​What kinds of symptoms do patients experience before receiving treatment?

The symptoms of tumors vary according to their location. The most common symptoms include chills, discomfort or pain, fatigue, fever, loss of appetite, night sweats, and weight loss. Brain tumor symptoms may include headaches, dizziness, vision trouble, and fuzzy memory.

​What is the impact on patients’ lives of living with these conditions?

Over time, a tumor can grow larger and become increasingly painful. If it not treated early, it may turn cancerous, which requires a longer treatment process or may not be treatable at all. Due to the symptoms of a tumor, adult patients may have difficulty caring for their families and completing day-to-day chores. They may miss work or lose their jobs altogether, resulting in a decrease in income for their families. Children can miss school or drop out, resulting in a lower quality of life in the future. In worst case scenarios, tumors can be life threatening. When a benign tumor turns cancerous, the patient may need chemotherapy or other types of therapy which are very expensive and often unaffordable.

What cultural or regional factors affect the treatment of these conditions?

Traditional interpretations of neurological symptoms: In many Malian communities, signs of brain tumors (chronic headaches, seizures, behavioral disorders, visual disturbances, paralysis) are sometimes attributed to spiritual possession or “djinns,” witchcraft, curses, divine punishment, or mystical attacks. Chronic headaches, common in tumors, are trivialized and perceived as consequences of fatigue, heat, or stress and treated with self-medication using paracetamol or herbal decoctions. These signs are often considered madness and hidden by families. Brain surgery is perceived as extremely risky, synonymous with death, memory loss, paralysis, or loss of the soul. Other factors include belief in traditional treatment, taboos, illiteracy, poverty, family-based decision-making, lack of services in regional and rural areas, insecurity, absence of imaging (CT/MRI), insufficient or absent human resources. In addition, diagnostic errors lead to confusion with other pathologies such as typhoid salmonellosis, malaria, migraine, epilepsy, and mental disorders.

What does the treatment process look like?

The patient undergoes a blood test, an ultrasound, and an x-ray. The patient will also receive a computerized tomography (CT) scan and/or a magnetic resonance imaging (MRI) scan in preparation for the patient's treatment. Sometimes a biopsy is required to confirm if the tumor is benign or malignant. For adult patients without any underlying conditions and depending on the tumors locations, the removal of a tumor surgery can be performed quickly. However, if the patient has underlying conditions such as high blood pressure or diabetes, or if the tumor is located in or near an organ such as the brain, the surgery will be high risk. Additionally, any underlying condition must be managed before they receive surgery. A patient usually spends about 2-3 days in the hospital.

What is the impact of this treatment on the patient’s life?

After the surgery, the patient will no longer experience pain or discomfort and will be able to resume their usual daily activities. Any other symptoms caused by the tumor such as chills or fever will be alleviated.

What potential side effects or risks come with this treatment?

The potential risks of undergoing surgery for tumor removal includes an infection at the site of the surgery and an allergic reactions to anesthesia. Additionally, nerves and/or nearby organs may become damaged.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Barriers to treatment include a high cost for Malian patients, fear of brain surgery, belief in traditional healers, misperceptions such as djinns, madness, or curses, trivialization of symptoms and self-medication, diagnostic errors, and delays in decision-making.

What are the alternatives to this treatment?

Although there are less invasive procedures, depending on the tumor's location, such as upper endoscopy and colonoscopy, open surgeries are primarily performed to remove tumors.