Surviving glioblastoma and a sense of disconnection

Living with glioblastoma - the need for integrated support based on experiences of chaos, loss of autonomy, and isolation in both patients and their relatives

PURPOSE

The aim of this study was to investigate the experiences of living with glioblastoma from the perspective of patients themselves as well as their closest relatives, focusing on the changes in the life situation and the need for support.

METHODS

Twenty-two semi-structured interviews were conducted with 12 patients (mean age 61 years, 7 male, 5 female) and 10 relatives (mean age 56 years, 3 male, 7 female). The relatives comprised of partners (n = 7), child (n = 1), sister (n = 1), or friend (n = 1). Questions focused on changes in the life situation and support needed to face these changes. Data was analyzed using inductive qualitative content analysis (QCA).

RESULTS

Living with glioblastoma dramatically changes the lives of both patients and relatives. Cognitive symptoms (e.g., speech and memory disturbances), deterioration of physical function (e.g., paresis), and psychological function (e.g., behavioral changes, anxiety) can lead to impaired family dynamics, social isolation, and fear of the future. Support from other family members, friends, and healthcare professionals is crucial. Timely, tangible, and easily available support from the healthcare system the entire disease trajectory is sought after, enabling individualized care with emotional support, clearer information, and faster feedback.

CONCLUSION

The changes in life situations faced by patients with glioblastoma and their closest relatives are dramatic and underline the importance of providing integrated care throughout the entire healthcare continuum, encompassing specialist neuro-oncological care, municipal support, and palliative care. Individualized support for both patients and relatives can enhance the sense of safety amid the chaos in their life situation.

A fast transition: A case study of patients' experiences during the diagnostic and surgical treatment phase of an accelerated brain cancer pathway

BACKGROUND

Patients receiving a brain cancer diagnosis may face cognitive decline and a poor prognosis. In addition, they suffer from a high symptom burden in a complex cancer pathway. The aim of this study was to investigate the early hospital experiences of brain tumour patients during the diagnostic and surgical treatment phase.

METHODS

A descriptive longitudinal single-case study design was used, and data were analysed via systematic text condensation.

RESULTS

The patients' experiences of being diagnosed with and treated for brain cancer were interpreted in terms of the central theme: a fast transition into an unknown journey. This theme consisted of the following subthemes: emotionally overwhelmed, putting life on hold and an unfamiliar dependency.

CONCLUSIONS

Patients diagnosed with brain cancer struggle with overwhelming emotions due to this sudden life-threatening diagnosis, their fear of brain surgery and their progressing dependence. Patients did not voice their feelings, fears or needs, so these may easily be overlooked and unmet. A proactive and continuous care approach throughout the diagnostic phase is needed to support these patients.

Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature

Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals' and patients' perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.

What we need to know about uncertainty in illness among people with primary malignant brain tumours: A mixed-methods systematic review

AIMS AND OBJECTIVES

To identify the characteristics of uncertainty in illness (UI) among people with primary malignant brain tumours (PMBT).

BACKGROUND

High recurrence rates and complex symptoms cause uncertainty in people with PMBT. Given the characteristics of PMBT, reviewing UI among people with PMBT will benefit future research and clinical intervention development.

DESIGN

A mixed-methods systematic review.

METHODS

We performed a mixed-methods systematic review (PubMed, CINAHL, Embase, PsycINFO, Scopus and Cochrane Library), including studies on UI among people with PMBT, searched from the databases' inception to the search date. The initial search was conducted in July 2021, with an additional search in March 2022. The major search terms were PMBT and UI, and no limitations were placed on the study design. The Cochrane tool was used to evaluate the risk of bias in randomised controlled trials, and JBI checklists were used to evaluate quasi-experimental studies, survey methodology studies and a case study. This review was reported using the PRISMA 2020 checklist. Both quantitative and qualitative research data were extracted, analysed and then integrated in three stages of a mixed-methods systematic review.

RESULTS

Eleven studies were included. Due to physical, psychological and social risk factors, the UI progression of people with PMBT was complex and ambiguous, although they adapted to the PMBT diagnosis and treatment process. Subsequently, we proposed a model of UI among people with PMBT.

CONCLUSIONS

UI has multidimensional characteristics, and healthcare providers need to consider these aspects for people with PMBT.

RELEVANCE TO CLINICAL PRACTICE

The proposed model provides directions for nursing practice and future research. Nurses caring for people with PMBT should comprehend their UI and intervene accordingly.

PATIENT OR PUBLIC CONTRIBUTION

This review incorporated data including people with PMBT in hospitals and communities. This analysis contributes to the clinical-to-community nursing transition process for people with PMBT.

MicroRNA-1269 is downregulated in glioblastoma and its maturation is regulated by long non-coding RNA SLC16A1 Antisense RNA 1

MicroRNA-1269 (miR-1296) promotes esophageal cancer. However, its role in other cancers, such as glioblastoma (GBM) is unclear. We predicted that miR-1269 might interact with long non-coding RNA (lncRNA) SLC16A1 Antisense RNA 1 (SLC16A1-AS1), a critical player in GBM. We then studied the interaction between SLC16A1-AS1 and miR-1269 in GBM. In this study, paired GBM and non-tumor tissues were used to analyze the expression of SLC16A1-AS1 and premature and mature miR-1269. The interaction of SLC16A1-AS1 with premature miR-1269 was analyzed with RNA pull-down assay and dual-luciferase reporter assay. Cellular fractionation assay was applied to determine the subcellular location of SLC16A1-AS1. Overexpression assays were applied to determine the role of SLC16A1-AS1 in miR-1269 maturation. BrdU, Transwell and cell apoptosis assays were performed to analyze the role of SLC16A1-AS1 and miR-1269 in GBM cell proliferation, migration, and invasion. Interestingly, we observed the upregulation of premature miR-1269 and downregulation of mature miR-1269 in GBM. SLC16A1-AS1 was also overexpressed in GBM. The direct interaction of SLC16A1-AS1 with premature miR-1269 was observed. SLC16A1-AS1 suppressed miR-1269 maturation and promoted cell proliferation, migration, and invasion, and inhibited cell apoptosis, while miR-1269 displayed the opposite trend. SLC16A1-AS1 partly reversed the effects of miR-1269 on GBM cell proliferation, movement and apoptosis. Moreover, SLC16A1-AS1 overexpression increased the level of ki-67, CDK4 and Bcl-2 in LN-229 and LN-18 cells. However, miR-1269 could partly reverse the effect of SLC16A-AS1 on protein levels. Overall, miR-1269 is downregulated in GBM and its maturation is regulated by SLC16A1-AS1.