| Theme | Malignancy in Chronic Renal Failure | |
|---|---|---|
| Title | Commencement of dialysis for cancer patients | |
| Publish Date | 2001/06 | |
| Author | Akira Ito | Department of Internal Medicine, Masuko Memorial Hospital |
| [ Summary ] | Medical specialists often find it difficult to decide whether they should provide dialysis as a treatment for renal dysfunction in terminal cancer patients. In principle, the decision should be left to the patient. However, there is some question as to the QOL which can be offered to dialysis patients. Medical science alone is insufficient to answer such a question. Here, I present three cases, examined from a psycho-social viewpoint. In case (1) treatment for mycosis fungoides was started in the tumorous stage and continued until the patient's death. In case (2) liver cancer occurred as a complication of liver cirrhosis in an irreversible stage, and dialysis was not provided for the patient, who was in a hepatic coma, in accordance with the wishes of the patient's family. In case (3) colon cancer metastasized to several organs, and dialysis was stopped at the patient's request. Conclusions: (1) It is important that patients be notified of pathogenesis, including cancer. (2) Patients and their families need to be provided with appropriate amounts of time and proper environments, in which to make decisions. (3) Proper disclosure of information, and team support by physicians in charge-including dialytic doctors-is necessary. |
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