Definition and Overview

Neuro-oncology consultation is an appointment with an oncologist who specialises in tumors or masses found in the central nervous system (neuro).

Oncology is generally the study of tumors, although health experts have limited the field to the diagnosis, treatment, and care of cancer. Neurology, on the other hand, is the field of science and medicine that studies the parts of the central nervous system such as the brain, spine, spinal cord and nerves.

Because the brain is critical to a person’s survival, any problem affecting it can be deemed serious or life-threatening. In some cases too, such as cancer in the gliomal tissue (glioma), the condition can worsen in a short time due to its aggressiveness.

A problem in the brain and other parts of the nervous system affects not only the physical movements but also the cognitive performance of the patient, as well as memory.

Who Should Undergo and Expected Results

Neuro-oncology consultation is recommended for:


1. Patients who have been diagnosed with neurological cancer – Cancer of the brain, for example, affects people of all ages, although they tend to be more common among children and males.


2. Those who are diagnosed with other types of cancer – Cancer affecting the brain can be deemed primary, which means they originate from the brain, or metastatic, which suggests the cancer cells come from other parts of the body. Usually, a neurology test is performed if the following symptoms are present:

  • Blurry vision
  • Disorientation
  • Dizziness and nausea
  • Projectile vomiting
  • Frequent headaches
  • Fatigue
  • Anemia
  • Loss of appetite
  • Unexplained and sudden weight loss
  • Seizure
  • Paralysis
  • Fainting


3. Patients who need a second opinion – A brain cancer diagnosis can be scary that patients may seek another expert’s opinion for confirmation or to get another perspective when it comes to the condition’s treatment and management.

It is expected that during the consultation, the neuro-oncologist will be able to:

  • Provide an accurate diagnosis
  • Stage and grade the cancer
  • Provide ideal treatment options based on multiple factors such as age, overall health of the patient, treatments available, and presence of other diseases
  • Confirm whether the tumor is malignant or benign

How Does the Procedure Work?

A consultation with a neuro-oncologist happens once the patient is referred by the primary physician. This could be a neurologist, paediatrician, ophthalmologist, or a general practitioner. It could be that the initial interventions to treat the patient or manage the symptoms didn’t work or the condition has worsened that it requires the skills of a specialist. Often, the primary doctor has already requested certain neuro tests that confirmed the presence of suspicious mass or lesion in the nervous system, particularly the brain.

During the consultation, the neuro-oncologist will:

  • Review the medical records of the patient
  • Interview the patient about his or her personal and family history, especially if they do not reflect in the medical records
  • Conduct more tests such as imaging (PET, CT, or MRI)
  • Assess the patient’s cancer (stage, grade and prognosis)


The neuro-oncologist will then create a treatment plan, which normally involves surgery, chemotherapy and radiation therapy. At this point, he will refer the patient to specialists in these specific areas (e.g., surgeon, radiologist) who can provide comprehensive information on the treatment, management and follow-up. All these specialists will work and collaborate to give the patient better chances of overcoming his or her illness.

A part of the treatment plan may be neuro-psychology, which refers to the treatment and management of the patient’s cognitive function that can be significantly affected by cancer. The neuro-oncologist may also recommend financial planning, counseling and group support therapy for the patient.

Some neuro-oncologists also extend their support to loved ones or caregivers, who will be oriented on their responsibilities in taking care of the patient.

Possible Risks and Complications

A cancer diagnosis is always difficult for any patient, more so if it has a poor prognosis, which usually happens when it affects the nervous system like the brain. The combination of the poor physical and emotional state of the patient may prevent him from following consultation schedules. If there’s a poor relationship between the doctor and the patient, the latter may feel less confident and uncomfortable to discuss his condition and symptoms, jeopardizing his treatment and survival in the process.

Reference:

  • Society for Neuro-Oncology
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