Quality of life after surgery for lower grade gliomas

BACKGROUND

Few large studies have investigated quality of life (QOL) for adults diagnosed with lower grade glioma (LGG).

METHODS

QOL was assessed for 320 adults with LGG (World Health Organization grade 2/3) enrolled in the International Low Grade Glioma Registry by using the Medical Outcomes Study 36-Item Short Form health survey. Data on symptoms were also collected. QOL outcomes were examined by treatment group and also compared to those from a population-based case-control study of meningioma (the Meningioma Consortium), in which 1722 meningioma cases diagnosed among residents of Connecticut, Massachusetts, California, Texas, and North Carolina from May 1, 2006 through March 14, 2013 were enrolled and frequency matched to 1622 controls by age, sex, and geography.

RESULTS

The LGG sample average age is 45 years at the time of interview and 53.1% male. Almost 55% of patients had received radiation and chemotherapy (primarily temozolomide); 32.4% had received neither treatment. Two-thirds of participants with LGG report difficulty with speaking, memory, or thinking, and over one of three reports personality change or difficulty driving. After controlling for age and other comorbidities, individuals with LGG report levels of physical, emotional, and mental health functioning below those reported in a meningioma as well as a general healthy population.

CONCLUSIONS

Despite being relatively young, persons with LGG report significantly reduced QOL compared to persons with nonmalignant brain tumors and to a control population, which highlights the need to better acknowledge and manage these symptoms for this group of patients diagnosed in the prime of life.

Exercise and pregnancy in primary care

An increasing number of women exercise throughout pregnancy. New evidence illustrates that moderate intensity exercise in healthy pregnant women, with certain considerations, does not increase adverse pregnancy risks. Exercise during pregnancy may actually decrease pregnancy-associated discomforts and improve maternal fitness and well-being. By following the American College of Obstetricians and Gynecologists recommendations, clinicians can confidently prescribe exercise to women during preconception, pregnancy, and the postpartum period.

Pediatric sun exposure

The risk of malignant melanoma may double if severe sunburns are experienced during childhood. Because children are exposed to sunlight for the longest period of time before age 21, regular use of sunscreen can reduce a child's lifetime risk of developing skin cancer. Therefore, preventive education is vital for parents of infants, preschool and school-age children, and adolescents. By assessing a child's risk factors, health care providers, teachers, and child-care professionals can incorporate preventive sun-safety education into their practice. This effort needs to occur at the community, state, and national level for widespread preventive sun safety and protection. In collaboration with the Healthy People 2000 project and in compliance with the United States Preventive Service recommendations, health care providers can help reduce the incidence of skin cancers in the American population.