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Case report
The management of patients with learning difficulties and testicular cancer: overcoming barriers to improve care
  1. Charlotte Emily Mott1,
  2. Kenrick Ng1 and
  3. Constantine Alifrangis1,2
  1. 1 Department of Medical Oncology, St Bartholomew's Hospital, London, UK
  2. 2 Oncology, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Constantine Alifrangis; constantine.alifrangis1{at}


Cancer-specific survival rates in patients with learning difficulties (LD) are poorer than the general population. Issues such as delayed diagnosis, compliance, consent and needs for individualised care and support requirements can make it more demanding to manage these patients in a busy clinical environment. Our case highlights a patient with learning disabilities who presented with advanced testicular cancer due to delayed detection, and the challenges needing consideration to ensure such patients receive good care. This report also highlights an example of adapting curative intent treatment to an individual with complex needs, and the importance of patient and family involvement in decision-making to ensure these vulnerable patients receive safe and effective healthcare. The practicalities of multidisciplinary team working in the context of key legislation and existing frameworks to guide practice in the management of LD patients are also discussed.

  • prevention
  • screening (oncology)
  • healthcare improvement and patient safety
  • oncology
  • disability

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  • Contributors CEM: background research and analysis, reporting of work, development of manuscript, revision of work, approval of final version, sourcing images. KN: planning an initial structure of report, background research and analysis, sourcing images, proofreading, development of manuscript, approval of final version. CA: proofreading, formatting, consenting patient, development of manuscript, approval of final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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