title: Exploration of the treatment challenges in men with intellectual difficulties and testicular cancer as seen in Down syndrome: single centre experience.
abstract: Down syndrome is the most common chromosomal disorder in humans as well as the most common cause of inherited intellectual disability. A spectrum of physical and functional disability is associated with the syndrome as well as a predisposition to developing particular malignancies, including testicular cancers. These tumours ordinarily have a high cure rate even in widely disseminated disease. However, individuals with Down syndrome may have learning difficulties, behavioural problems, and multiple systemic complications that have the potential to make standard treatment more risky and necessitates individualized approach in order to avoid unacceptable harm. There is also suggestion that tumours may have a different natural history. Further, people with learning disabilities have often experienced poorer healthcare than the general population. In order to address these inequalities, legislation, professional bodies, and charities provide guidance; however, ultimately, consideration of the person in the context of their own psychosocial issues, comorbidities, and possible treatment strategies is vital in delivering optimal care. We aim to present a review of our own experience of delivering individualized care to this group of patients in order to close the existing health inequality gap.
authors.affiliation: The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK. shaista.hafeez@rmh.nhs.uk.|The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK. shaista.hafeez@rmh.nhs.uk.
authors.forename: Shaista
authors.initials: S
authors.lastname: Hafeez
authors.affiliation: The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK.|Guy's and St Thomas' NHS Foundation Trust, St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: Mausam
authors.initials: M
authors.lastname: Singhera
authors.affiliation: The Institute of Cancer Research, 123 Old Brompton Road, London, SW7 3RP, UK.|The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Huddart
mesh_terms: D015897:Comorbidity; D004314:Down Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications* / Q000628:therapy*; D013736:Testicular Neoplasms / Q000150:complications* / Q000628:therapy*