Note: This is part two of Dr. Michael Wang’s series that specifically addresses Brain Cancer Treatment during the Coronavirus Pandemic. You can read part one here.
Michael Wang, MD., Ph.D., member of AFCR Scientific Advisory Board
In addition to surgery, radiation therapy and chemotherapy are the other two major medical procedures to treat brain cancers. Patients receiving those therapies are facing the same challenges as patients who need surgery: The ongoing COVID-19 pandemic may cause a delay or even discontinuation of their treatment plan.
To balance risks between possible tumor progression and hospital-associated COVID-19 infection, which may pose imminent danger to the life of some patients, world-class neurosurgeons at Beijing Tiantan Hospital have published guidelines to help neuro-oncologists adopt a set of “new normal” practices in monitoring or treating patients with brain tumors such as neuroglioma and the deadly glioblastoma multiforme (GBM). The institution’s lead neuro-surgeon, Dr. Tao Jiang, is a senior investigator associated with a U.S.-led global clinical trial program, GBM AGILE, targeting the brain tumors. The guidelines developed by him and his team are based on successful clinical experience, in compliance with U.S. best practices and serve as valuable advice for doctors and patients to take actions on.
If you are a neuroglioma or GBM patient, consult with your doctors to see whether some of the suggestions offered by Dr. Jiang’s team and listed below would be beneficial for your condition. Adapting to COVID-19’s circumstances is important.
- Radiation or chemotherapy therapy should be discontinued if the cancer patient is tested positive for COVID-19 and has symptoms. The therapies could be resumed after the infectious disease is cured and proper evaluation is performed by the patient’s doctors.
- If COVID-19 testing results are inconclusive for a patient or a confirmed COVID-19 patient only shows minor symptoms, radiation therapy could continue under the condition that strict protection measures for medical care providers are put in place by the hospital and complete disinfection procedures for equipment and location are followed.
- Brain MRI (magnetic resonance imaging) scanning is the most important tool for post-surgery monitoring and treatment follow-up. However, every time an MRI scan is performed, people involved, including the patients and MRI technologists, will be exposed to a risk of COVID-19 infection. To reduce that risk, longer intervals between MRI scans should be adopted for high grade neuroglioma patients who don’t have newly developed post-surgery symptoms, provided that the patients are taking appropriate adjuvant therapy after surgery.
- For low grade neuroglioma patients without the “wild type IDH” biomarker, intervals between follow-up MRI scans could also be increased if the patients don’t show symptoms or their symptoms remain stable.
- If an MRI scan must be performed soon, patients should go to the nearest hospital or facility for the imaging procedure. If patients need to receive treatment on post-surgery epilepsy, telemedicine is the preferred option to provide guidance for patients to take medications.
The “new normal” practice guidelines introduced above are filled with actionable information for neurologists to make appropriate adjustments to the treatment plans for patients with newly diagnosed or recurrent neuroglioma or GBM. I hope the information is beneficial for you or your loved ones who may be fighting brain tumors in the midst of the COVID-19 pandemic.