Beloop bij een hersentumor - Walter Taal image/svg+xml Beloop bij een hersentumor - Walter Taal 8 november 2019 Walter Taal 5B Palliative treatment Anti-tumor treatment no longer possibleIn case of a glioblastoma, almost always a phase is reached whereanti-tumor treatment is no longer possible. This period is also calledthe ‘palliative phase’.Symptoms during the palliative phaseIn this phase the patient could experience (an increase in) symptomsas an (in)direct result of the brain tumor. It is good to know thattreating these symptoms is possible.You can read more about this below (5B).Please note! A doctor can never predict how long someonehas to live. Treatment of symptomsAs soon as anti-tumor treatment is no longer possible, the phase ofsymptomatic or palliative treatment starts.Letter for patients and proxiesAt the bottom of this page is a link to a letter containing more informationabout the end-of-life phase for patients with a brain tumor and their closeones. This is information about the expected course of the final phase oflife and the care that can be provided in this phase. The letter alsoprovides advice and references in support of loved ones (and care givers).More clarity gives less uncertainty and therefore a better quality of life.Save the letter below however for later, if you are not up to it now. Youcan also have the letter read by someone else first.This is the end of this tool. For questions or comments, contact us: Phone: 06-22545185 of 06-33342008 (nurse practioners) Email: hersentumorpoli@erasmusmc.nl Click here for the letter 5A Symptoms in theend-of-life phase 4B Possible 2nd and followinganti-tumor treatment Tumor growth on the MRI scanSince regular MRI scans are made, tumor growth is likely to be noticedvia imaging before patients experience (an increase in) symptoms. Symptoms Usually, the tumor grows back at the same location as before. Therefore,it is likely that any symptoms patients might experience comply withearlier symptoms (see 1A). Contact us in case you start experiencingthese symptoms again. Epilepsy(Recurring) epileptic seizures are not always a sign of tumor growth.Many factors can cause epilepsy, such as stress and a lack of sleep.An increased frequency of seizures is always a reason to contact yourphysician. Please note! Not everyone with a glioblastoma experiences epilepsy. Effectiveness of additional treatmentTreatments against the tumor will become less effective. The tumorbecomes more resistant, meaning it becomes less sensitive to treatments.Side effects of additional treatmentSide effects can play a more prominent role, for example because ofdeterioration of the patient’s condition.BalanceThe assessment about the feasibility of additional treatment is based onthe balance between the chance of success and thechance of adverse effects. Besides prolonging thelife span, the quality of life plays an important role inthis decision. If the chance of success is small andthe chance of side effects if big, then another courseof treatment is not advised.DecisionEvery patient is discussed in a multidisciplinary meeting. This means thatdifferent specialists (such as the neurologist, radiologist, radiotherapist,oncologist and neurosurgeon) will attend this meeting. After the patienthas been adequately informed about the different options, he/she willmake the final decision together with the treating physician. Treatmentfocused on symptoms (see 5B) is also a choice. Side effects Effectiveness 4A Symptoms in case of recurrentgrowth of the tumor