relaxation

Talk with your doctor or other member of your health care team about controlling your headaches with complementary medicine.

More Information

Coping with Cancer

Managing Stress

Evaluating Complementary and Alternative Therapies