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Cerebral gliomas: Treatment, prognosis and palliative alternatives

Malignancies of the brain are complicated matters. The diagnosis of a brain tumor monumentally alters the course of life for the patient, their friends, and their family. Gliomas are the most common type of primary brain tumors in the United States affecting more than 20 000 people annually. Depending on the clinical situation, surgical resection of the mass remains the primary mode of treatment. Adjuvant therapies with external beam radiation and chemotherapy are often utilized. In many cases, the most advanced interventional technologies do not cure or prevent progression of the disease to its final stage – death. The bombardment with multiple treatment modalities is exhaustive for already ill patients, and even more devastating to patients and their families when unsuccessful at providing a quality of life that is in accordance with the patient’s desires. In these cases, it is important to incorporate a discussion of living a higher quality of life for the limited time the patient has remaining, rather than pursuing a myriad of experimental treatments. In this manuscript, we present a series of topics necessary to facilitate this communication between the physician, patient, and their families.