Taking care of patients with brain tumor-related epilepsy

Patients with brain tumor-related epilepsy (BTRE) present a complex therapeutic profile and require a unique and multidisciplinary approach. They, in fact, must face two different pathologies at the same time, brain tumor and epilepsy. There are many factors to take into consideration. First, there is the management of pharmacological therapies: the concurrent use of antiepileptic drugs (AEDs), chemotherapy (CT), and support therapies can present problems with drug interactions and collateral effects. Secondly, there is the concern for maintaining a good quality of life (QoL) for these patients. In addition, we must recognize the fact that epilepsy still brings with it stigma and can cause the individual who is diagnosed with the disease to feel socially outcast and severely invalided. Lastly, economic and social implications for the costs (i.e. direct and indirect) of treating two serious pathologies are discussed. Considering all of these factors, it is understandable that freedom from seizures or at least a reasonable control of them, is of utmost importance for the patient, if he/she is to resume his/her professional life, function successfully in a social context, and conduct a satisfying family life.Therefore, it is necessary to develop a customized treatment plan for each individual with BTRE. This requires a vision of patient management concerned not only with medical therapies related to the oncological disease and to the correct choice of antiepileptic therapies, but also with emotional and psychological support for the individual and his/her family. In addition, the team of healthcare professionale should create a relationship with BTRE patients that focuses on accompanying them and their family throughout the illness, offering not only medical support, but also the opportunity for patients to be heard and to be supported during medical and personal challenges and/or difficulties. Taking care of the patient with brain tumor-related epilepsy means listening to him/her, understanding his/her choices and respecting his/her priorities. Healthcare practitioners need to appreciate the fact that "taking care of" these patients does not mean "curing" as much as it means recognizing and responding to the needs of each unique individual.