Challenges in the care of Ewing’s sarcoma in a Jehovah’s Witness patient
Carlos Julio Vargas-PotesDiana Marcela Mendoza-UrbanoLuis Gabriel Parra-LaraAngela Regina Zambrano HarveyPublished in: Biomedica : revista del Instituto Nacional de Salud (2023)
Ewing’s sarcoma is a bone and soft tissue neoplasm, whose management is related to hematological toxicity. This aspect represents a medical and ethical challenge in Jehovah’s Witnesses patients, who, due to their religious beliefs, reject the blood component transfusion, with the risk of discontinuing chemotherapy or using suboptimal doses.
We present the case of a 34-year-old Colombian woman, Jehovah’s Witness, diagnosed with Ewing’s sarcoma with clinical stage IIB (T1N0M0) in the left maxillary and mandibular regions, treated with chemotherapy, who presented a hemoglobin nadir of up to 4.5 g/dL, and surgical indication as part of the treatment. In these patients, the transfusion decision has ethical implications that require therapeutic alternatives and a multidisciplinary approach.
Keyphrases
- soft tissue
- healthcare
- newly diagnosed
- end stage renal disease
- cardiac surgery
- ejection fraction
- case report
- decision making
- chronic kidney disease
- locally advanced
- squamous cell carcinoma
- quality improvement
- oxidative stress
- palliative care
- prognostic factors
- acute kidney injury
- bone mineral density
- radiation therapy
- rectal cancer
- combination therapy
- body composition
- high grade
- bone loss
- chronic pain