Q: Why me?
A: To date it is not clear why brain tumours occur. There are theories revolving around possible connections to certain genetic traits, familial clusters, and prior exposure to industrial chemicals, etc., but their roles are not entirely certain. A history of exposure to ionising radiation does correlate in some cases with an increased chance of developing a brain tumour. Instead of dwelling on what cannot be influenced as it has already occurred, it is better to shift the focus to the options to deal with it. The arsenal available at the disposal of neurosurgeons today is indeed formidable and expanding by the day—you are not alone in your fight.
Q: How long do I have to live?
A: The focus here, at least in the beginning, should revolve around what can be done for you, what treatment options are available to you, and how to arrive at a decision that lies in your best interests along with your attending physicians. Despite the large volume of data published, the “how-long”, after a point, still remains individual. Maintaining a positive attitude in the face of this adversity is certainly an influential factor in prognosis.
Q: How much percent chance do I have of a “cure”, and if not, then of “recurrence”?
A: Percentages are derived from statistics, and calculated from a large number of documented observed and follow-up cases. They only indicate “less chance” and more “chance”, and not a figure you should fix upon as a definitive.
Q: A second opinion?
A: A second opinion is certainly warranted, especially in difficult cases involving more sensitive locations and disputable therapeutic strategies. But it is wise to remember that the best approach would be to settle on the neurosurgeon with the most documented experience in that particular area of expertise. Too much of drifting from neurosurgeon to neurosurgeon is not advisable, and can result at times in serious loss of time, besides compounding the already present feelings of confusion and uncertainty.
Q: Is this really necessary?
A: Once the well thought out decision has been taken to implement a therapeutic option, it is advisable to go ahead with it without much further beating about the bush. Uncertainty, confusion, and a lack of confidence are natural, but should not come in the way of expressing your trust in your chosen neurosurgeon, and giving them leeway to carry through the treatment at the highest possible standards and in your best interests. There are questions to which they have answers… and there are questions to which none exist at the moment. It may prove difficult, but this ought to be remembered and respected.
Pre- and Post- operative:
Q: Why do I need to take “steroids”?
A: The “steroids” you are requested to take are not the ones that are used in bodybuilding, etc. The ones you will be given are different, and have other properties that are highly beneficial for you. They help in significant reduction of swelling and oedema, which is very important before an operation. Further, the natural reaction to any body tissue to trauma of any kind—including that which is unavoidably inflicted during surgery—is to swell. After a surgery on the brain, therefore, it is very important to take this medicine to minimise the amount of post-operative swelling and oedema.
Q: What now?
A: The first few days will be spent recovering from the surgery. Once this period is over and you have been mobilised and are stable health-wise, the question of further treatment, if any is needed at all, will be discussed. In any case, there can be no question of further treatment strategies until the final results of the histopathology are certain.
Q: Is anti-epileptic medication really necessary?
A: Whether you have had fits before or not, after a large surgery, depending on the location of the tumour, it is at times prudent to give post-operative prophylactic cover with anti-convulsants. After a delicate operation, the last thing you need is a seizure that could lead to hypoxia and perhaps even to bleeding.
Chemotherapy & Radiotherapy:
Q: Is chemotherapy dangerous?
A: No medicine, however relatively harmless, is without side effects. What is important is to weigh the potential benefits against the possible undesirable side effects, and decide on the option that offers you the most with minimal harm incurred. When chemotherapy has been suggested, this has been done taking everything into due consideration.
Q: What can go wrong during chemotherapy:
A: The potential side effects are many, but the one that can be life threatening is the risk of bleeding secondary to a reduction in blood platelet levels which is often seen during chemotherapy.
Q: Is radiotherapy dangerous?
A: There are certainly undesirable side effects, but what is important is to weigh the potential benefits against the possible undesirable side effects, and decide on the option that offers you the most with minimal harm incurred. When chemotherapy has been suggested, this has been done keeping your best interests in mind.
Q: What can go wrong during radiotherapy?
A: The potential side effects are many, but the ones that you should certainly bear in mind is the potential damage to cognitive functions, and the fact that following radiotherapy, future surgery becomes more difficult and complicated.
last changed 26/05/2011.
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