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Consent to cancer registrationan unnecessary burden

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1130
  1. I C M Paterson, consultant clinical oncologist
  1. Velindre Hospital, Cardiff

    Imagine this scenario. Mrs “I-Could-Be-Anybody” enters the consulting room with husband and daughter in tow. Consultant, looking and feeling uncomfortable, says: “Unfortunately, the biopsy report confirms our suspicions and fears that you have a cancer in the throat. The best treatment for this will be what we call a pharyngolaryngectomy, which means taking out part of the gullet and all of the voice box, and filling the defect with a length of your small bowel. We will also take out the lymph nodes from one side of your neck, and we might have to follow this up with radiotherapy over six to seven weeks. You won't be able to speak properly again, and you may have to have a machine to hold against your neck so that you can have a voice like a Dalek with which to communicate. Your swallowing won't be particularly easy either. I regret to say that your chances of surviving the operation and the cancer are probably no more than 20% …

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