frontal lobe tumour

My daughter in law in Canada had breast cancer 7 years ago and was recently diagnosed with tumours in the spine,shoulder,hips and brain. The tumour in the brain,attached to the frontal lobe, was removed by surgery four weeks ago and was benign, so thought not to be part of the recurring breast cancer. Recently her pain increased and her GP gave her an anti inflammatory (non steroid as the steroids used at the time of the surgery caused euphoria) and then tylenol3, 3 times daily. Yesterday she had slurred speech and loss of use of her legs. She has been suffering from extreme fatigue for several days. My son took her to emergency  where they have kept her in overnight and plan to do a CT scan tomorrow. She had not yet started chemo treatment planned for the other tumours as her euphoria caused her to believe that she was cured and did not need the treatment. the doctors advised waiting for a while. My worry is that this new conditon may be due to the frontal lobe surgery and not to the medications prescribed. Would it be normal for such side effects to show up after a period of four weeks and are they likely to be temporary.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine your relative and obtain a history, I can not tell you what the exact cause of her symptoms is. However I will try to provide you with some useful information.

As you mention, following surgery to the frontal lobes, changes in mood and personality can occur. These typically appear in the days following recovery from surgery; some of the changes are temporary, due to swelling around the area of the surgery, and improve over days to weeks. Sometimes, when there is extensive swelling, steroids are needed to bring the swelling down. If an extensive part of the frontal lobe was damaged or resected, then more permanent changes can occur. If there are neurologic changes that do not show up until weeks after surgery, complications such as bleeding or fluid build up or rarely even infection need to be excluded, depending on what the exact neurologic symptoms are. Also as you mention, alternatively, the symptoms may be medication-induced, and this would be more likely if the patient was asymptomatic for several weeks after surgery, then the symptoms appeared after medication intake; in that case, these would be temporary and would resolve once the medication wears off.

It is always important in patients with brain surgery and with cancer to exclude depression or mania or other psychiatric disorders as being the cause to new personality or mood symptoms.

Continued followup with physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[pats2137]

Thank you so much for your helpful reply. The blood tests at the hospital showed some infection and a CT scan of the liver shows multiple small lesions on the liver which were not picked up by a scan in the earlier stages of investigation. They have prescribed strong antibiotics and her oncologist will see her on 21st, hoping that the antibiotics will have worked and that she can start the chemo. We feel devastated by this news as the prognosis seemed better when the tumours were only in the bones.