Best care practices in neuro-oncology

Neuro-oncology is a wide-ranging area of cancer treatment and there are various best care practises involved in ensuring patients receive the best care possible. Here to provide an expert insight into this important topic is world-leading cancer specialist Professor Karol Sikora.

What is neuro-oncology?

Neuro-oncology is a specialised field of medicine focused on the diagnosis and treatment of brain and spinal cord tumours, as well as tumours affecting the peripheral nerves. These tumours can be benign (non-cancerous) or malignant (cancerous) and may originate from brain tissue or spread to the nervous system from other parts of the body (metastatic tumours).

What are the key principles of best care practices in neuro-oncology?

Multidisciplinary approach

The management of neuro-oncological conditions requires a multidisciplinary team approach involving various specialists including:

• neurosurgeons;
• neurologists;
• radiation oncologists;
• medical oncologists;
• neuroradiologists;
• neuropathologists, and;
• specialised nursing staff.

This collaborative approach ensures comprehensive evaluation, personalised treatment planning, and ongoing support for patients and their families.

Individualised treatment plans

Each patient with a neuro-oncological condition presents with unique characteristics and treatment needs. Best care practices in neuro-oncology involve developing individualised treatment plans tailored to the specific type and stage of the tumour, as well as the patient's overall health, preferences, and goals. Treatment modalities may include:

• surgery;
• radiation therapy;
• chemotherapy;
• targeted therapy;
• immunotherapy, or;
• a combination of these approaches.

Advanced imaging techniques

Accurate diagnosis and monitoring of neuro-oncological tumours rely on advanced imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET) and functional imaging modalities. These imaging studies help to assess tumour location, size, extent of invasion, response to treatment and detection of recurrence.

Precision medicine

Advancements in molecular profiling and genomic testing have revolutionised the field of neuro-oncology, allowing for the identification of specific genetic alterations and biomarkers associated with tumour growth and progression. Precision medicine approaches enable oncologists to tailor treatment strategies based on the molecular characteristics of the tumour, thereby optimising therapeutic efficacy and minimising adverse effects.

Supportive care

In addition to disease-directed therapy, best care practices in neuro-oncology emphasize the importance of supportive care measures to address the physical, emotional and psychosocial needs of patients throughout their cancer journey. This may include pain management, symptom control, nutritional support, rehabilitation services, psychological counselling, and palliative care interventions aimed at enhancing quality of life and promoting overall well-being.

What are the challenges in neuro-oncology care?

Tumour heterogeneity

Neuro-oncological tumours exhibit significant heterogeneity in terms of histopathological features, genetic mutations, treatment response and clinical outcomes. This heterogeneity poses challenges in accurately characterising tumours, predicting prognosis, and selecting optimal treatment strategies.

Blood-brain barrier

The blood-brain barrier (BBB) presents a formidable obstacle to the delivery of therapeutic agents to brain tumours, limiting the effectiveness of systemic chemotherapy and immunotherapy. Overcoming the BBB remains a major challenge in neuro-oncology research and drug development.

Treatment toxicity

Neuro-oncological treatments, particularly surgery, radiation therapy, and chemotherapy, can be associated with significant toxicity and adverse effects, including cognitive impairment, neurologic deficits, fatigue, nausea and immune suppression. Minimising treatment-related toxicity while maximising therapeutic benefit is a critical consideration in neuro-oncology care.

How do best care practices in neuro-oncology aim to better quality of life?

Best care practices in neuro-oncology involve a comprehensive, multidisciplinary approach focused on individualised treatment planning, advanced diagnostic imaging, precision medicine and supportive care interventions. Despite the challenges posed by tumour heterogeneity, the blood-brain barrier, and treatment toxicity, ongoing research and innovation continue to drive advancements in neuro-oncology care, with the ultimate goal of improving patient outcomes and quality of life.

If you’re looking for leading neuro-oncology support, arrange a consultation with Professor Sikora via his Top Doctors profile.