Follow-up treatment for brain tumors?
Hello Dr.
Chen: My mother was diagnosed with a brain tumor (located in the posterior right parietal lobe) on December 26, 2007.
She underwent resection on December 29, and the pathology report in early January indicated a malignant tumor (partially differentiated, stage III).
Subsequently, she received radiation therapy.
During the treatment, a new tumor, larger than the previous one, was found at the original site.
In February, she underwent another resection.
After the surgery, a small lesion was detected behind her ear, suspected to be a third tumor.
Instead of a third surgery, she was treated with 30 days of continuous radiation therapy.
During this period, she continued to take medications for epilepsy, hypertension, and steroids.
Radiation therapy was completed in mid-April.
On May 8, during a follow-up MRI, the doctor stated that the third tumor was no longer visible and that she only needed to have another follow-up scan in three months.
Consequently, all medications were discontinued.
Is it unnecessary for her to continue taking medication? Or should we consider the possibility of discomfort if she stops taking her medications? I asked her attending physician, who mentioned that since there is no tumor, there is no need for medication.
However, I have observed that the surgical site where the bone flap was repaired appears swollen.
My mother’s overall health is stable, but her emotional state is difficult to manage, with fluctuations between irritability and mood swings.
Therefore, I would like to ask if it is indeed unnecessary to continue medication for the tumor or the surgical site.
Thank you.
Ya Wai, 30~39 year old female. Ask Date: 2008/05/23
Dr. Chen Sirong reply Oncology
Hello, the medications can be divided into three categories:
1.
Anticancer drugs: Post-surgery chemotherapy (nitrosourea-based) such as PCV can also increase survival, especially in anaplastic astrocytoma, where 50% of patients can survive up to 157 weeks.
Additionally, temozolomide can be used orally during recurrence, with a response rate of up to 35%.
However, she currently has no tumors, so there is no need for anticancer medication.
2.
Symptom control medications: For conditions like hypertension and epilepsy, she was previously concerned about seizures or had experienced them, so she was taking medication.
Since she has not had any seizures currently, the medication has been discontinued, correct?
3.
Regarding the wound part, are you referring to the need for antibiotics to prevent infection? If the wound is healing well post-surgery, then that should be sufficient.
Reply Date: 2008/05/23
More Info
Managing post-surgery care for brain tumor patients is a complex process that requires careful attention to both physical and psychological aspects of recovery. Your mother’s case, involving multiple surgeries and treatments for malignant brain tumors, highlights several critical areas of concern that caregivers and healthcare providers must address.
Understanding Post-Surgery Care
1. Monitoring for Recurrence: After surgery, regular follow-ups with MRI scans are essential to monitor for any recurrence of the tumor. In your mother’s case, the fact that the third tumor was not visible on the latest MRI is a positive sign. However, it is crucial to continue monitoring as brain tumors can recur, especially in cases of high-grade tumors like anaplastic astrocytomas.
2. Medication Management: The discontinuation of medications such as anti-seizure drugs and steroids is often based on the absence of active disease and the patient's current health status. However, it is essential to maintain open communication with the healthcare team regarding any new symptoms or changes in behavior. If your mother is experiencing swelling at the surgical site or emotional instability, these could be signs that further evaluation is needed.
3. Emotional and Psychological Support: Emotional fluctuations, irritability, and mood swings can be common after brain surgery, particularly in cases involving significant neurological changes. These symptoms may be due to a combination of factors, including the effects of surgery on brain function, the stress of dealing with a serious illness, and potential changes in brain chemistry. Engaging with a psychologist or psychiatrist who specializes in neuro-oncology can provide valuable support and coping strategies for both your mother and your family.
4. Physical Care and Rehabilitation: Post-surgery, it is vital to ensure that your mother engages in appropriate rehabilitation exercises to regain strength and function. Depending on her condition, physical therapy may be beneficial. Additionally, caregivers should be vigilant about any signs of infection at the surgical site, such as increased redness, swelling, or discharge.
5. Lifestyle Adjustments: Encouraging a healthy lifestyle can significantly impact recovery. This includes a balanced diet, regular physical activity as tolerated, and avoiding substances that could negatively affect her health, such as alcohol and tobacco.
6. Communication with Healthcare Providers: It is crucial to maintain regular communication with your mother’s healthcare team. If you notice any concerning symptoms, such as persistent headaches, changes in consciousness, or new neurological deficits, these should be reported immediately.
7. Educational Resources: There are numerous resources available for caregivers and patients dealing with brain tumors. Books, support groups, and online forums can provide valuable information and emotional support. Organizations like the American Brain Tumor Association offer educational materials and resources for patients and families.
Conclusion
In summary, managing post-surgery care for brain tumor patients involves a multifaceted approach that includes monitoring for recurrence, managing medications, providing emotional support, ensuring physical rehabilitation, and maintaining open communication with healthcare providers. Your mother’s emotional and physical well-being is paramount, and addressing her symptoms holistically will contribute to her overall recovery. If there are any uncertainties regarding her care or if new symptoms arise, do not hesitate to reach out to her medical team for guidance.
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