Abstract
The assessment of suffering in cancer patients affected by dementia can be challenging. We report a patient with advanced skin cancer and dementia who was admitted to our hospital without appropriate diagnosis as having cerebral infarction at previous hospitals. Case:An 85-year-old woman presented with existing cognitive dysfunction from 2009 and progression of a left facial skin tumor existing from 2013. She was admitted to hospital A for facial skin tumor with dysphagia, and diagnosed as having advanced skin cancer with dementia in June 2014. After palliative therapy for the skin tumor, she was transferred to hospital B. The physicians at both hospitals explained the presenting symptoms as complications of her advanced skin cancer and dementia. She was admitted to our hospital at 36 days after symptom onset, and we diagnosed subacute cerebral infarction based on head CT and MRI examinations. In this case, the patient’s advanced cancer and dementia might have interfered with the recognition of her symptoms of cerebral infarction. A detailed interview on admission might have contributed to our decision for further examination. Although the diagnosis of cerebral infarction could not palliate her physical symptoms, it might assist the family to recognize her suffering or to provide care perceiving her poor prognosis. Additionally, the diagnosis might have an effect for emotional satisfaction of the family.
