Approved by the Cancer.Net Editorial Board, 10/2022

Almost everyone gets a headache from time to time. This happens when the muscles, nerves, and blood vessels in your head and neck become inflamed and cause pain.

When you have cancer, it is important to pay attention to your headaches. They can be a symptom of cancer itself or a side effect of your cancer treatments. Headaches can be painful and disruptive so it is important to talk to your health care team when they happen.

Managing side effects, which can include headaches, is an important part of cancer care and treatment. This is called palliative and supportive care. Talk with your health care team regularly about any symptoms you or the person you are caring for experience. This includes a new problem or if a problem worsens.

What are primary and secondary headaches?

Headaches can be described as "primary" or "secondary." Knowing the type of headache you have can help your health care team know how to treat it.

Primary headaches include migraines, cluster headaches, and tension headaches. These are called primary headaches because the headache is the main problem. It is not a symptom of another problem. However, for people with cancer, primary headaches can feel worse than usual or be more frequent.

Secondary headaches are caused by other medical conditions, such as a brain tumor, head injury, infection, or medicine. For people with cancer, secondary headaches may be a side effect of medication or a result of the cancer itself.

Primary and secondary headaches are common in people with cancer.

What are common symptoms of headaches?

Pain is the most common symptom of headaches. It can be described in terms of the location, quality, and severity. Your health care team may ask you to describe the pain your feeling using these categories.

Location is the place where the pain occurs. It may occur in different areas of your head or neck. Common headache locations include:

  • Forehead or temples

  • Back of the neck

  • Concentrated over the eyes

Quality means how the headache feels to you. Not all headaches feel the same. They can feel like throbbing pain, stabbing or piercing pain, feel more like pressure, or a dull ache.

Severity is the level of pain from your headache. It may range 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 severe. Other times, they start with severe pain and remain that way.

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

  • Nausea and vomiting

  • Dizziness

  • Blurred vision

  • Sensitivity to light or noise

  • Fever

  • Difficulty moving or speaking

  • Pain that increases with activity

Is there a pattern to my headaches?

Your health care team will also want to know if there is a pattern to your headaches. For example, when and how often they occur. Think about the timing, frequency, triggers, and duration of your headaches.

Timing 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 later in the day are often tension headaches.

Frequency is how often you have a headache. For example, you may experience headaches occasionally, weekly, or daily.

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

Duration is how long the headache lasts. It may range from minutes to hours to days. Some headaches start and end very suddenly. Others come and go over several hours or days.

Consider keeping a diary to track these details about your headaches. This will help your doctor diagnose and treat your headaches. A headache diary can be written down in a notebook or tracked on your phone, such as with the free Cancer.Net app.

What causes headaches?

Headaches can occur for many different reasons. People with cancer may want to be aware of the causes so they can be on the lookout for symptoms of headaches. Keep in mind, other factors such as stress, fatigue, anxiety, and sleeping problems may also cause headaches.

Certain cancers. Some cancers may be more likely to cause headaches. These include:

  • 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

Cancer treatments. Some cancer treatments can cause headaches. These include:

  • Some types of chemotherapy

  • Radiation therapy to the brain

  • Immunotherapy

Side effects of cancer or cancer treatment. Sometimes, the side effects caused by cancer or cancer treatment can also cause headaches. These include:

  • Anemia, a low red blood count

  • Hypercalcemia, a high level of calcium

  • Dehydration, a loss of too much water from the body caused by severe diarrhea or vomiting

Infections. Infections can also cause headaches. And certain cancer treatments can make you more susceptible to infections. Examples of infections that can cause headaches include sinusitis and meningitis. Sinusitis is a common infection of the sinuses. Meningitis is an uncommon infection of the protective membranes covering the brain and spinal cord.

Medication for cancer-related symptoms or other conditions. Sometimes, medication you are given to treat other cancer-related conditions can cause headaches. These include:

  • Antibiotics, used to treat infections

  • Antiemetics, used to prevent or treat nausea and vomiting

  • Heart medicine

How are headaches diagnosed?

Let your health care team know if you experiencing headaches. Your health care team will evaluate your symptoms and medical history. They will also conduct a physical exam. This information will help determine the headache type and cause.

Tell your doctor if your headaches:

  • Are frequent or severe

  • Wake you up at night

  • Change in frequency or other patterns

  • Are new or exhibit new symptoms

Your doctor may recommend certain medical tests to help diagnose the cause of your headaches:

How to treat and manage headaches when you have cancer

You should always let your health care team know if you are experiencing headaches, especially if they are frequent and do not resolve. They can help you treat and manage your headaches.

Many headaches can be treated and managed at home. Rest, activities that help you reduce your stress, staying hydrated, and eating well can help you feel better and prevent headaches. Avoiding caffeine or reducing the amount of caffeine you have every day can help, too.

When possible, doctors treat the condition that causes the headache. This can be done using medication or other strategies. Tell your health care team about any over-the-counter pain medication you take.

Medications to prevent and treat headaches or reduce the pain:

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

  • Prescription narcotic pain relievers, like codeine

  • Tricyclic antidepressants

  • Triptan medications, like sumatriptan (Alsuma, Imitrex, Zecuity)

  • Steroid medications, especially for headaches caused by cancer that spreads to the brain

  • Antibiotics, if an infection is causing the headache

Some complementary therapies may also help relieve and prevent headaches:

  • Acupuncture, which is the use of fine needles placed in specific points of the body

  • Massage

  • Visual imagery

  • Relaxation

Talk with your health care team about ways to control your headaches with complementary therapies, also called integrative medicine.

Questions to ask the health care team about headaches and cancer

  • Could my headaches be caused by cancer or cancer treatment? Or are they caused by another problem?

  • Are headaches a common side effect of the cancer or the cancer treatment I will receive?

  • How soon should I call you if I develop headaches or if my headaches get worse?

  • How can I get in touch during and after regular business hours?

  • What are ways I can track my headaches? Why is this helpful?

  • What treatments do you recommend for my headaches?

  • Do you recommend any complementary therapies for headaches?

  • Are there things I can do at home to ease my headaches?

Related Resources

Managing Stress

Evaluating Complementary and Alternative Therapies

How Symptom Tracking Makes Cancer Care Better

Pain Management