Dr Leeper on Meaningful Survivorship Care for Geriatric Patients With Brain Cancer

“Ultimately, the approach emphasizes shared decision-making and respect for individual values. Rather than assuming that all patients prioritize aggressive treatment, clinicians [should] seek to understand each person’s unique definition of QOL and tailor care plans accordingly, ensuring that medical decisions support the goals that matter most to patients and their families.”

Heather Leeper, MD, an associate professor of medicine and assistant professor of neurology at UChicago Medicine, discussed optimal survivorship care for geriatric patients with brain cancer.

Caring for older adults with brain tumors requires an individualized approach that extends beyond disease-directed treatment and focuses on each patient’s personal goals and priorities, Leeper said. Because brain tumors encompass a wide range of diagnoses, including glioblastoma, aggressive meningiomas, and brain metastases, treatment decisions are often guided by the biology of the disease, as well as by what patients hope to achieve throughout the rest of their life, she continued.

For patients with glioblastoma, particularly older adults who often face limited survival, oncologists should emphasize understanding what matters most to each individual, Leeper said. Conversations frequently center on quality of life (QOL), meaningful experiences, and personal milestones, rather than treatment outcomes alone, she added. Patients may identify important events they hope to attend, such as weddings, graduations, family reunions, birthdays, or the birth of a grandchild. In these situations, care teams work collaboratively with patients and families to maximize the likelihood of reaching those goals, sometimes encouraging flexibility in scheduling important celebrations so patients can participate during the times when they are still feeling well, she said.

This patient-centered philosophy extends to individuals with other serious brain tumors, including aggressive meningiomas and metastatic disease, Leeper said. Oncologists help patients evaluate how they want to spend their remaining time and whether specific interventions align with those priorities, she noted. Discussions may include the benefits and burdens of continued treatment, clinic visits, physical therapy, occupational therapy, and other supportive services. For some patients, pursuing every available treatment option remains their primary goal, and they choose to continue therapy as long as possible, she added. Others, after learning more about their prognosis and treatment expectations, may decide that spending time with family, traveling, or participating in other meaningful activities is more important than ongoing medical appointments, she said.

Ultimately, the approach emphasizes shared decision-making and respect for individual values, Leeper said. Rather than assuming that all patients prioritize aggressive treatment, it is important to seek to understand each person’s unique definition of QOL and tailor care plans accordingly, ensuring that medical decisions support the goals that matter most to patients and their families, she concluded.