Informing patients before receiving radiation therapy is a fundamental ethical imperative. As a condition of the possibility of autonomy, information allows people to make health decisions concerning themselves, which is required by French law. This information includes in particular the potential risks due to radiation therapy. It is therefore necessary to think about what risk is, and how to define and assess it, in order to finally communicate it. The practice of informing people involves many ethical issues relating to the very content of the information, the form in which it is transmitted or even the intention that leads the health professional to say (or not to say) the risk. The transmission of information also questions the way to build a relationship of trust with the patients and how to integrate their own representations about these treatments. Between the risks of paternalism or even defensive medicine, this practice is at the heart of our professional practice.
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http://dx.doi.org/10.1016/j.canrad.2023.06.006 | DOI Listing |
J Med Case Rep
December 2024
College of Medicine and Life Sciences, Division of Plastic and Reconstructive Surgery, University of Toledo, 3000 Arlington Ave, Toledo, OH, 43614, USA.
Background: Although rare, melanoma confined to the dermis or subcutaneous tissue without evidence of a primary cutaneous site should provoke consideration of melanoma of unknown primary. This diagnosis carries a favorable prognosis when compared with cutaneous metastatic melanoma. Several hypotheses have been proposed for how melanoma of unknown primary develops, two of which were considered in our patient case: (1) spontaneous regression of the primary tumor following metastasis or (2) the traumatic implantation of ectopic melanocytic cells in other tissues, such as the subcutaneous tissue.
View Article and Find Full Text PDFBMC Med
December 2024
Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Geert Grooteplein 10, Nijmegen, 6500HB, the Netherlands.
Background: Palliative sedation involves the intentional proportional lowering of the level of consciousness in patients with life-limiting disease who are experiencing refractory suffering. The efficacy of palliative sedation needs to be monitored to ensure patient comfort. The aim of this study was to evaluate the efficacy using discomfort levels combined with sedation/agitation levels.
View Article and Find Full Text PDFBMC Urol
December 2024
Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Background: Immune checkpoint inhibitors (ICIs) alone or in combination with standard chemotherapy for advanced urothelial carcinoma (UC) have been tested as first-line treatment in clinical trials. This study aimed to evaluate the clinical outcomes of programmed cell death 1 (PD-1) inhibitor alone or combined with chemotherapy for patients with locally advanced or metastatic UC in a real world clinical care setting, and sought to identify prognostic factors for overall survival (OS).
Methods: A retrospective, real-world study involving 35 locally advanced or metastatic UC patients treated with PD-1 inhibitor alone or in combination with chemotherapy was conducted.
Sci Rep
December 2024
Department of Radiation Oncology, University Hospital of Regensburg, Franz-Josef-Strauß Allee 11, Regensburg, Germany.
There are concerns that radiotherapy for prostate cancer influences health-related quality of life in the long term. Furthermore, it is unclear whether postoperative radiotherapy is associated with a different quality of life due to a higher treatment burden compared to patients having received definitive radiotherapy for prostate cancer. This study enrolled 247 patients with localized or locally advanced prostate cancer who received external radiotherapy between 2011 and 2021.
View Article and Find Full Text PDFClin Colorectal Cancer
December 2024
Department of Surgery, HagaZiekenhuis, The Hague, The Netherlands.
Introduction: Data regarding the incidence and outcomes of mismatch repair deficient (dMMR) rectal cancer is limited. This study characterizes dMMR rectal cancer patients, comparing response after neoadjuvant radiotherapy and oncological outcomes to mismatch repair proficient (pMMR) rectal cancer patients.
Method: A retrospective cross-sectional cohort study was conducted in 67 Dutch centers.
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