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Reminder of important clinical lesson
CASE REPORT
Ethics of a therapeutic trial: addressing limitations of an active intervention in optic nerve lymphoma
  1. Rohan Bir Singh1,2,
  2. Sahil Thakur2,
  3. Parul Ichhpujani2,
  4. Suresh Kumar2
  1. 1Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, Punjab, India
  1. Correspondence to Dr Rohan Bir Singh, dr.rohandhaliwal{at}gmail.com and Parul Ichhpujani, itdrparul{at}gmail.com

Summary

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.

  • ethics
  • chemotherapy
  • radiotherapy
  • ophthalmology
  • visual pathway

https://doi.org/10.1136/bcr-2018-224217

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    Footnotes

    • Contributors PI first saw, diagnosed and managed the patient. ST prepared the initial manuscript. RBS and SK aided in imaging, manuscript revision and editing.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.