Symptom control and supportive care in primary and secondary brain tumours

During all phases of cancer treatment suppotive care and symptom control are important issues. This starts already in the diagnostic phase and has to be continued till the end of life. Nevertheless, symptoms and problems are often underestimated or even not recognized. This is especially true in brain tumour patients who, in comparison with other cancer patients, have a large number of relatively severe problems and concerns. The major problems reported by patients with primary or secondary brain tumours are headache, epileptic seizures, neurological deficit leading to disability, cognitive dysfunction, fatigue, depression, emotional and psychosocial distress, thromboembolic disease and complications from the use of drugs (corticosteroids, anticonvulsants and chemotherapy). Palliative treatment may initially be directed against the primary tumour or against metastatic disease. Only when these anti-tumour treatments have failed, palliative treatment will be primarily aimed at relief of symptoms.