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- Title
Syncope in a patient with ENT cancer and palliative care needs - challenge or not?
- Authors
Moarcăș, Monica; Bleotu, Eugen Florin; Mihăilescu-Marin, Maria-Mirabela
- Abstract
Carcinomas of the head and neck area are among the top 6 cancers in global frequency. Syncope is a rare symptom in these patients, but with an important impact on quality of life. The purpose of this article is to present the case of a patient with cancer of the left piriform sinus requiring palliative care who developed in the advanced stage syncope which were difficult to manage therapeutically. Material and method: The medical file of the patient, a beneficiary of the services of the Hospice Casa Speranței Brașov Foundation, was analyzed and the evolution under the symptom control plan introduced during admissions was followed. Case presentation: We present the case of a 57-year-old male patient with operated, radiotreated, recurrent left pyriform sinus carcinoma, with secondary lymph node lesions who developed polymorphic syncope. At first, they were controlled nonpharmacologically. In evolution, they were associated with painful episodes, therefore dexamethasone was replaced with methylprednisolone alongside the opioid treatment. There was also an increased frequency of syncope associated with primary generalized tonic-clonic seizures requiring anticonvulsant therapy. The patient's autonomy was reduced and the phenomena of orthostatic hypotension increased, requireing the addition of Fludrocortisone according to interna&sup&supțional guidelines. Discussions: Syncope secondary to carotid sinus syndrome was due to orthostatic hypotension and neurally mediated reflex mechanism. On this basis, non-pharmacological methods have been associated with anti-inflammatory and mineralocorticoid drug treatment. Conclusions: Although a rare symptom in palliative care, syncope in patients with ENT cancers greatly affects their quality of life and therapeutic management is a challenge for professionals and patients' families.
- Subjects
PALLIATIVE treatment; CANCER treatment; SYNCOPE; CANCER patients
- Publication
Paliatia: Journal of Palliative Care, 2023, Vol 16, Issue 4, p36
- ISSN
1844-7058
- Publication type
Article