Glioma Surgery: Is it worth operating on these patients asks Prof.Khaleeq-uz-Zaman

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Glioma Surgery: Is it worth operating on these
patients asks Prof.Khaleeq-uz-Zaman

Our objective should be survival with quality of life

KARACHI: Is it worth operating on Glioma patients because our objective should be survival with quality o life. This was stated by Prof. Khaleeq-uz-Zaman Prof. of Neurosurgery at Pakistan Institute of Medical Sciences while making a presentation during the 26th National conference of Pakistan Society of Neurosurgeons held here recently. Prof. Khaleeq was of the view that we need to change our culture to ensure patient safety.
We have heard excellent presentations on Nanno technology and some other sophisticated techniques from the learned speakers but I wish to bring the audience close to ground realities that we face in Pakistan. We must know what our culture is and many of these newer sophisticated things are beyond one’s imagination. I wish my colleagues to come closer to reality from imagination. Outcome of gliomas surgery remains poor, dismal, grim, worse, lethal and fatal. Patients with haemorrhage go from place to place for diagnosis. After operation the patient goes from one surgeon to another with a hope to get better. The objective of treatment should not only be prolongation of life of the patient but also ensure good quality of life. It affects the whole family hence the quality of life of every one is affected from patients to relatives to the whole family.
One of the studies stated that from 1993 to 2004, the patient’s quality of life has not improved after gliomas surgery. With all the morbidity, the problems remain the same. Declining survival rate in advanced age has been observed, hence one often thinks whether it is worth operating on these patients, he remarked. Prognosis is better in children than adults. We have failed to make much headway in this regard and incentives are needed for drug development. The patients need tender loving care. He advised his colleagues not to start playing God since it is not our job. Risk factors, he said, include the tumour size, its depth, location and type of tumour. Sometimes it is said, the operation was successful but the patient has gone to the next world? Hence, we must ask ourselves; did we achieve the goal of surgery? How you count on six month to twelve months survival which has cost the patient over two lac rupees? He laid emphasis on skills development and said that we must ask ourselves what we are doing was right or not? Whether it is head injury or high grade gliomas, do it for patient safety. In view of the progress being made in medicine, in the days to come personalized targeted therapy might become possible, he remarked.
Summing up the discussion Prof. Tariq Salahuddin who was chairing the session commended Prof. Khaleequz Zaman who, he said, always comes up with a philosophical talk covering important issues with an emotional touch. We all need to be realistic and make decisions keeping up the professional ethics in view of the economic resources, he added.