12 March 2019
Missed opportunities for diagnosing brain tumours
Brain tumor outcomes are very poor because they usually come to attention late and are often diagnosed in accident and emergency following an acute episode such as a fit.
There are over 11,000 new cases of brain tumour in the UK each year. The outcomes are very poor because they usually come to attention late and are often diagnosed in accident and emergency following an acute episode such as a fit. Patients and GPs often find it difficult to recognise the early symptoms of brain tumours, which up to now have not been well described.
This makes the new study led by the University of Cambridge and recently published in the British Journal of General Practice of considerable importance. The research team, including Dr Suzanne Scott, Senior Lecturer in Health Psychology from King’s College London, interviewed 39 adult patients recently diagnosed with a brain tumour, and their family members. They reported many subtle 'changes' rather than 'symptoms' which are often noticed by others rather than by the patient, and which frequently lead to loss of interest or less ability to engage with daily living activities.
The most common changes are in speaking, writing, comprehension, memory, concentration and multitasking, along with sleep and other abnormal feelings in the head, including headache and dizziness. More than half of the patients in the study noticed these changes more than six months before seeking help and many had several consultations with their GP before referral or diagnostic imaging.
The authors say that increasing GPs' (and presumably the public's) awareness of the changes preceding brain tumour diagnosis, along with effective patient-GP communication with follow-up (safety netting), could lead to more rapid investigation and referral.
“Very little is known about the pathways to diagnosis from the patient’s perspective,” said Dr Suzanne Scott from King’s College London. “This study gives us an insight into what patients and their family noticed in the weeks and months before diagnosis, and their journey through the healthcare system.”
Missed opportunities for diagnosing brain tumours in primary care? Qualitative study findings was published in the British Journal of General Practice on 12 March, 2019.