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Brain and spinal tumours

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Supportive therapy for brain and spinal cord cancer

Supportive therapy is commonly used to treat the symptoms caused by brain and spinal cord tumours, but it does not treat the cancer. The drugs used may help lessen symptoms from the cancer or the treatment.

Supportive therapy may be used to treat:

  • swelling of the brain (cerebral edema) or of the spinal cord (spinal edema)
  • headache or other pain
  • nausea or vomiting
  • fatigue
  • seizures

Drugs, doses and schedules vary from person to person. It is important to report side effects to the healthcare team. Doctors may also grade (measure) how severe certain side effects are. Sometimes supportive therapy drugs need to be adjusted if side effects are severe.


A corticosteroid is any steroid hormone that acts as an anti-inflammatory by reducing swelling and lowering the body’s immune response (the immune system’s reaction to the presence of foreign substances). These drugs are used to treat cerebral or spinal edema. Swelling is caused by the growing tumour pressing on areas of the brain or spinal cord. Normal tissue may also swell as a reaction to surgery or radiation. Worsening cerebral edema can result in a cancer-related emergency referred to as increased intracranial pressure.

A person with cerebral edema may experience the following signs and symptoms:

  • headache
  • nausea with or without vomiting
  • vision problems
  • decreased levels of consciousness
  • a worsening of any neurological problems first noticed at diagnosis

A person with spinal edema may experience:

  • nausea with or without vomiting
  • numbness, tingling or loss of feeling in the legs or arms
  • loss of bladder or bowel control
  • pain in the back or neck
  • paralysis
  • decreased levels of consciousness
  • a worsening of any neurological problems first noticed at diagnosis

Most people with brain or spinal cord tumours will be given corticosteroids to treat or prevent edema. The most common corticosteroids used are:

  • dexamethasone (Decadron, Dexasone) – most common
  • prednisone (Deltasone)
  • methylprednisone (Medrol)

The drug is given at the lowest effective dose for each person and is gradually tapered down and discontinued after the person finishes treatment.

If the edema no longer responds to corticosteroids, mannitol (Osmitrol) may be used.

Possible side effects

Possible side effects of corticosteroids include:

  • infection
    • There is an increased risk of infection for people who are taking corticosteroids.
    • Taking these drugs may mask infection by reducing signs and symptoms, such as fever, sore throat or redness, swelling and discomfort around an incision or intravenous site.
    • Doctors may prescribe antibiotics along with corticosteroids.
  • digestive problems
    • Some people may have nausea, heartburn and stomach irritation or bleeding.
    • Taking the medication with food or milk can help reduce these side effects.
  • increase in blood sugar
  • frequent urination and increased thirst
  • increased appetite and weight gain
  • trouble sleeping
  • mood changes, restlessness, excitement or nervousness
  • weakness and decrease in muscle size
  • swelling of the face, feet, legs and arms
  • unusual hair growth on the body or face
  • decreased or blurred vision

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Up to 60% of people with brain tumours will have a seizure during their illness.

Anticonvulsants (anti-seizure medications) are given to people with brain tumours who have already had a seizure. Usually, anticonvulsants are not given to prevent seizures in people who have not had them.

The most common anticonvulsants used are:

  • phenytoin (Dilantin) – the most commonly used
  • carbamazepine (Tegretol)
  • valproate (Depakote)
  • levetiracetam (Keppra)

The level of the anticonvulsant drug in the blood is checked through regular blood tests. To be safe and effective, the drug level must stay within a certain range.

Possible side effects

Possible side effects of anticonvulsants include:

  • dizziness
  • drowsiness
  • uncontrolled muscle and eye movements
  • clumsiness
  • nervousness
  • confusion
  • slurred speech
  • nausea or vomiting
  • constipation
  • diarrhea
  • skin rash or itching
  • swollen, painful and bleeding gums
  • headache
  • blurred or double vision
  • trouble sleeping

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For more detailed information on specific drugs, go to sources of drug information.


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