Elsevier

Social Science & Medicine

Volume 51, Issue 4, 15 August 2000, Pages 589-598
Social Science & Medicine

How was life after treatment of a malignant brain tumour?

https://doi.org/10.1016/S0277-9536(00)00002-2Get rights and content

Abstract

The malignant glioma is a severe disease with an unfavourable prognosis. Aside from a few case studies, the knowledge of the victimised patients’ lives from diagnosis to death is mainly restricted to studies assessing functional status and rating quality of life by means of questionnaires. From a clinician’s perspective this knowledge is not sufficient. By introducing the concepts ‘time of everyday life’ and ‘time of disease’, the purpose of this paper is to supplement with descriptive knowledge of clinical value. Twenty-eight patients with malignant gliomas and their spouses were followed during the course of the disease by repeated interviews. The time after treatment was then judged as representing, ‘time of everyday life’ or ‘time of disease’. Life after treatment turned out to be quite varied. To slightly more than a third of the patients’, life-continuity was lost, experiencing only ‘time of disease’. Among the others who were judged to experience ‘time of everyday life’ and who were of working age, nearly two-thirds were able to resume work or studies on a part-time basis. In the total sample, the mean ‘time of everyday life’ turned out to be nearly equal to ‘time of disease’, 6.1 and 5.4 months, respectively. The findings are illustrated by case descriptions and the conceptualisation of time into ‘everyday life’ and ‘disease’ is proposed as meriting further study.

Section snippets

Participants

Thirty consecutive patients having been diagnosed with malignant glioma grade III–IV were prospectively included in a clinical trial evaluating a cytostatic treatment (estramustine phosphate) in addition to radiotherapy in the years 1991–1993. The inclusion criteria were that the prospective patient be between 18 and 70 years of age and displayed a performance status of 0–2 according to the WHO scale. Only two patients intended for the study failed to fulfil the inclusion criteria: one due to

Findings and reflections

The main findings of the interviewer’s judgements are presented in Table 1. The table is divided into two groups. The patients in the first group (cases 1–10) were judged as having post-treatment time signifying only ‘time of disease’, while the second group (cases 11–28) also displayed a certain amount of ‘time of everyday life’. Some of these patients were able to resume working in one or another manner. The findings will be presented as case descriptions reflecting important dimensions from

On method

The distribution of the participating patients’ tumour locations, featuring a dominance of frontal and temporal tumours without hemispheric differences, is well in accordance with what has previously been presented (Kraemer & Bullard, 1994). While inclusion criteria might restrict generalisability, only two patients out of 32 in the consecutive series did not fulfil the inclusion criteria. Since chemotherapy is not a part of the primary routine treatment of patients with malignant glioma, its

Acknowledgements

This study was supported by the Swedish Foundation for Health Care and Allergy Research (Värdalstiftelsen).

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