Definition and Overview

Neuro-cancer patients who have received treatment for their condition are scheduled for a follow-up consultation with their oncologist. The goal is to monitor the effectiveness of the treatment and ensure that no complications have developed that can further worsen the condition.

A neuro-oncologist is a doctor that specialises in cancer that affects the nervous system, especially the brain. According to the American Brain Tumor Association, there are at least 70,000 diagnosed primary brain tumors each year in the United States alone. Overall, around 700,000 people in the country are expected to develop the condition.

A person can be afflicted with any kind of brain tumor (there are currently 120), although most of the time, the cases are classified as meningioma, which affects the brain’s meningeal tissue. This is benign. In certain cases, however, the tumor turns out to be malignant or cancerous.

If it is cancerous, the oncologist will determine whether it is primary or metastatic, which means the cancer has originated from another part of the body and is sometimes called secondary cancer.

Tumors in the nervous system like the brain are classified as serious even if they are not benign or not cancerous as they can still put undue pressure on the brain that can lead to bleeding and death of the tissue.

Therefore, adequate and prompt treatment is necessary and this can include chemotherapy, radiation therapy and surgery. After the patient has completed his treatment, he will be scheduled to meet his oncologist for follow-up care.

Who Should Undergo and Expected Results

A neuro-oncology follow-up is conducted to:


1. Monitor the effects of the treatment – During the follow-up, the oncologist will find the answers to the following questions to determine if the treatment has been successful:

  • Has the tumor shrunk?
  • Has the tumor’s progress stopped or delayed?
  • Did the symptoms improve?
  • Are there risks and complications after the treatment?


2. Prevent or detect recurrence or spread – The follow-up is also necessary to determine if the cancer has recurred. The rate of recurrence depends on the type of cancer, previous treatments, and the presence of other factors. There is a tendency for a relapse to be more aggressive and is therefore more life threatening than the first. For this reason, it is essential that the recurrence is caught as early as possible, if not prevented for as long as it takes.


3. Determine whether the patient is on remission – Remission refers to the non-detection of signs and symptoms of cancer, which can be confirmed by certain tests. Often, this is confused with being cured or cancer-free, but many health experts now view the latter as a misnomer as there is no sure way of assessing whether there are cancer cells left.


4. Help the patient receive palliative care – Palliative care refers to the management of symptoms. Normally, it is recommended when the disease has already become terminal or end-stage.

How Does the Procedure Work?

A follow-up begins after the initial consultation and treatment have been completed. This means that the patient has already gone through surgery, radiation therapy, chemotherapy and other forms of medical intervention. However, it is possible that the patient is still taking medications.

Follow-up care is performed not just once but several times at certain intervals. For a patient who has gone through brain surgery, for example, the schedules are often frequent, more so if there are complications. However, if the patient is recovering well and no adverse effects have been noted, the follow-up visits are reduced to, say, once every 6 months.

Depending on the patient’s recovery and other unique circumstances, the oncologist may:

  • Recommend more or new treatment (if the current treatment plan is not working as expected)
  • Refer the patient to palliative care if the condition is already considered terminal or non-treatable
  • Work with other members of the healthcare team, which may include surgeons, radiologists, neuropsychologists, and occupational and physical therapists to help the patient increase his chances of surviving his illness.
  • Monitor the effects of the treatment on the physical and mental health of the patient
  • Review previous medical records and update them when needed
  • Recommend clinical trials and assist the patient during the application


Follow-up can be conducted in a hospital or a clinic. Each session may take 30 minutes to an hour.

Possible Risks and Complications

Follow-up care can be time-consuming and difficult for neuro cancer patients especially if they already have advanced symptoms or are living far away from the clinic. What neuro-oncologists can do is to take advantage of new technologies that allow them to perform some of the follow-up meetings remotely. These could be through video conferencing or VOIP (voice over Internet).

Reference:

  • Society for Neuro-Oncology
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