In the Journal of the Norwegian Medical Association no 3-4 February 2011, Tom Børge Johannesen MD, as coauthor, contributes to an overview on diagnosis and treatment of malignant brain tumors in adults.
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Around 200 Norwegians over the age of 15 are struck by a malignant brain tumor known as high-grade glioma per year. As of today, there is no cure for this cancer type and five year survival per 2008 is 6.1%.
Increase in cases
The number of new cases is increasing and has almost doubled since 1980. Primarily, this is due to an aging population and better diagnostics. Changes in risk factors can not be excluded but so far there are only two documented factors that can lead to brain tumors: congenital genetic conditions and high energy radiation (radioactivity, x-rays and radiation therapy.
Standard treatment today is surgery, radiation therapy and chemotherapy. Until a few years ago there was no room for chemotherapy in the treatment of malignant brain tumors. However, a study in 2005 showed much better results by combining surgery with chemotherapy.
Physical and psychological symptoms
High-grade gliomas develop quickly and in comparison to other malignancies they not only give physical symptoms but also directly influence the patient’s emotional and cognitive functioning. Surgery gives increased survival and quality of life and in many cases the patient can be more quickly mobilized with help from physical, occupational and speech therapists and neuropsychologists.
Undertreatment of the Elderly
Traditionally one has been restrictive in surgical treatment of high-grade gliomas in patients over 70 years old. However, the article presents data that also older persons in good health profit from the operation and thereby perhaps are undertreated.
Great Necessity of Follow up
Symptoms from malignant brain tumors influence the patient’s and family’s quality of life. Several factors contribute therefore to these patients being invisible to the public eye. The article shows the need of follow up and better collaboration with primary health care.