Essential Resources on Brain Tumor Diagnosis and Treatment

Surgery can be a scary and nerve wracking event, especially brain surgery. Being mentally prepared and having some knowledge of what to expect will help you better understand the post-surgery process.

The typical hospital stay can be anywhere from 2-14 days depending on the patient. The length of the stay varies per person and is dependent on prior health status, location and size of the tumor resected, and possible side effects or “neurological deficits” after surgery. It is very likely that you will spend at least one night in the ICU and then be transferred to a less intensive level of care. After brain surgery the concern for swelling and bleeding requires close monitoring. This includes taking your vital signs and nurses performing “neuro checks” every 1-2 hours depending on the facility’s protocol and then progress to every four hours. These neurological assessments include assessing your mental status, level of alertness, and strength.

Whether the tumor is low or high grade you may experience the following after surgery:

• Generalized weakness or weakness on one side of the body
• Headache
• Difficulty with speech
• Poor balance, lack of coordination, or difficulty walking
• Confusion or forgetfulness
• Seizures

Although headache is normal and expected, you may not develop any of the listed above side effects. Some of these side effects may only last for a short amount of time although some will possibly last longer. Make sure that you communicate with your healthcare staff about the onset of any new changes that you develop.

While in the hospital, depending on your condition, your healthcare team will collaborate with you on whether any physical, occupational, or speech therapy is required either in a outpatient or short term rehabilitation setting. Your healthcare team will collaborate with you and help decide what your best plan for success is.

It is normal to be nervous and scared for this journey. Education and knowing what the hospital stay is all about can help ease that anxiety. If therapy is required, stay positive and work hard with therapy. Always keep in mind to be patient and kind to yourself throughout this process!

~Author Laura Vega BSN, RN is a medical writer specialized in content for the healthcare community

Aphasia is a language disorder that affects the ability to communicate and understand verbal and/or written language. Although it is most commonly found in stroke patients it can also occur in brain injuries and brain tumors.

People with aphasia have difficulty understanding others, expressing themselves or they may struggle with both. It is very common and natural for people with aphasia to become frustrated, angry, and depressed. Being trapped in your own mind and unable to communicate your needs, wants, and thoughts can feel hopeless.

Trying to determine what someone with aphasia is attempting to communicate can also be frustrating for their loved ones. Friends and family may sit there going around in circles while trying to figure out what the patient is saying and likely resulting in both people getting very frustrated and losing patience. When the person with aphasia becomes frustrated it becomes even more difficult for them to communicate. Below are some helpful tips in communicating and helping someone with aphasia communicate.

• Speak in short and brief sentences
• Use yes or no questions
• Do not ask open ended questions
• Slow down your speech and annunciate your words
• Communication board- single words or pictures to point
• Eliminate background noise
• Give them time to express themselves
• Celebrate moments that a person successfully expresses themselves

There are many speech therapy programs designed to work with aphasia patients. It may also be helpful to attend these sessions with your loved one in order to implement the methods used in therapy. The idea is to continue using these techniques at home in order to overcome or better manage aphasia. Providing support, communication training, and resources will help improve the quality of life of both person with aphasia and their loved ones.

~Author Laura Vega BSN, RN is a medical writer specialized in content for the healthcare community

Many people have never heard of ‘neuropsychology,’ and may be surprised to learn there is another specialist who can join their treatment team.

A Neuropsychologist is a Psychologist who has received additional specialized, formal training in neuroanatomy, medical illness, and measurement of ‘cognition,’ or thinking skills. Neuropsychologists are found in hospitals, rehabilitation centers, and private clinics, and see patients with a wide variety of neurological and medical conditions.

Typically, individuals are referred to a neuropsychologist due to declines in cognition or their ability to function in daily activities. Cognitive declines might include difficulty processing information, remembering, or making decisions. Functional declines might include problems with tasks like managing money, making meals, bathing, etc. The neuropsychological evaluation includes an interview in which the doctor will gather information about your developmental, medical, and psychological history, in addition to testing which measures how well your brain is working. The tests can identify patterns of strengths and weaknesses in cognitive functions like reading, language, attention, learning and memory, processing speed, reasoning, and problem-solving. Assessing your mood and behavior is a large part of a neuropsychological evaluation, as changes in these can impact daily functioning.

People are sometimes reluctant to have a neuropsychological evaluation, which can take hours to complete. While the evaluation could be tiring, it should not be seen as something scary or negative. For brain tumor patients, a neuropsychologist is oftentimes an integral member of your medical care team, and their assessment can help you understand how your brain is working, and identify how you can make your brain work better for you.

A neuropsychological evaluation can provide valuable information for people with a history of brain tumor, or for someone newly diagnosed. As examples, neuropsychological evaluations can detect subtle declines in cognitive functioning that may be related to the presence of a brain tumor, even if there are no obvious outward signs of cognitive decline; establish a pre-surgical or pre-treatment “baseline,” and track cognitive changes over time; detect tumor recurrence before changes are noticeable on a brain scan; provide recommendations regarding accommodations for school or work; help distinguish between the cognitive and functional effects of brain tumor, treatment, or other contributing factors (such as other neurological disease, psychological distress, fatigue, pain, sleep disturbances, etc.). The neuropsychologist will typically meet with you and your care partners to review the results and translate the findings into helpful recommendations.

Neuropsychologists do not prescribe medications, but may do psychological treatment, make recommendations for cognitive rehabilitation, suggest strategies for improving daily functioning, and assist with treatment planning.

Points to note:
The rates of neuropsychological impairment in brain tumor patients range from 12.5 - 91%.
Chemotherapy can contribute to cognitive decline, and about 30% of patients have cognitive impairments after chemotherapy, even without disease progression.
Identifying the causes of cognitive or functional declines can provide targets for intervention, and aid in predicting the level of improvement which might be achieved.

Citations:
Caponnetto et al. (2024), Psychological and neuropsychological clinical impact in brain cancer patients and evidence-based psychological intervention: a systematic review of the literature
Johnson & Wefel (2013), Relationship between cognitive function and prognosis in glioblastoma
Liu et al. (2023), The percentage of cognitive impairment in patients with major depressive disorder over the course of the depression: A longitudinal study
Noll, Bradshaw, Rexer, & Wefel (2018), Neuropsychological Practice in the Oncology Setting
Wefel, Parsons, Gondi, & Brown (2018), Neurocognitive aspects of brain metastasis