Brain tumors and driving

Excerpt

Referring to the article: “Current practices of driving restriction implementation for patients with brain tumors” by Thomas et al., published in your journal in October 2010 (published online) [1], I am writing to inform readers of the recent initiative of the Cancer Institute NSW Oncology Working Group for Neuro-oncology (NSWOG, Australia) to address the serious issue of driving a motor vehicle after diagnosis of a brain tumor. Driving a motor vehicle is a complex task and patients diagnosed with a brain tumor are at a higher accident risk because of the significant neurocognitive deficits associated with the disease. As the authors pointed out, seizures, memory lapses, and cognitive dysfunction can result from both benign and malignant brain tumors, placing the driver, its passengers and innocent bystanders in danger. In the USA, it is up to individual States to enforce reporting of conditions which impair driving. In Australia, the driver licensing authority (DLA) holds the legal responsibility to determine eligibility to drive, and the treating clinician’s role to provide relevant medical information [2]. In practice however, the responsibility lies with the clinician. Australia is fortunate to have formalized recommendations, but despite the release of “Assessing Fitness to Drive” by Austroads (guidelines approved by all Australian licensing authorities), patients are often given conflicting advice with regards to their ability or fitness to drive. This is consistent with the findings and conclusions generated by Thomas and colleagues. In an Australian survey of practicing neurosurgeons, neurologists and radiation oncologists (n = 194), 73% of respondents were not aware of any current guidelines [3]. Unanimously, the conclusion and recommendation reached by both the USA and Australian surveys were to form a multidisciplinary working party to develop more specific guidelines [1, 3]. …