TY  - CHAP
M1  - Book, Section
TI  - Lessons Learnt from a Deaf Patient with Ovarian Cancer
A1  - Flaum, Nicola
A1  - Hasan, Jurjees
A2  - Velikova, Galina
A2  - Fallowfield, Lesley
A2  - Younger, Jane
A2  - Board, Ruth E.
A2  - Selby, Peter
Y1  - 2018
N1  - 
T2  - Problem Solving in Patient–Centred and Integrated Cancer Care
AB  - A  58-year-old  woman  with  relapsed  platinum-resistant  high-grade  serous  carcinoma  of  the  ovary  was  admitted  with  abdominal  pain,  distension  and  constipation.  A  CT  scan  showed  multifocal  small  bowel  obstruction  from  progressive  peritoneal  disease.  At  initial  presentation  she  had  International  Federation  of  Gynecology  and  Obstetrics  stage  IIIC  disease.  She  received  surgery  and  adjuvant  carboplatin  and  paclitaxel;  after  progression  8  months  later  she  received  another  six  cycles  of  carboplatin  and  paclitaxel,  resulting  in  stable  disease  6  weeks  before  admission.  Her  comorbidities  included  profound  hearing  loss  since  having  meningitis  as  an  infant.  She  lived  with  her  husband,  who  was  also  deaf.  She  had  chronic  anxiety  and  worried  about  the  impact  of  her  disability  on  her  treatment.Options  of  chemotherapy  and  best  supportive  care  were  discussed  through  a  British  Sign  Language  (BSL)  interpreter.  Surgery  to  relieve  bowel  obstruction  was  not  deemed  feasible  given  diffuse  serosal  disease  and  multi-level  small  bowel  obstruction.  She  wished  to  have  chemotherapy,  and  commenced  cisplatin  and  gemcitabine  with  parenteral  nutritional  support.  Care  was  managed  through  a  multidisciplinary  team  (MDT)  comprising  oncologists,  palliative  care  specialists,  specialist  nurses,  dietitians  and  a  discharge  planning  team.  A  BSL  interpreter  was  available  every  day  to  facilitate  communication  with  the  patient  and  her  husband.  Chemotherapy  was  withdrawn,  as  no  clinical  improvement  was  observed  after  two  cycles  of  treatment.  Following  discussion  with  the  patient  and  her  family  it  was  agreed  she  would  go  home  and  receive  best  supportive  care.  At  the  patient's  request,  a  complex  venting  jejunostomy  was  fashioned  to  replace  a  nasogastric  tube.  Shortly  afterwards,  she  developed  intra-abdominal  sepsis  and  died  in  hospital  9  weeks  after  admission.What  are  the  evidence  base  and  rationale  for  this  patient's  treatment?How  did  the  patient's  deafness  affect  her  care?How  can  communication  in  deaf  cancer  patients  be  optimized?How  do  the  principles  of  patient-centred  care  relate  to  this  case?What  was  the  influence  of  integrated  cancer  care  for  this  patient?  
SN  - 
PB  - EBN Health
CY  - New York, NY
Y2  - 2021/03/05
UR  - hemonc.mhmedical.com/content.aspx?aid=1152359448
ER  -