What to Know About Telehealth for Brain Tumors

If you have been diagnosed with a brain tumor, you may be able to get some of your medical care with telehealth. Treatment for brain tumors requires in-person procedures, but important aspects of your care—such as monitoring tumor symptoms and managing the side effects of treatment—can often be facilitated with telehealth. 

Healthcare providers’ offices are taking precautions to see patients safely during the COVID-19 pandemic. But cancer, including a brain tumor, is one of the risk factors for severe COVID-19 illness. Your practitioner may advise you to avoid exposure to the virus by getting as much of your medical care via telehealth as possible. 

When to Use Telehealth for Brain Tumor Care 

A great deal of your brain tumor care is focused on managing symptoms while recovering from surgery and radiation treatment. Brain tumors are often treated with chemotherapy and steroids. And the effects of brain tumors vary—some may require treatment with anti-epilepsy drugs (AEDs), hormone therapies, and more. 

The most useful situations for using telehealth for your brain tumor care include: 

• Checking in with your healthcare provider about stable symptoms 
• Talking about medication side effects 
• Managing headaches
• Discussing results of diagnostic testing, such as lab tests or imaging studies 
• Getting refills or adjustments of your medication prescriptions
• Discussing when and how to stop taking any medications that you don’t need to take anymore
• Showing your healthcare provider a photo or live video of your surgical wound if you have had surgery 
• Showing your healthcare provider a photo or live video of your brain shunt if you have one 
• Asking any questions you have about your condition, wound care, or your shunt

Improvement of the effects of a brain tumor can be gradual. A complete cure can be possible with some brain tumors, but there is a risk of cancer recurrence with other types of brain tumors. Your healthcare provider will need to assess the therapeutic effects of your treatments, as well as the side effects, and screen for signs of tumor recurrence. 

Benefits and Challenges 

Telehealth can be a valuable adjunct to your in-person care if you have a brain tumor. People who are able to access brain tumor care via telehealth report high levels of satisfaction with their care.

There are a number of specific advantages to telehealth care for brain tumors, including:

• Avoiding unnecessary exposure to the virus
• Ability to get care without making transportation arrangements 
• Maintaining safety from falls or other injuries if your mobility is impaired
• Ability to check in frequently with your healthcare providers
• Convenience of scheduling sequential appointments that aren’t geographically close to each other

Research shows that real-time telehealth care leads to better treatment adherence for people who are undergoing treatment for a brain tumor.

Challenges

There are challenges when it comes to incorporating telehealth with brain tumor care, however. It is not adequate to get all of your brain tumor care via telehealth. A detailed physical examination, including a neurological examination, is not possible without in-person care.

For example, subtle signs of a worsening tumor, such as swelling behind the eyes, can be detected with an in-person physical examination before signs emerge on brain imaging studies—and these subtle signs cannot be identified via telehealth.

A thorough shunt examination also requires in-person care. Surgery, radiation, some types of chemotherapy, and shunt maintenance must be administered in person by a healthcare professional, and seizures or brain edema (swelling around the tumor) must be managed in person. 

How to Prepare for a Telehealth Visit for Brain Tumor Care 

Your healthcare team might facilitate your telehealth care. However, if they cannot do so, you can contact your health payer (insurance, Medicaid, or Medicare) to find out where you can seek this type of care.

You will receive a list of providers who are covered by your payer. You will need to provide permission so your new provider (or providers) can access your medical records and take on the telehealth portion of your care.

You will also need to get set up for the technological aspects of this care. This can involve using your own computer and internet, or locating another place to access this technology.

You might consider using:

• A device loaned to you by a family member or friend
• Your local library
• A community facility

Often, you can reserve a room at a community facility so you can discuss your care in private. You can have a friend or family member who lives with you and helps you with your care accompany you to your visit if you think this would be helpful.

You can prepare for your telehealth visit in advance by keeping track of your symptoms. Since there are many types of brain tumors, the effects that your healthcare provider will want to know about can differ.

You should check about the specific signs that you need to look for at the time of your diagnosis and again at the time of your treatment. If you do not know the signs that you should be tracking, contact your healthcare provider's office and request this information.

In general, if you have been diagnosed or treated for a brain tumor, you should track the following issues between each of your in-person or telehealth visits in a calendar or a dated diary:

• Headaches, including frequency, severity, and duration
• Blood pressure (daily), using a home blood pressure device if possible
• Pulse rate (daily)
• Weight (once per week)
• Subtle changes in your balance
• Any numbness, tingling, or unusual sensations

What Happens During the Visit 

Your telehealth visit may be done with video or only with a voice call—depending on your access to various forms of technology and what your healthcare provider feels is necessary for your care.

You might have some telehealth visits with your neurologist, neurosurgeon, oncologist, physical therapist, and/or nurse. During your visit, you will have time to discuss your concerns, and your healthcare provider will also ask specific questions about your symptoms, medications, and side effects.

You may also be asked to share any details that you have been asked to track (such as blood pressure readings), or these already may have been sent to your provider directly from a store-and-forward device.

A cognitive assessment may be part of your visit. This could include answering questions and completing tasks, such as drawing a clock. 

Your provider may also do a partial physical examination, which can include asking you to move your face, arms, and legs. This can show signs of asymmetric movement and will help your provider detect severe problems with muscle weakness or diminished coordination. Strength and sensation cannot be adequately evaluated via telehealth. 

A Word From Verywell

There are many different aspects of brain tumor care. Some of them can be managed via telehealth and do not necessarily require in-person care. Staying safe from COVID-19 and other infections is important when you are being treated for and recovering from cancer.

A telehealth visit gives you the opportunity to discuss your symptoms and verify things are moving in the right direction. Minor changes to your prescriptions can be made, and your medical team can often identify major issues that require in-person care when evaluating you through a telehealth visit.

Research on the impact of telehealth on quality of life for people who are undergoing treatment for a brain tumor is ongoing.