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Low Grade Glioma: A Qualitative Study of the Wait and See Approach

Published online by Cambridge University Press:  02 December 2014

Caroline Hayhurst ,
Daniel Mendelsohn  and
Mark Bernstein
Caroline Hayhurst*
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Daniel Mendelsohn
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Mark Bernstein
Affiliation:
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
*
Division of Neurosurgery, Toronto Western Hospital, West Wing, 4th Floor, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada
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Abstract

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Background:

There is no consensus on the best management of adults with presumed low grade glioma (LGG). Studies have suggested uncertainty and anxiety associated with a wait and see approach contribute to reduced quality of life. This study aims to explore the impact of a diagnosis of LGG, to address concerns regarding the uncertainty of the diagnosis and the role of wait and see from the patient's perspective.

Methods:

Qualitative research methodology was used. A semi-structured interview was conducted with 24 patients with imaging evidence of LGG but no prior intervention. All patients had been followed for at least one year prior to interview. Verbatim transcripts were subjected to thematic analysis.

Results:

The median age of participants was 47 (range 21 - 82) and the median duration of follow-up 37 months (range 12 - 156 months). Fifty percent presented with seizures. Five overarching themes emerged from the data; 1) patients experience initial devastation followed by acceptance and low anxiety; 2) absence of symptoms mitigates anxiety concerning the possibility of progression; 3) patients would prefer to defer surgery until there is progression or a change in their quality of life; 4) anxiety is reduced by trust in the physician; 5) quality of life is not affected by the diagnosis, as fear of morbidity from intervention is greater than the fear of uncertainty.

Conclusions:

The wait and see approach does not contribute to anxiety or reduction in quality of life in patients with LGG.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 2 , March 2011 , pp. 256 - 261
Copyright
Copyright © The Canadian Journal of Neurological 2011

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