[Case report of a patient with renal cell cancer and his fateful progress - Breaking Bad News].
"Breaking Bad News" outlines a pathway for medical and other professional staff to deliver bad news to patients, clients, their families and carers. Bad news can mean different things to different people. Basically, it means any information which adversely and seriously affects an individual point of view of future or situations without any feeling of hope. The way a doctor or other health or social care professionals deliver bad news places an indelible mark on the doctor/professional-patient relationship. The debate about the levels of truth given to patients about their diagnosis has developed significantly over the last few years. While doctors and professionals now increasingly share information it has been the practice to withhold information because it was believed to be in the best interests of the patient. We discuss the situation of a patient with renal cancer who developed metastases after surgery. Unfortunately a tumour embolism from the kidney flashed into the pulmonary arteries. First it was not for sure if there were any metastases beside the tumour embolus. Months after embolectomy by thoracic surgery there was certain evidence of multiple pulmonary nodal lesions. First and second line chemotherapies failed and the patient died within several months after start of pharmacologic treatment. The case report discusses diagnosis and procedures, how the patient was supported and the way he got information at any critical date.
Abteilung für Innere Medizin, Krankenhaus Barmherzige Brüder - Wien, Wien, Austria. abteilung.interne@bbwien.at
Stefan
S
Kudlacek
Johannes G
JG
Meran
D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000523:psychology / Q000556:secondary* / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy / Q000523:psychology; D010166:Palliative Care / Q000523:psychology*; D026706:Paternalism; D010358:Patient Participation / Q000523:psychology; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014342:Truth Disclosure