Dr Nandish Kumar, Consultant, Medical Oncologist, HCG Cancer Hospital, Kalaburgi

Cancer treatments have witnessed a revolutionary change over the last few decades. With significant development in research, new treatment methods are being innovated that are more effective than how it used to be earlier. This is why many types of cancers are now curable and can be prevented with effective treatment and post-treatment care. However, the treatment process also brings an array of side effects with itself.

When any healthy tissue or organ is affected and a health problem arises, it is referred to as a cancer treatment side effect. These side effects vary from patient to patient depending on the type of the treatment. For some, the side effects are temporary, while for others, they can continue for years after the treatment is over. These can disrupt the daily routine and hamper the quality of life.

Of the many side effects, some patients complain of headaches, and in most cases, they are migraine headaches.

How is migraine headache different from regular headache?

Headache is a common phenomenon and almost everyone get a headache, either occasionally or regularly. These are annoying and pressurizing pains in the head that can be mild or severe and can last for few minutes to an entire day or week.

A type of headache, migraine causes excruciating pain that feel like throbbing or pulsating on one side of the head. Along with the severe headache, the patient may also feel nauseated, vomit or stay sensitive to lights and sound. These types of headaches can last for a few hours or continue for days and interrupt daily activities. Migraines are usually diagnosed based on the duration for which the patient has suffered the headache.

Certain types of cancers like brain and spinal cord cancer, nasopharyngeal cancer, lymphoma, pituitary gland tumours or if the cancer has spread to the brain. In other cases, they might be caused due to effects of the cancer treatment given to the patient. Some types of chemotherapy, radiation therapy to the brain and immunotherapy by using the body’s immune system to fight and kill cancer cells can cause migraine headaches. Even medications taken for cancer treatment, anaemia, high levels of calcium in the body, low platelet count, and dehydration during cancer treatment can trigger a migraine headache while stress, lack of sleep and anxieties can worsen the pain.

Symptoms of Migraine Headache in Cancer Patients

Factors that indicate a migraine headache include:

• At which time of the day does the headache occur?

• How many times a week does it happen – one or twice or daily or more?

• What triggers a headache – unbearable cold, flashing lights, loud noises, or any specific food?

• For how long does the headache stay – a few hours or a day? Or does it happen suddenly?

• Which areas of the head does it pain more – on the eyes, forehead or temples, neck or side of the head?

• How severe is the pain – mild or unbearable?

• How does the patient feel – dull pain, stabbing or throbbing?

Managing and treating migraines for Cancer patients

The treatment for migraines can be different from other headaches, so its very important to classify them appropriately. Patients are often prescribed medications for cancer-related or other types of pain. Some of these medicines may trigger migraine or may not be ideal since they do not target migraine specifically. Medicines are usually prescribed depending on the frequency of the migraine headache, ongoing treatment and cancer care plan and overall health.

Combining medication with lifestyle and behavioural measures can help manage migraine effectively.

• Take a break and move to a calm environment on the first sign of migraine headache. Relax and apply hot and cold compress therapy or take a warm shower.

• Sleep adequately. Migraine may keep you from getting sound sleep but maintaining regular sleep-wake cycle, avoiding distractions and relaxing while listening to soothing music and reading a book might help. Sleep for at least seven to eight hours.

• Eat well and do not skip meals. Be consistent with your food routine and avoid items that you suspect are triggering migraine.

• Exercise regularly to maintain healthy weight, keep anxiety and depression at bay. Choose an exercise that has been prescribed by the doctor and does not leave you exhausted.

• Stay hydrated. Make sure to drink water at least 8 glasses of water in a day and caffeinated drinks in moderation.

• Unfriend stress by keeping your daily routine, work environment simple. Take breaks when you feel overwhelmed. Stay positive and work towards achieving your goals.

• Doing yoga, especially deep breathing exercises for at least 10 mins can help you relax.

• Maintain a migraine diary to note down the trigger points. Sharing them with the doctors will help in making modifications in treatment and care plan, if required.

While these may take some time to show their benefits, it will help in managing migraine headache better and thereby, improving the quality of life. Keep the physician informed if the intensity of headache increases and get routine check-ups done.