title: Ethical and clinical dilemmas in patients with head and neck tumors visiting a field hospital in the Philippines.
abstract: OBJECTIVE
  To describe clinical and ethical dilemmas in patients presenting with head and neck (H&N) tumors to a field hospital in the "subacute" period following a typhoon.
  
  
  METHODS
  We retrospectively reviewed charts of H&N patients presenting to an integrated Israeli-Filipino medical facility, which was operated more than 11 days.
  
  
  RESULTS
  Of the 1,844 adult patients examined, 85 (5 percent) presented with H&N tumors. Of those, 70 (82 percent) were females, with a mean age of 43 ± 15 years. Thyroid neoplasms were the most common tumors (68, 80 percent). Despite limited resources, we contributed to the workup and treatment of several patients. To better illustrate our dilemmas, we present four key patients, in whom we favored diagnostic/therapeutic interventions in two, and opted to defer any intervention in two.
  
  
  CONCLUSIONS
  In a relief mission, despite the lack of clinical and pathological staging and questionable continuity of care, surgical interventions can be considered for therapeutic, palliative, and diagnostic purposes.
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Otolaryngology - Head & Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Marom
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Segal
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel.
authors.forename: Tomer
authors.initials: T
authors.lastname: Erlich
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Erez
authors.initials: E
authors.lastname: Tsumi
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Merin
authors.affiliation: Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Trauma Unit, Meir Medical Center, Tel Aviv University Sackler School of Medicine, Kfar Saba, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055867:Cyclonic Storms; D004190:Disasters; D004992:Ethics, Medical; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units / Q000941:ethics*; D018579:Patient Selection / Q000941:ethics*; D010679:Philippines; D012066:Relief Work / Q000941:ethics*; D012189:Retrospective Studies; D055815:Young Adult