Skip to main content
SpringerLink
Log in

Palliative Care in Neuro-oncology

  • Chapter
  • First Online:
Brain Tumors

  • 199 Accesses

Abstract

Palliative care is a critical component of the treatment of patients with brain tumors. In this chapter, we define palliative care as an active approach throughout the course of disease that encompasses the total care of patients and their caregivers. Increasingly, neuro-oncologists will be providing palliative care to their patients which requires the development of communication skills, a framework for delivering bad news and tools to help discuss prognosis. In this chapter, we also discuss which elements of palliative care may be outside of the scope of a neuro-oncologist and require the sub-specialty skills of our Palliative care colleagues. Specific symptoms such as cognitive dysfunction, fatigue, mood disturbance, insomnia and headaches are discussed with strategies to help alleviate patient suffering. Advanced care planning, hospice and end of life care remain important components of neuro-oncologic care in patients with incurable brain tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 24.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 32.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Taylor LP, Besbris JM, Graf WD, Rubin MA, Cruz-Flores S, Epstein LG, et al. Clinical Guidance in Neuropalliative Care: An AAN Position Statement. Neurology. 2022;98(10):409–16. https://doi.org/10.1212/wnl.0000000000200063.

  2. Faithfull S, Cook K, Lucas C. Palliative care of patients with a primary malignant brain tumour: care review of service use and support provided. Palliat Med. 2005;19(7):545–50. https://doi.org/10.1191/0269216305pm1068oa.

    Article  PubMed  Google Scholar 

  3. McFarlin JM, Barclay JS. Communicating effectively. In: Creutzfeldt CJ, Kluger BM, Holloway RG, editors. Neuropalliative care. A guide to improving the lives of patients and families affected by neurologic disease. Cham: Springer; 2019. p. 151–60.

    Chapter  Google Scholar 

  4. Gofton TE, Graber J, Carver A. Identifying the palliative care needs of patients living with cerebral tumors and metastases: a retrospective analysis. J Neurooncol. 2012;108(3):527–34. https://doi.org/10.1007/s11060-012-0855-y. Epub 2012 Mar 31.

    Article  PubMed  Google Scholar 

  5. Gilligan T, Coyle N, Frankel RM, Berry DL, Bohlke K, Epstein RM, et al. Patient-clinician communication: American Society of Clinical Oncology consensus guideline. J Clin Oncol. 2017;35(31):3618–32. https://doi.org/10.1200/JCO.2017.75.2311. Epub 2017 Sep 11.

    Article  PubMed  Google Scholar 

  6. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES—A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302–11. https://doi.org/10.1634/theoncologist.5-4-302.

    Article  CAS  PubMed  Google Scholar 

  7. Back AL, Arnold RM, Tulsky JA. Mastering communication with seriously ill patients: balancing honesty with empathy and hope. Cambridge: Cambridge University Press; 2009.

    Book  Google Scholar 

  8. Sharma A, Taylor LP. Malignant brain tumors. In: Creutzfeldt CJ, Kluger BM, Holloway RG, editors. Neuropalliative care. A guide to improving the lives of patients and families affected by neurologic disease. Cham: Springer; 2019. p. 117–33.

    Chapter  Google Scholar 

  9. Walbert T. Integration of palliative care into the neuro-oncology practice: patterns in the United States. Neurooncol Pract. 2014;1(1):3–7. https://doi.org/10.1093/nop/npt004.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Walbert T, Glantz M, Schultz L, Puduvalli VK. Impact of provider level, training, and gender on the utilization of palliative care and hospice in neuro-oncology: a North-American survey. J Neurooncol. 2016;126(2):337–45. https://doi.org/10.1007/s11060-015-1973-0. Epub 2015 Oct 30.

    Article  PubMed  Google Scholar 

  11. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. NEJM. 2010;363:733–42.

    Article  CAS  PubMed  Google Scholar 

  12. Walbert T. Palliative care, end-of-life care, and advance care planning in neuro-oncology. Continuum. 2017;23(6):1709–26. https://doi.org/10.1212/CON.0000000000000538.

    Article  PubMed  Google Scholar 

  13. Gehring K, Patwardhan SY, Collins R, Groves MD, Etzel CJ, Meyers CA, et al. A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. J Neurooncol. 2012;107(1):165–74. https://doi.org/10.1007/s11060-011-0723-1. Epub 2011 Oct 2.

