Delay in Diagnosis of Brain Tumors: A Dilemma For Neurosurgical Community Due To Spirituality and Quackery In A Developing Country

Authors

  • Usman Ahmad Kamboh
  • Sidra Abid
  • Mehwish Manzoor
  • Mehreen Mehboob
  • Sana Jamal
  • Mohammad Ashraf et al.

DOI:

https://doi.org/10.36552/pjns.v26i3.796

Abstract

Objectives:  Primary and metastatic brain tumors are a significant cause of mortality and morbidity. The complex pathway to a cancer diagnosis is not human error and the achievements of better outcomes solely depend on the early diagnosis and management of symptomatic tumors. The estimated time between the first presentation to any health care professional and diagnosis is approximately 3 times longer in the UK as compared to other developed countries.

Material and Methods:  It was a descriptive study and included 52 patients who were admitted to the Neurosurgery department at Jinnah hospital Lahore. The required data were collected either directly from the patients or from the hospital record of discharged patients. Our study compares the time interval difference of presentation of a patient to a local care provider (Quacks, Hakeem, and spiritual healers) and Neurosurgeon as well as delay in surgical intervention even after diagnosis and radiological investigations.

Results:  54% of patients presented with supratentorial lesions and out of these, parietal lobe lesions were more common (39%) while 29% of lesions were infratentorial. Around 50% of patients presented to a Local Care Provider within 20 days. However, only 42% of patients presented to a neurosurgeon after 6-9 months of the onset of symptoms.

Conclusion:  Public awareness is the key to timely diagnosis, proper management, and better outcomes. The availability of specialists in peripheral hospitals can bring a change in this regard.

References

Ostrom QT, Gittleman H, Fulop J, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008 – 2012. Neuro Oncol. 2015; 17: 1-62.

Crocetti E, Trama A, Stiller C, et al. Epidemiology of glial and non-glial brain tumors in Europe. Eur J Cancer, 2012; 48: 1532-42.

Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer, 2012; 106: 1262-7.

Patel V, Neil L, Sarah R: Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience. J Neuro-Oncology, 2019: 1-8.

Walker D, S Wilne S, Grundy R, et al. Community awareness in Brain Tumors, Head Smart: Neuro Oncol. 2016; 18 (3): 445-54.

Best M, Butow P, Olver I. Spiritual support of cancer patients and the role of the doctor. Support Care Cancer, 2014; 22 (5): 1333-9.

Schultz M, Lulav-Grinwald D, Bar-Sela G. Cultural differences in spiritual care: findings of an Israeli oncologic questionnaire examining patient interest in spiritual care. BMC Palliat Care, 2014; 13: 19.

Yates JS, Mustian KM, Morrow GR, et al. Prevalence

of complementary and alternative medicine use in cancer patients during treatment. Support Care Cancer, 2005; 13: 806-11.

Forman D, Bray F, Brewster DH, et al. editors. Cancer incidence in five continents, vol. X. Lyon: IARC, 2014.

American Cancer Society. Cancer facts and figures. Available online: http://www.cancer.org.

Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS (2018) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011 – 2015. Neuro Oncol 20: iv1-iv86.

Curtin SC, Minino AM, Anderson RN. Declines in cancer death rates among children and adolescents in the United States, 1999 – 2014. NCHS Data Brief, 2016: 257: 1-8.

Shaw EG, Robbins ME. The management of radiation-induced brain injury. Cancer Treat Res. 2006; 128: 7-22.

Davies E, Clarke C. Early symptoms of brain tumors. BMJ. JNNP. 2004; 75 (8): 68-9.

Grant R. Overview: brain tumor diagnosis and management/Royal College of Physicians Guidelines. J Neurol Neurosurg Psych. 2004; 75: 18-23.

William H, David K. Clinical features of primary brain tumors: a case-control study using electronic primary care records. Br J Gen Pract. 2007; 57 (542): 695-9.

Schmidt-Hansen M, Berendse S, Hamilton W. Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review. Fam Pract. 2015; 32 (6): 618-23.

Chen CH, Sheu J, Lin HC, et al. Association of migraines with brain tumors: a nationwide population-based study. J Headache Pain, 2018; 15 (1): 111.

Lipsman N, Skanda A, Kimmelman J, et al. The attitudes of brain cancer patients and their caregivers towards death and dying: a qualitative study. BMC Palliat Care, 2007; 6: 7.

Schultz M, Lulav-Grinwald D, Bar-Sela G. Cultural differences in spiritual care: findings of an Israeli oncologic questionnaire examining patient interest in spiritual care. BMC Palliat Care, 2014; 13: 19.

Downloads

Published

2022-09-30

Issue

Section

Original Articles