Nursing Care for the Patient

When caring for an individual who has been diagnosed with a glioma, a nurse provides care dependent upon the progression of the tumor. A patient may require care ranging from post-surgery care after the resection of the tumor to palliative care when no other treatment is suitable for the patient. Just how treatment and outcome depend on the location and size of the glioma, the care that a patient may require is also dependent on the characteristics of the tumor. Extra assistance with mobility or completing activities of daily living (ADLs) are most likely tasks when the nurse will assist the patient. ADLs include everyday tasks like bathing, grooming (brushing hair, brushing teeth), getting dressed, eating, and using the bathroom. When it comes to doing a nursing assessment, it would most likely be directed specifically on a patient's neurological status because the brain is the affected organ. Changes in cognition, memory, movement, sight and a variety of other functions regulated by that brain may be affected by the presence of a glioma so a nurse will assess neurological function and provide care accordingly.

Treatment Options

Typically, a medical oncologist will review the medical history of a patient with a brain tumor and perform a full diagnostic evaluation. Treatment plans are then based on the patient's specific diagnosis. The decision of which treatment is most appropriate involves an entire neurosurgery team for the patient including: a neurosurgeon, pathologist, radiation oncologist, medical oncologist, psychologist, rehabilitation therapist and other cancer experts across a variety of disciplines.

The following therapies are treatment options that may be used depending on the type, size and location of the tumor:

• Surgery
• Immunotherapy
• Patients who are battling cancer are usually considered to be immunocompromised 
• This therapy uses the body's immune system to fight cancer in a special way. Learn more
• Chemotherapy
• Involves the use of anticancer drugs to stop or slow the growth of cancerous cells in the body
• More information regarding the different types of chemotherapy and how it may be administered may be found here.
• Radiation
• Uses energy which is targeted to a specific area to shrink tumors
• Click here for more information and to learn about the different types of radiation
• Gamma Knife Stereotactic Radiosurgery
• A non-invasive surgery option compared to traditional neurosurgery
• Does not use a knife, drugs or weeks of radiation so it is easier for patients to return to everyday living

Therapies may be used alone, or in combination with  one another.

The Cancer Treatment Center reports these common side effects during treatment:

• Nausea
• Hair loss
• Vomiting
• Diarrhea
• Increased risk of infection (from low white blood cell counts)
• Fatigue (from low red blood cell counts)
• Easy bruising and bleeding (from low blood platelet counts)

A patient's health care team will work with them during treatment. The care team will monitor pertinent blood labs and help manage side effects from the treatment. One of the main goals is to maintain the best quality of living possible while the patient is enduring difficult cancer treatments.

Sources:

Gamma Knife. (n.d.). Retrieved February 13, 2015, from http://www.legacyhealth.org/health-services-and-information/health-services/for-adults-a-z/cancer/all-cancer-services/radiation-oncology/gamma-knife.aspx

How we treat cancer. (2014, January 1). Retrieved February 13, 2015, from http://www.cancercenter.com/how-ctca-treats-cancer/

Headache? Fatigue? Depression? Maybe It's A Brain Tumor

Let's use an example: Say someone you know is experiencing the following symptoms: headache, fatigue and depression. What is your first guess? Maybe something like stress or a significant life event (death of a loved one, divorce, job loss, etc) was the root cause? My initial thoughts would probably be similar and I would not show an immediate cause for concern. However, these symptoms may actually be something serious.

MAYBE these symptoms are caused by a brain tumor. Depending on the size and location of a glioma the most common symptoms may include any of the following:

• Headaches
• Seizures
• Sensory (touch) and motor (movement control) loss
• Deep venous thrombosis (DVT, or blood clot)
• Hearing loss
• Vision loss
• Fatigue
• Depression
• Behavioral and cognitive (thinking) changes
• Endocrine dysfunction (hormone/gland changes)

Gliomas may present as one or more of these symptoms which may make an early diagnosis difficult. Specifically, headaches, fatigue, depression, and endocrine dysfunction may all be related to other diseases. Therefore, brain tumors may go unnoticed until they grow to be a larger size and/or cause more troubling symptoms like seizures. hearing or vision loss, or even loss of sensory and motor function. 

Of course, experiencing any of the above may  contribute to reasons why a patient may seek care but the most obvious would be those "troubling symptoms" that I listed. If someone is experiencing an unusual amount of fatigue or has a new onset of depression, it would be a good idea to seek advice from a health care provider. Also, headaches which occur most frequently in the morning upon waking, would be something else to mention to a health care provider. 

Sources:

Brain Tumor Symptoms. (2014, January 1). Retrieved February 7, 2015, from http://www.abta.org/brain-tumor-information/symptoms/