Discussion Part One (graded)\t\u00a0\t\u00a0\tC.G. is a 69-year-old male with a history of right head and neck cancer that you have been following for one year. The carcinoma was initially localized to the head and neck-specifically at the left lingual tonsil region and went on to complete a total of 6 weeks of radiation and chemotherapy. Recently, the last PET scan indicated some metabolic activity in the left lymph node area along with other regions of abnormal metabolic activity in the body-particularly the liver and the lungs indicating metastasis. C.G. indicates that he is tired of the effects of chemotherapy and radiation and does not want to pursue any more treatment for cancer.\t\u00a0\t\u00a0\tBackground:\t\u00a0\tRight head and neck cancer with metastasis to liver and lungs; patient is refusing further treatment.\t\u00a0\tPMH:\t\u00a0\tHypertension\t\u00a0\tHyperlipidemia\t\u00a0\tStomatitis\t\u00a0\tAnemia\t\u00a0\tNeutropenia\t\u00a0\tCurrent medications:\t\u00a0\tCarvedilol 12.5 mg po 1 daily\t\u00a0\tFurosemide 40 mg po daily\t\u00a0\tSurgeries: \ufffd\t\u00a0\t2012: right radical neck dissection\t\u00a0\tAllergies:\t\u00a0\tNone\t\u00a0\t\u00a0\tVaccination History:\t\u00a0\tInfluenza vaccine last received 1 year ago\t\u00a0\tReceived pneumovax at age 65\t\u00a0\tReceived Tdap 5 years ago\t\u00a0\tHas not had the herpes zoster vaccine\t\u00a0\tSocial history and Risk Factors:\t\u00a0\tFormer smoker-stopped smoking at the time his cancer was diagnosed-2 years ago\t\u00a0\tNegative for alcohol intake or drug use\t\u00a0\tPatient does not have an advanced directive or living will. He is refusing further treatment for his cancer and his wife and children are in disagreement with him. The patient wants to know what his options are for the remainder of his life.\u00a0\t\u00a0\tFamily history:\t\u00a0\tNegative\t\u00a0\t\u00a0\t\u00a0\tDiscussion Part One:\t\u00a0\t\u00a0\t\u00a0\tProvide differential diagnoses (DD) with rationale.\t\u00a0\tFurther ROS questions needed to develop DD.\t\u00a0\tIdentify the legal\/ethical issues involved with the patient and describe your approach to addressing end-of-life care for this patient.<\/p>\n","protected":false},"excerpt":{"rendered":"
Discussion Part One (graded) \u00a0 \u00a0 C.G. is a 69-year-old male with a history of right head and neck cancer that you have been following for one year. The carcinoma was initially localized to the head and neck-specifically at the Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-230093","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230093","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=230093"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230093\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=230093"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=230093"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=230093"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}