    Article  CAS  PubMed  Google Scholar 

  14. Thomas AA, Carver A. Essential competencies in palliative medicine for neuro-oncologists. Neurooncol Pract. 2015;2(3):151–7. https://doi.org/10.1093/nop/npv011. Epub 2015 May 12.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Porter AB, Heshan L, Sadhna K, Cerhan JH, Sloan JA, McMurray R, et al. A phase III randomized, double-blind placebo-controlled study of armodafinil (Nuvigil) to reduce cancer-related fatigue in patients with high-grade glioma (Alliance A221101). J Clin Oncol. 2020;38:15. Epub 2020 May 25.

    Article  Google Scholar 

  16. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012;11:CD006145. https://doi.org/10.1002/14651858.CD006145.pub3.

    Article  PubMed  Google Scholar 

  17. Robertson ME, McSherry F, Herndon JE, Peters KB. Insomnia and its associations in patients with recurrent glial neoplasms. Springerplus. 2016;5(1):823. https://doi.org/10.1186/s40064-016-2578-6. eCollection 2016.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ford E, Catt S, Chalmers A, Fallowfield L. Systematic review of supportive care needs in patients with primary malignant brain tumors. Neuro Oncol. 2012;14(4):392–404. https://doi.org/10.1093/neuonc/nor229. Epub 2012 Feb 3.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Huang J, Zeng C, Xiao J, Zhao D, Tang H, Wu H, et al. Association between depression and brain tumor: a systematic review and meta-analysis. Oncotarget. 2017;8(55):94932–43. https://doi.org/10.18632/oncotarget.19843.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nelson S, Taylor LP. Headaches in brain tumor patients: primary or secondary? Headache. 2014;54(4):776–85. https://doi.org/10.1111/head.12326.

    Article  PubMed  Google Scholar 

  21. Shimmer BP, Funder JW. Adrenocorticotropic hormone, adrenal steroids, and the adrenal cortex. In: Brunton LL, Knollmann BC, Hilal-Dandan R, editors. Goodman & Gilman’s: the pharmacological basis of therapeutics, 13th ed. McGraw-Hill. 2017. https://accessmedicine-mhmedical-com.offcampus.lib.washington.edu/content.aspx?bookid=2189&sectionid=172482605. Accessed 24 Jan 2021.

  22. National POLST Paradigm Task Force. POLST legislative guide. 2014. http://www.polst.org. Accessed 24 Jan 2021.

  23. Mahmoudian T, Mohammadi Zadah M. Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children. Epilepsy Behav. 2004;5:253–5.

    Article  CAS  PubMed  Google Scholar 

  24. Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K. Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005;55(3):164–77. https://doi.org/10.3322/canjclin.55.3.164.

    Article  PubMed  Google Scholar 

  25. Sizoo EM, Braam L, Postma TJ, Pasman HRW, Heiman J, Klein M, et al. Symptoms and problems in the end-of-life phase of high-grade glioma patients. Neuro Oncol. 2010;12(11):1162–6. https://doi.org/10.1093/neuonc/nop045. Epub 2010 Jan 27.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Krouwer HG, Pallagi JL, Graves NM. Management of seizures in brain tumor patients at the end of life. J Palliat Med. 2000;3(4):465–75. https://doi.org/10.1089/jpm.2000.3.4.465.

    Article  CAS  PubMed  Google Scholar 

  27. Drumm MR, Dixit KS, Grimm S, Kumthekar P, Lukas R, Raizer JJ, et al. Extensive brainstem infiltration, not mass effect, is a common feature of end-stage cerebral glioblastomas. Neuro Oncol. 2020;22(4):470–9. https://doi.org/10.1093/neuonc/noz216.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Neurology, Neurologic Surgery and Medicine | UW Medicine, Fred Hutchinson Cancer Center, Alvord Brain Tumor Center, Seattle, WA, USA

    Young-Bin Song & Lynne P. Taylor

Authors
  1. Young-Bin Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lynne P. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lynne P. Taylor .

Editor information

Editors and Affiliations

  1. Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

    Nimish A. Mohile

  2. Department of Neurological Sciences, University of Vermont Larner College of Medicine, Burlington, VT, USA

    Alissa A. Thomas

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Song, YB., Taylor, L.P. (2023). Palliative Care in Neuro-oncology. In: Mohile, N.A., Thomas, A.A. (eds) Brain Tumors. Springer, Cham. https://doi.org/10.1007/978-3-031-41413-8_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-41413-8_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-41412-1

  • Online ISBN: 978-3-031-41413-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation