| [ Summary ] |
For patients with chronic renal insufficiency it must be shocking to be diagnosed with additional malignant tumors especially in ESRD. Their doctors must then consider starting dialysis therapy. Although we need to try to achieve both control of renal failure and cure of malignant tumors, we must also have the flexibly to cope with various situations individual patients experience. Elderly patients are especially difficult to judge their understand the medical care. It is also hard to interpret their will. When the patient's will is not certain to decide their therapeutic strategy due to cognitive impairment, members of their family or the medical/care team must presume his will. Notification of malignant diseases to patients with impaired cognition is often hard to decide. However we must be aware that the patients always have the right to know their own conditions. |