Holistic General Practice: A Student`s Perspective.

Area of Science:

• Oncology
• Surgical Oncology
• Medical Decision Making

Background:

• A patient diagnosed with rectal cancer and co-existing anxiety and depression underwent neoadjuvant chemotherapy.
• The chemotherapy resulted in a complete response, with no evidence of active cancer detected.
• This outcome created a dilemma regarding the planned surgical intervention.

Purpose of the Study:

• To explore the challenges in surgical decision-making for rectal cancer patients achieving complete response after neoadjuvant chemotherapy.
• To understand the impact of patient anxiety and support systems on treatment choices.
• To emphasize the importance of a thorough medical history, including review of systems, in cancer diagnosis.

Main Methods:

• Case presentation of a patient with rectal cancer.
• Discussion of treatment options following neoadjuvant chemotherapy.
• Analysis of patient's psychological state and decision-making process.

Main Results:

• The patient exhibited significant hesitation towards surgery due to the absence of detectable cancer post-chemotherapy.
• Lack of support contributed to the patient's inability to make a definitive decision after multiple consultations.
• The case underscores the critical role of the review of systems in identifying initial symptoms, such as those leading to the rectal cancer diagnosis.

Conclusions:

• Successful neoadjuvant chemotherapy in rectal cancer necessitates careful re-evaluation of surgical plans and patient readiness.
• Addressing patient anxiety and providing adequate support are crucial for navigating complex treatment decisions.
• The case illustrates the value of comprehensive patient assessment and shared decision-making in oncology.