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结直肠癌临终关怀中的困难与差异:一个患者的故事

Difficulties and Disparities in Colorectal Cancer End-of-Life Care: A Patient's Story.

作者信息

Ranson Stacy, Noreika Danielle, Rivet Emily B

机构信息

Division of Colon and Rectal Surgery, Virginia Commonwealth University, Richmond, Virginia.

Palliative Care Services, Hospice and Palliative Medicine, Richmond, Virginia.

出版信息

Clin Colon Rectal Surg. 2024 Apr 29;38(1):74-80. doi: 10.1055/s-0044-1786393. eCollection 2025 Jan.

Abstract

Patients with advanced colorectal cancer nearing the end of life require a multidisciplinary approach to address the unique challenges they face. Using a case vignette, we outline the various stages of a patient's journey with advanced rectal cancer and the common obstacles to their care as they interface with the medical system. We highlight how Black persons might be vulnerable to differences in screening, treatment, procedural interventions, end-of-life care, and health care decision-making. The article also addresses how health inequities and barriers relating to concordant treatment goals can impact the relationship between patient and surgeon. This vignette illustrates the importance of ensuring a team approach to treatment and the value of early involvement of palliative medicine for patients with advanced colorectal cancer.

摘要

晚期结直肠癌临终患者需要多学科方法来应对他们面临的独特挑战。通过一个病例 vignette,我们概述了晚期直肠癌患者病程的各个阶段以及他们在与医疗系统对接时护理中常见的障碍。我们强调黑人在筛查、治疗、程序性干预、临终护理和医疗保健决策方面可能容易受到差异的影响。本文还探讨了与一致治疗目标相关的健康不平等和障碍如何影响患者与外科医生之间的关系。这个 vignette 说明了确保团队治疗方法的重要性以及姑息医学早期介入对晚期结直肠癌患者的价值。

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