Experiences in extending palliative care to neuro-oncology patients in Indonesia

Neuro-oncology cases are unique compared to other type of tumors. The symptoms of tumor of the central nervous system (CNS) varied from one patient to another, depending on the size and anatomic location of the tumor. Tumor of the CNS needs comprehensive management and special treatment. By the time of the diagnosis, the palliative treatment in neuro-oncology patients should be considered due to high morbidity and mortality of the tumor. The symptoms that emerged from CNS tumors cause disability and reduce the patient's quality of life (QoL) and should be addressed in palliative care. The assessment of patients by a palliative team should result in therapeutic plan in hospital and home care after patients are discharged. The palliative care of neuro-oncology patients in developing country such as Indonesia is challenging. Resources limitation and allocation in palliative care complicate the implementation of palliative care in Indonesia. Appointing brain tumor patient's caregiver is also difficult since the other family members should fulfill another need of the family. Therefore, the implementation of palliative care on neuro-oncology cases in Indonesia needs an adjustment to obtain optimal outcome.