Someone with brain cancer can expect different kinds of symptoms, all of which change as brain cancer progresses. There’s likely to be an overall decline, which affects the body as whole. There also may be an effect on a specific area of the brain or on the whole brain, which may be caused by swelling and the tumor.

Different areas of the brain control different body functions. A tumor in an area of the brain associated with a certain function will affect that function. For example, a tumor in an area that controls speech will affect someone’s ability to talk. Such effects are among the early symptoms of brain cancer and often lead to its diagnosis. As the tumor grows these symptoms become more obvious.

The effect of a tumor and swelling on the whole brain affects the general functioning of the brain. As the cancer progresses it may produce these symptoms:

• increased sleepiness;
• decreased ability to move around;
• trouble speaking or understanding conversation;
• loss of memory and especially the ability to form new memories;
• impaired judgment, especially the ability to judge how much help one needs to get around;
• weakness, which may affect only one side of the body;
• seizures;
• headaches;
• extreme mood changes.

Medications can help with some of these symptoms. Steroids are often used to decrease swelling in the brain and around the tumor. Anticonvulsants are used to manage seizures. Acetaminophen (Tylenol®) can be used to ease headaches. Occasionally stronger painkillers such as opioids are used, but the headaches usually are not difficult to control. Pain medications can be used for other types of pain, but usually pain is not a significant problem with brain cancer.

As coordination and alertness decrease, swallowing can become difficult. Difficulty with swallowing may cause secretions to enter the lungs, which may increase lung congestion. Eating may also become an issue. Often liquids are harder than solids to control and swallow. A liquid can spill prematurely into the back of the throat and cause coughing. Thickening agents, available in pharmacies, can be added to liquids to help swallowing. Speech-language specialists can help with swallowing problems as well as with any communication issues that may arise. Difficulties with swallowing, eating and drinking need individual solutions that make the patient comfortable.

When a person is having trouble swallowing, family members may worry that the person isn’t getting enough food or fluids. Yet, difficulty swallowing is only one factor that may be contributing to issues related to food and fluids. Commonly cancer patients lose their appetite and thirst. Medications such as steroids may increase appetite. If someone’s appetite is good, but the person has trouble swallowing, then ways must be found to satisfy hunger.

As brain cancer progresses, the possibility of falling is an increasing concern. People generally get weaker as any cancer progresses. With brain cancer there are added issues of balance, coordination and judgment, which may prevent a patient from asking for help. It’s challenging to prevent falling when both mobility and judgment are affected. It’s important to accept that a caregiver can only do what’s possible, and often it’s not possible to have someone at the bedside around the clock. You may want to ask for a physiotherapist or occupational therapist to assess the situation and offer advice.

Someone with brain cancer may experience symptoms that are common to most cancers generally, which affect energy, strength, appetite, breathing and responsiveness.