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Case Reports
. 2018 Mar 28:2018:bcr2018224217.
doi: 10.1136/bcr-2018-224217.

Ethics of a therapeutic trial: addressing limitations of an active intervention in optic nerve lymphoma

Rohan Bir Singh  1   2 , Sahil Thakur  2 , Parul Ichhpujani  2 , Suresh Kumar  2
Affiliations
Case Reports

Ethics of a therapeutic trial: addressing limitations of an active intervention in optic nerve lymphoma

Rohan Bir Singh et al. BMJ Case Rep. .

Abstract

We report a unique case of optic nerve lymphoma after completion of chemotherapy for non-Hodgkin's lymphoma. The uncommon nature of presentation, our therapeutic dilemma and the further course of treatment are reported. In cases with extremely poor prognosis, unnecessary treatment puts additional strain both financially and psychologically on the patients and their family. Therapeutic focus should be on hospice care and family counselling. The decision to not treat is a crucial component of cancer management; however, the ethics of this decision are yet to be suitably addressed by the literature.

Keywords: chemotherapy; ethics; ophthalmology; radiotherapy; visual pathway.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Clinical image montage showing normal extraocular muscle movements.
Figure 2
Figure 2
MRI showing focal areas of thickening and signal change in the intracanalicular segment of the left optic nerve approximately 11 mmx6.5 mm along with sclerosed skull secondaries. STIR: short tau inversion recovery sequence, CHOP: cyclophosphamide, hydroxydaunorubicin, vincristine and prednisolone.
See this image and copyright information in PMC

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References

    1. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA 2012;307:1513–6. 10.1001/jama.2012.362 - DOI - PubMed
    1. Cassel CK, Guest JA. Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA 2012;307:1801–2. 10.1001/jama.2012.476 - DOI - PubMed
    1. Zaman AG, Graham EM, Sanders MD. Anterior visual system involvement in non-Hodgkin’s lymphoma. Br J Ophthalmol 1993;77:184–7. 10.1136/bjo.77.3.184 - DOI - PMC - PubMed
    1. MacKintosh FR, Colby TV, Podolsky WJ, et al. . Central nervous system involvement in non-Hodgkin’s lymphoma: an analysis of 105 cases. Cancer 1982;49:586–95. 10.1002/1097-0142(19820201)49:3<586::AID-CNCR2820490331>3.0.CO;2-C - DOI - PubMed
    1. Kim JL, Mendoza PR, Rashid A, et al. . Optic nerve lymphoma: report of two cases and review of the literature. Surv Ophthalmol 2015;60:153–65. 10.1016/j.survophthal.2014.11.004 - DOI - PMC - PubMed

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