A recent inquiry highlighted concerns that a 90-year-old patient was denied further cancer treatment after an initial radiotherapy session, with a retired nurse suggesting age was the reason for denial. Dr. Martin Scurr, in a medical column, addressed these concerns, proposing a more likely explanation rooted in the specific type of cancer and treatment protocol.
The patient in question had a cancerous growth on his neck and had undergone one radiotherapy session before being informed that further treatment was not possible, without an explicit explanation. The retired nurse's suggestion that the patient's age made him a low priority was presented as a potential, though unconfirmed, reason.
Dr. Scurr suspects the growth was a basal cell carcinoma, the most common type of skin cancer, often caused by prolonged sun exposure. This type of cancer typically grows and damages surrounding tissue but rarely spreads to other parts of the body. While surgery is a common treatment, other options include topical chemotherapy and photodynamic therapy. Radiotherapy is also a recognized treatment, particularly for older patients, as it can be administered as a single, high dose, avoiding the need for surgery and subsequent stitch removal, which can be more suitable for individuals with other health conditions or a shorter life expectancy.
This single-dose radiotherapy approach can be effective in the short to medium term, offering a less invasive and draining option compared to a course of treatment spread over multiple visits. Dr. Scurr noted that for a 90-year-old patient, this method would be a logical approach, provided the General Practitioner (GP) was kept informed for monitoring purposes. He advised the patient to consult his GP for clarification and peace of mind.
In a separate medical query, a patient reported a sudden and unexplained hypersensitivity to sugar, finding even a small amount unbearably sweet. After initial treatment from his doctor proved ineffective, Dr. Scurr suggested this taste distortion, known as sweet hypergeusia, likely stems from issues with the tongue's taste bud nerves. Potential causes include Type 2 diabetes, imbalances in electrolytes like sodium, potassium, zinc, or iron, or infections, including those related to COVID-19. Certain medications, such as ACE inhibitors for high blood pressure or some antibiotics, can also affect taste perception.
Dr. Scurr speculated that the prescribed drops might have contained nystatin, an antifungal, suggesting the GP suspected oral thrush. He recommended blood tests for iron and electrolytes to further investigate the cause.