scholarly journals Ethical Considerations in the Treatment of Head and Neck Cancer

2002 ◽  
Vol 9 (5) ◽  
pp. 410-419 ◽  
Author(s):  
David P. Schenck
Keyword(s):  
Decision Making ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Ethical Issues ◽  
Case Reports ◽  
Medical Science ◽  
Biomedical Ethics ◽  
Medical Decision

Background The second half of the 20th century saw not only important developments in medical science and technology, but also a rapid growth in the application of biomedical ethics in medical decision making. Withdrawal of treatment, allowing to die, informed consent, and patient autonomy are concerns that now comprise a part of the overall medical treatment, particularly in patients with head and neck cancers. Methods The author discusses ethical issues relating to disfigurement/dysfunction in head and neck cancer patients and examines the aspects of “principlism” — autonomy, nonmaleficence, beneficence, and justice. Two case reports are presented to illustrate the ethical challenges that may confront physicians who treat head and neck cancer patients. Results Head and neck oncology generates unique problems relating to disfigurement and dysfunction. An algorithm that considers the patient's medical good and greater good, as well as the goods of others, can assist in arriving at appropriate ethical decisions. Conclusions Bioethical decision making requires the integration of virtues with principles, followed by the application of these standards to each patient.

scholarly journals Deliberações clínicas na atuação em pacientes com câncer de cabeça e pescoço: atualidades e desafios na disfagia

2020 ◽  
Vol 31 (4) ◽  
pp. 693-697
Author(s):  
Guilherme Maia Zica ◽  
Andressa Silva de Freitas
Keyword(s):  
Decision Making ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Clinical Decision Making ◽  
Clinical Decision

Starmer H, Edwards J. Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia. Semin Speech Lang. 2019 Jun;40(3):213-226.

Irradiation-Induced Atherosclerosis: A Factor in Therapeutic Planning

1992 ◽  
Vol 101 (3) ◽  
pp. 222-228 ◽  
Author(s):  
W. Frederick McGuirt ◽  
Robert S. Feehs ◽  
Harriet L. Strickland ◽  
Gene Bond ◽  
William M. McKinney
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Carotid Atherosclerosis ◽  
Case Reports ◽  
Neck Disease ◽  
Choice Of Treatment ◽  
Long Term Follow Up ◽  
Early Primary

Early primary head and neck cancers (stages I and II) and occult metastatic neck disease have caused debate regarding the choice between surgery and irradiation. The arguments for each are reviewed with a new consideration: the acceleration and/or induction of carotid atherosclerosis in irradiated patients. We present clinical case reports (n = 9), a retrospective clinical evaluation for the occurrence of carotid atherosclerosis in irradiated head and neck cancer patients (n = 57), and a comparison study of the extent and distribution of atherosclerosis in irradiated (n = 29) and nonirradiated head and neck cancer patients controlled for age, blood pressure, and tobacco use. The results show that carotid atherosclerosis is found in a wider anatomic distribution and to a greater extent in irradiated than in nonirradiated patients. We conclude that carotid atherosclerosis is induced and/or accelerated by neck irradiation. The implications as they relate to choice of treatment, to pretreatment evaluations, and to long-term follow-up are discussed.

The impact of patients’ and physicians’ characteristics on surgery decision for head and neck cancer: Results of a national survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14151-e14151
Author(s):  
Agnès Dupret-Bories ◽  
Pascale Grosclaude ◽  
Sebastien Lamy ◽  
Antoine Nebout ◽  
Pierre Bories ◽  
...  
Keyword(s):  
Decision Making ◽  
Socioeconomic Status ◽  
Head And Neck Cancer ◽  
Risk Aversion ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Behavioral Characteristics ◽  
Head And Neck Oncology

e14151 Background: The choice between surgical or medical treatments in head and neck cancer is a function of many patient-related and disease-related factors. We investigated how physicians' behavioral characteristics and patients’ socioeconomic status could affect medical decision-making. Methods: A nationwide cross-sectional online survey of surgeons and (radiation) oncologists specialized in head and neck oncology collected data on medical decision-making for 7 clinical vignettes involving head and neck squamous cell carcinoma patients that were representative of routine practice. Questionnaires elicited physicians' demographic and occupational characteristics along with their individual behavioral characteristics according to the decision theory framework. Patients’ gender and socioeconomic position were distributed across vignettes using a Latin square design. Results: We obtained 206 assessable answers. A multivariate analysis shows that surgeons suggested surgery more often than other professionals, which is mostly related to vignettes corresponding to clinical cases for which there is no consensus, so oncologists are 68% less likely than surgeons to choose surgery. For clinical vignette with an absence of consensus, physicians with lower risk aversion recommend more often surgery compared to those with higher risk aversion (OR = 1.88, p = 0.052). When the vignette corresponds to a clinical case for which there is a surgical consensus decision the isolated male blue-collar worker has a 75% lower chance of being offered surgery compared to the married male small business owner (OR = 0.25, p = 0.024). We did not observe any differences based on the patient's gender. Conclusions: Patients’ socioeconomic status did affect our clinical management decisions in head and neck oncology. The significant association between medical decision and individual behavioral characteristics of the physician documented still understudied mechanisms that involved nonbiological factor to explain clinical practices variations.

scholarly journals Prediction model for tube feeding dependency during chemoradiotherapy for at least four weeks in head and neck cancer patients: A tool for prophylactic gastrostomy decision making

2020 ◽  
Vol 39 (8) ◽  
pp. 2600-2608 ◽  
Author(s):  
Anna C.H. Willemsen ◽  
Annemieke Kok ◽  
Sander M.J. van Kuijk ◽  
Laura W.J. Baijens ◽  
Remco de Bree ◽  
...  
Keyword(s):  
Decision Making ◽  
Head And Neck Cancer ◽  
Prediction Model ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Tube Feeding
Sign in / Sign up

Export Citation Format

Share Document