Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-22T20:12:36.263Z Has data issue: false hasContentIssue false
  • English
  • Français

Low Grade Glioma: A Qualitative Study of the Wait and See Approach

Published online by Cambridge University Press:  02 December 2014

Caroline Hayhurst ,
Daniel Mendelsohn  and
Mark Bernstein
Caroline Hayhurst*
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Daniel Mendelsohn
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Mark Bernstein
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
*
Division of Neurosurgery, Toronto Western Hospital, West Wing, 4th Floor, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

There is no consensus on the best management of adults with presumed low grade glioma (LGG). Studies have suggested uncertainty and anxiety associated with a wait and see approach contribute to reduced quality of life. This study aims to explore the impact of a diagnosis of LGG, to address concerns regarding the uncertainty of the diagnosis and the role of wait and see from the patient's perspective.

Methods:

Qualitative research methodology was used. A semi-structured interview was conducted with 24 patients with imaging evidence of LGG but no prior intervention. All patients had been followed for at least one year prior to interview. Verbatim transcripts were subjected to thematic analysis.

Results:

The median age of participants was 47 (range 21 - 82) and the median duration of follow-up 37 months (range 12 - 156 months). Fifty percent presented with seizures. Five overarching themes emerged from the data; 1) patients experience initial devastation followed by acceptance and low anxiety; 2) absence of symptoms mitigates anxiety concerning the possibility of progression; 3) patients would prefer to defer surgery until there is progression or a change in their quality of life; 4) anxiety is reduced by trust in the physician; 5) quality of life is not affected by the diagnosis, as fear of morbidity from intervention is greater than the fear of uncertainty.

Conclusions:

The wait and see approach does not contribute to anxiety or reduction in quality of life in patients with LGG.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 2 , March 2011 , pp. 256 - 261
Copyright
Copyright © The Canadian Journal of Neurological 2011

References

1van den Bent, MJ, Afra, D, de Witte, O, et al.Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005; 366(9490):985–90.CrossRefGoogle ScholarPubMed
2Smith, JS, Chang, EF, Lamborn, KR, et al.Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. J Clin Oncol. 2008; 26(8):1338–45.Google Scholar
3McGirt, MJ, Chaichana, KL, Attenello, FJ, et al.Extent of surgical resection is independently associated with survival in patients with hemispheric infiltrating low-grade gliomas. Neurosurgery. 2008; 63(4):700–7; author reply 707-8.Google Scholar
4Rezvan, A, Christine, D, Christian, H, et al.Long-term outcome and survival of surgically treated supratentorial low-grade glioma in adult patients. Acta Neurochir (Wien). 2009; 151(11):1359–65.Google Scholar
5Sanai, N, Polley, MY, Berger, MS.Insular glioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg. 2010; 112(1):1–9.Google Scholar
6Osoba, D, Aaronson, NK, Muller, M, et al.Effect of neurological dysfunction on health-related quality of life in patients with high-grade glioma. J Neurooncol. 1997; 34(3):263–78.CrossRefGoogle ScholarPubMed
7Kash, KM, Holland, JC, Osborne, MP, Miller, DG.Psychological counseling strategies for women at risk of breast cancer. J Natl Cancer Inst Monogr. 1995;17:73–9.Google Scholar
8Kennedy, TJ, Lingard, LA.Making sense of grounded theory in medical education. Med Educ. 2006; 40(2):101–8.Google Scholar
9Strauss, A, Corbin, J.Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage Publications; 1998.Google Scholar
10Pope, C, Mays, N, Ziebland, S.Analysing qualitative data. In: Pope, C, May, N, editors. Qualitative research in health care. London: BMJ Books; 2000. p. 78.Google ScholarPubMed
11Taphoorn, MJ, Heimans, JJ, Snoek, FJ, et al.Assessment of quality of life in patients treated for low-grade glioma: a preliminary report. J Neurol Neurosurg Psychiatry. 1992; 55(5):372–6.Google Scholar
12Taphoorn, MJ, Schiphorst, AK, Snoek, FJ, et al.Cognitive functions and quality of life in patients with low-grade gliomas: the impact of radiotherapy. Ann Neurol. 1994; 36(1):48–54.Google Scholar
13Struik, K, Klein, M, Heimans, JJ, et al.Fatigue in low-grade glioma. J Neurooncol. 2009; 92(1):73–8.Google Scholar
14Klein, M, Heimans, JJ, Aaronson, NK, et al.Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study. Lancet. 2002; 360(9343):1361–8.Google Scholar
15Taphoorn, MJ, Heimans, JJ, Snoek, FJ, et al.Quality of life and neuropsychological functions in long-term low-grade glioma survivors. Int J Radiat Oncol Biol Phys. 1994; 29(5):1201–2.Google Scholar
16Reijneveld, JC, Sitskoorn, MM, Klein, M, et al.Cognitive status and quality of life in patients with suspected versus proven low-grade gliomas. Neurology. 2001; 56(5):618–23.Google Scholar
17Edvardsson, T, Ahlstrom, G.Illness-related problems and coping among persons with low-grade glioma. Psychooncology. 2005; 14(9):728–37.Google Scholar
18Edvardsson, T, Ahlstrom, G.Being the next of kin of a person with a low-grade glioma. Psychooncology. 2008; 17(6):584–91.Google Scholar
19Edvardsson, T, Pahlson, A, Ahlstrom, G.Experiences of onset and diagnosis of low-grade glioma from the patient’s perspective. Cancer Nurs. 2006; 29(5):415–22.Google Scholar