TY  - CHAP
M1  - Book, Section
TI  - A Patient with Breast Cancer and Dementia
A1  - Josephs, Debra
A1  - Kok, Kimberley
A1  - Martin, Finbarr
A1  - Karapanagiotou, Eleni
A2  - Ring, Alistair
A2  - Harari, Danielle
A2  - Kalsi, Tania
A2  - Mansi, Janine
A2  - Selby, Peter
PY  - 2018
T2  - Problem Solving in Older Cancer Patients
AB  - A  75-year-old  woman  with  oestrogen  receptor-negative,  HER2-negative  metastatic  breast  cancer  was  referred  for  consideration  of  palliative  treatment.  Her  metastatic  disease  (multiple  pulmonary  nodules  only)  had  recently  been  diagnosed  on  routine  surgical  follow-up,  6  months  after  radical  mastectomy  and  axillary  node  clearance.  She  attended  the  clinic  appointment  with  her  daughter  and  son-in-law,  who  said  she  had  moderate  Alzheimer's  dementia  (Mini-Mental  State  Examination  14/30),  but  maintained  a  good  level  of  function.  She  was  independent  in  basic  activities  of  daily  living  (ADL),  but  not  in  instrumental  ADL.Three  months  later,  a  re-staging  CT  scan  revealed  evidence  of  progressive  disease.  A  decision  was  made  to  offer  the  patient  systemic  therapy  with  oral  capecitabine.BackgroundHow  would  you  assess  this  patient's  capacity  to  consent  to  treatment?  What  is  the  definition  of  'capacity',  and  is  there  a  test  to  determine  mental  capacity?What  would  your  management  be  if  this  patient  were  assessed  to  have  no  capacity  with  regards  to  consenting  to  the  specific  decision  about  her  options  for  treatment?What  is  the  evidence  base  for  her  treatment  options?What  other  considerations  should  be  made  when  offering  this  patient  systemic  anticancer  therapy?  
SN  - 
PB  - Clinical Publishing
CY  - New York, NY
Y2  - 2021/03/06
UR  - hemonc.mhmedical.com/content.aspx?aid=1152358406
ER  -