Seeking Help: Navigating Malignant Brain Tumor Treatment Options

Q: Seeking Help: Navigating Malignant Brain Tumor Treatment Options

Hello： 1. Without the name of the medication, I cannot confirm whether it is covered by health insurance. I believe Chang Gung Hospital would not deceive patients. 2. I suggest considering the option of discontinuing treatment. Family members do not need to fe

My brother has been diagnosed with a malignant brain tumor... please help me?

My brother was diagnosed with a malignant brain tumor after fainting and being admitted to Kaohsiung Chang Gung Memorial Hospital at the end of May this year.
The doctor immediately announced that surgery was necessary within two days, stating that one of the tumors was larger and needed to be removed first due to the risk to his life.
In addition to that tumor, there were three smaller tumors, but they were located deeper and could not be removed together due to the associated risks.
After the removal of the larger tumor, he followed the doctor's instructions and underwent nearly two months of radiation therapy.
However, last week he started vomiting after eating, experienced seizures, and had a persistent fever, leading to his readmission to the intensive care unit.
An MRI revealed that the smaller tumors had significantly increased in size, and the doctor indicated that the radiation therapy was ineffective and could be discontinued.
The doctor informed us that if we chose surgery, there was a high risk that he might be left with only one functioning arm or leg, or could become severely impaired, and even with surgery, complete removal was not possible.
There is also an option for chemotherapy with a new drug, but it is not covered by health insurance and would cost around 500,000 NTD, which could extend his life by six months to a year.
I am the only one in the family earning money, and we simply do not have 500,000 NTD available for chemotherapy.
Currently, my brother is in the hospital receiving no active treatment, only IV fluids containing antibiotics, steroids, anti-inflammatory medications, pain relief, and anti-seizure medications, which seem to be aimed at preventing symptoms.
I would like to ask for your advice on whether this new drug is truly not covered by health insurance, or if you could suggest what I can do to help save my brother.
You can reply to me via email or call me at (0960-368875).
I truly feel helpless.

sammi, 20~29 year old female. Ask Date: 2004/09/01

Dr. Chen Sirong reply Oncology

Hello: 1.
Without the name of the medication, I cannot confirm whether it is covered by health insurance.
I believe Chang Gung Hospital would not deceive patients.
2.
I suggest considering the option of discontinuing treatment.
Family members do not need to feel that providing treatment is the only way to honor the patient.
Timely discontinuation of treatment can reduce the patient's suffering and allow for a peaceful passing, which is truly a way to help the patient.
Sincerely, Dr.
Chen Sih-Jung, Oncology.

Reply Date: 2004/09/01

More Info

I'm truly sorry to hear about your brother's situation. Navigating the complexities of malignant brain tumor treatment can be overwhelming, especially when faced with difficult decisions regarding surgery, radiation therapy, and chemotherapy. Here’s a comprehensive overview of the options available and some considerations that may help you in this challenging time.

Understanding the Diagnosis and Treatment Options
1. Surgical Intervention:
- It seems your brother underwent surgery to remove the larger tumor, which was a critical step given the potential life-threatening nature of the mass. However, the presence of smaller tumors that are inoperable poses a significant challenge. The decision to operate on brain tumors often weighs the benefits of removing the tumor against the risks of neurological deficits, which can include weakness, speech difficulties, or cognitive changes. If the smaller tumors are growing, it may indicate that they are aggressive or resistant to treatment.

2. Radiation Therapy:
- Radiation therapy is typically used after surgery to target residual tumor cells. However, if the recent MRI shows that the smaller tumors have increased in size despite radiation, it may suggest that they are not responding to this treatment. This can be disheartening, but it’s important to discuss with the oncologist whether there are alternative radiation techniques, such as stereotactic radiosurgery (e.g., Gamma Knife), which can deliver high doses of radiation to specific areas while sparing surrounding healthy tissue.

3. Chemotherapy:
- Chemotherapy can be an option, especially if the tumor type is known to respond to specific agents. You mentioned a new chemotherapy drug that is not covered by insurance. While it’s true that some newer treatments may not be covered, it’s essential to consult with the oncologist about the potential benefits versus the costs. There may also be clinical trials available that could provide access to cutting-edge treatments at no cost.
4. Palliative Care:
- Given your brother's current condition, it’s crucial to consider palliative care, which focuses on providing relief from symptoms and improving quality of life. This can include managing pain, nausea, and seizures, as well as providing emotional and psychological support for both your brother and your family.

Financial Considerations and Support
- Insurance and Financial Aid:
- It’s understandable that the cost of treatment is a significant concern. Reach out to your brother's healthcare provider to discuss financial assistance programs or payment plans. Many hospitals have social workers who can help navigate insurance issues and connect you with resources for financial aid.

- Additionally, organizations such as the American Cancer Society or local cancer support groups may offer assistance or guidance on how to manage treatment costs.

Emotional and Psychological Support
- Support Networks:
- This is an incredibly tough time for you and your family. Don’t hesitate to seek support from friends, family, or support groups for caregivers of cancer patients. Sharing experiences and feelings can be therapeutic and provide you with additional resources and coping strategies.

Next Steps
- Consultation with Specialists:
- If you haven’t already, consider seeking a second opinion from a neuro-oncologist or a specialized brain tumor center. They may offer insights into alternative treatment options or clinical trials that could be beneficial.

- Open Communication with Healthcare Providers:
- Keep an open line of communication with your brother’s medical team. Ask questions about all available treatment options, their potential outcomes, and the implications of each choice. Understanding the rationale behind their recommendations can help you make informed decisions.

In conclusion, while the journey ahead may seem daunting, there are options available, and support is out there. Your brother’s health and comfort should be the priority, and exploring all avenues for treatment and support can help you navigate this challenging time. Please take care of yourself as well, as your well-being is crucial in supporting your brother.

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