A prospective study of introducing self-determined treatment policy for the patients with hypopharyngeal cancer

Abstract

A total of 57 patients with hypopharyngeal cancer were given an opportunity to select their treatment options after a thorough explanation of the tumor stage, treatment modalities, complications due to treatment, and prognosis. As a result, many patients selected chemoradiotherapy as the initial treatment. Two patients requested treatment at other institutes and were immediately transferred. A 91-year-old patient with T4N3M0 tumor declined treatment. The duration from the initial visit to the start of treatment course was prolonged because of the informed consent process. Patient rejection of salvage surgery following the failure of chemoradiotherapy increased. However, both the physician-patient relationship and physician-patient's family relationship in the uncured group did not deteriorate. No change in the 3-year crude survival rate by introducing self-determined treatment was observed at this time. It is ideal that the patient choice of treatment options is the one physician recommend. Meanwhile, physicians should consider ideal treatment options, which are most desirable for the patient. In conclusion, thorough informed consent provides positive clinical impact even with ominous hypopharyngeal cancer.