How a Brain Tumor Board Guides Treatment Decisions After Surgery

Dr. D. Ryan Ormond, a neurosurgeon at University of Colorado, explains that at his center, “Every patient goes to this tumor board where we have a discussion with all the specialists, make a decision plan by consensus for what’s going to happen.”

What is a Tumor Board?

A tumor board is a group of healthcare professionals who specialize in treating cancer.

“If there’s any question about treatment plan, we have a brain tumor board that’s specific with all the specialists relevant to neuro-oncology and we present the patient’s information and imaging and have a discussion about plan of care before any treatment happens,” Dr. Ormond explains.

This team can include an array of specialists, such as:

• Surgeons
• Medical oncologists
• Radiation oncologists
• Pathologists
• Radiologists
• Genetic counselors

Other specialists such as nurses, social workers, and patient navigators may also be consulted to ensure comprehensive support for your physical and emotional well-being throughout your cancer journey.

The tumor board meets regularly to review complex cases and provide expert recommendations on the next steps in treatment.

How Does the Tumor Board Make Decisions?

The tumor board carefully evaluates multiple factors, including:

• Surgical Findings: The extent to which the tumor was removed and whether there is any evidence of remaining cancer cells
• Pathology Reports: The microscopic analysis of your tumor, which provides information about its aggressiveness, margins, and molecular markers
• Imaging Results: Post-surgical imaging studies help determine whether cancer has spread or if additional treatment may be necessary
• Cancer Stage and Grade: The tumor board considers the stage (extent of spread) and grade (how abnormal the cancer cells appear) to assess the likelihood of recurrence
• Your Overall Health: Your age, underlying medical conditions, and ability to tolerate further treatment are all factored into the decision
• Available Treatment Options: The latest research, clinical trials, and personalized treatment strategies help shape the board’s recommendations

After reviewing these factors, the tumor board provides guidance on whether further treatment is necessary and what options are most suitable.

What are the Treatment Options for Glioma?

Depending on your individual case, the tumor board may suggest one or more of the following treatments.

• No Further Treatment: If the tumor was completely removed and there are no signs of remaining cancer, your doctors may recommend regular monitoring with follow-up appointments and imaging.
• Chemotherapy: This involves using powerful drugs to target and destroy cancer cells that may still be present in your body.
• Radiation Therapy: High-energy radiation is used to eliminate any remaining cancer cells in a specific area, often recommended if there were close or positive surgical margins.
• Targeted Therapy: These are medications designed to attack specific genetic or molecular features of your cancer, which may be an option if your pathology report identifies particular mutations.
• Immunotherapy: This treatment helps your own immune system recognize and fight cancer cells more effectively.
• Hormone Therapy: For hormone-sensitive cancers (such as certain breast and prostate cancers), medications may be used to block hormones that fuel tumor growth.
• Participation in Clinical Trials: Your doctors may recommend enrolling in a research study to access emerging treatments that are not yet widely available.

Each recommendation is personalized based on the specifics of your case, aiming to optimize outcomes while minimizing side effects.

Should I Get a Second Opinion?

Getting a second opinion is always a reasonable choice, especially if you are unsure about your diagnosis or recommended treatment plan.

A different medical team may offer additional insights or identify nuances in your pathology report that could influence treatment decisions. Some hospitals and cancer centers may also have access to newer therapies, specialized clinical trials, or different approaches to care. A second opinion can provide reassurance that your treatment plan is appropriate and aligns with the latest medical evidence.

Seeking advice from a doctor who has extensive experience in treating your specific type of cancer may be beneficial. Most doctors encourage second opinions, and many insurance plans cover them. You can request that your medical records, including imaging and pathology reports, be shared with another specialist for review.

Questions to Ask Your Doctor

• Will my care be reviewed by a tumor board?
• What sort of specialists will be involved in my care?
• When can I expect the tumor board’s recommendation?
• Will the tumor board give me options to choose from?

Learn more about SurvivorNet's rigorous medical review process.

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