Brain Tumour Treatment During Covid – Can It Be Delayed?

Brain tumour is a condition which needs to be attended to immediately without causing much delay.

Any delay in treatment can further complicate the condition and can be fatal in some cases. During the current pandemic times, treating the patients have become a matter of concern as the patients are scared to visit hospitals due to the fear of infection. 

Unlike other cancers, brain tumours do not spread to other organs. They are either benign or malignant, and the latter is divided into high grade or low grade. 

The key question is how long can tumour treatment be delayed? Since each case and condition is unique, the treatment will vary from case to case. The best practice would be to adopt a customised approach.

Though, some tumours do not pose any neurological complication, delaying the treatment due to covid may cause other complications. It is however worthwhile to have a talk with your neurosurgeons regarding the options of different treatment methods during this time. 

So, in essence, brain tumour that is a threat to life cannot wait. For such patients, timely treatment has to be arranged as per schedule. 

Chemotherapy and immunity concerns

Chemotherapy can weaken one’s immune system and hence may increase the risk of infection, hence cancer patients are at a higher risk of complications from COVID-19.

Currently, no evidence has emerged to support changing or withholding chemotherapy among cancer patients. As a result, withholding critical anti-cancer or immunosuppressive therapy is not an option to be exercised.

The frequency of blood testing will depend solely on the kind of chemotherapy needed. Since it’s important to have a watch on the infection, it is imperative to have a check on the blood count periodically. Ensuring safety protocols and exercising caution is important while undergoing the required tests.

Radiation can be delayed only when the risk of tumour progression is minimal. However, if the radiation has commenced then it’s good to finish it within the set period, as any delay can render the process ineffective.

Lifestyle changes that can be adopted

It is of utmost importance to keep a brain tumour patient away from infection, stress or any other behavioural issues during the pandemic. Here are 3 key tips that can be practiced for the same

• Follow a healthy and well balanced diet
• Practice a mild exercise or meditation routine to keep one active and relaxed
• Ensure proper sleep pattern. A good sleep is the as important as medicine

Treatment protocol

Before the treatment starts, telehealth services may be used to prepare a thorough evaluation of the patient’s symptoms and tumour images. In case, the symptoms are not advanced or severe, then the doctor may suggest postponing the surgical treatment.

For patients suffering from high grade tumours, surgical procedure may be advised without any delay. A Neurosurgeon will then decide to proceed accordingly. For elderly patients, chemotherapy may be suggested after confirmation of the diagnosis by a biopsy, especially for those suffering from certain health complications.

With regard to patients accepting treatment at home post-surgery , so as to reduce the risk of corona virus infection, the family members need to be well trained to take care of the patient. The patient should have a healthy and well balanced diet daily and ensure a good night’s sleep as well.

While a stream of new guidelines to manage surgical patients have already been suggested and implemented, oncology patients and specifically neuro-oncology patients have to be looked after with extra care and attention as their condition can change overnight. 

By Dr. Raghuram G, Senior Consultant, Neurosurgeon, Columbia Asia Referral Hospital Yeshwanthpur (A unit of Manipal Hospitals)