Dear Mr. Freud,
I hope this letter finds you in good health. As per your request for a copy of your medical history, please be assured that we are in the process of compiling a comprehensive record of your medical treatments, consultations, and outcomes. Due to the sensitive nature of medical records and the importance of maintaining patient confidentiality, we will arrange for these documents to be securely delivered to you or made available for collection at your convenience.
In the interim, I would like to take this opportunity to discuss the current understanding of oral cancer, as well as alternative treatments that may be of interest to you. Oral cancer is a significant public health concern, and advancements in research have provided us with a deeper understanding of its etiology, progression, and management.
Traditional treatments for oral cancer typically include surgery, radiation therapy, and chemotherapy. These modalities can be used alone or in combination, depending on the stage and location of the cancer, as well as the patient’s overall health and treatment preferences.
Surgery aims to remove the cancerous tissue and may involve resection of a portion of the oral cavity, which can include the tongue, jaw, or other affected areas. Radiation therapy uses high-energy beams to destroy cancer cells, and it can be delivered externally or internally (brachytherapy). Chemotherapy involves the use of drugs to kill cancer cells or stop them from dividing.
In recent years, there has been a growing interest in alternative and adjunctive treatments. These include:
- Targeted therapy: This form of treatment uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. For example, cetuximab is a monoclonal antibody that targets the epidermal growth factor receptor (EGFR), which is often overexpressed in oral cancer cells.
- Immunotherapy: This approach harnesses the body’s immune system to fight cancer. Pembrolizumab and nivolumab are immune checkpoint inhibitors that have shown promise in treating certain types of oral cancer.
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Photodynamic therapy (PDT): PDT uses a drug, called a photosensitizer, and a particular type of light to kill cancer cells. The drug only becomes active when exposed to the light, allowing for targeted treatment.
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Gene therapy: Although still largely experimental, gene therapy aims to repair or replace defective genes responsible for cancer development.
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Complementary and alternative medicine (CAM): Some patients explore CAM options, such as herbal remedies, acupuncture, and nutritional supplements, to support overall health and manage symptoms. However, it is crucial to discuss these with your healthcare provider to ensure they do not interfere with conventional treatments.
It is important to note that while these alternative treatments can offer additional options, they may not be suitable for every patient. The choice of treatment should be based on a thorough discussion with your healthcare team, taking into account the specifics of your case, including the type, location, and stage of the cancer, as well as your personal preferences and overall health.
Please feel free to schedule an appointment to discuss your treatment options in more detail or to address any other concerns you may have regarding your oral health.
Your medical history will be prepared with the utmost care and attention to detail, and we will notify you as soon as it is ready for your review.
Sincerely,
Prof. Dr. R. E.
Oral and Maxillofacial Surgeon
Vienna
2024-01-30 17:49 Telekonsultation
Dear Professor Freud,
Enclosed is a detailed account of your medical history, as per your request. Please find below the comprehensive summary of the interventions and treatments you have undergone, along with commentary on how these might differ with the advancements in medical knowledge and technology up to the year 2024.
NIKOTIN Abusus
Your history of significant tobacco use, starting at the age of 24 and escalating to 20 cigars a day by 1923, is a critical factor in your diagnosis and treatment. In 2024, the link between tobacco use and oral cancer is well-established, and cessation support would be a primary recommendation alongside any treatment.
Cardiac Incident and Arrhythmia (1889)
Your cardiac issues would have been managed with more advanced cardiac care and monitoring technologies available in 2024, including potentially the use of beta-blockers or other antiarrhythmic medications.
Painful Swelling in Palate (1917)
The lesion you initially dismissed would likely have been identified earlier with modern imaging techniques such as MRI or PET scans, potentially leading to an earlier intervention.
First Operation (April 20, 1923)
The excisional biopsy performed by Dr. Hajek would be similar in 2024, though with more precise imaging guidance and possibly the use of a surgical microscope for better visualization.
Consultation with Prof. Pichler (September 23, 1923)
The meticulous planning and preparation you received would be commended even today. However, in 2024, we might also consider neoadjuvant therapies, such as chemotherapy or targeted therapy, to shrink the tumor preoperatively.
Second Operation (October 4 and 11, 1923)
The two-stage operation you underwent would now be performed with advanced hemostatic techniques and possibly with the aid of robotic surgery for greater precision. The use of microvascular free flap reconstruction could offer better functional and aesthetic outcomes compared to skin grafts.
Third Operation (November 12, 1923)
Further resection would be guided by intraoperative frozen section analysis in 2024 to ensure clear margins. The use of reconstructive techniques would aim to preserve as much function as possible.
Fourth Operation (November 17, 1923)
The Steinach operation you underwent would not be considered a viable treatment for cancer in 2024. Instead, more evidence-based systemic therapies would be offered.
Radiotherapy (1934)
Modern radiotherapy techniques such as intensity-modulated radiotherapy (IMRT) or proton therapy would minimize damage to surrounding tissues and are more effective in targeting the lesion.
Recurrence of Cancer (1936)
The recurrence would be managed with a combination of surgery, radiotherapy, and possibly chemotherapy or immunotherapy, depending on the specific molecular characteristics of your tumor.
Fifth Operation (September 23, 1938)
Again, modern surgical techniques and postoperative care would be employed, with a focus on minimizing morbidity and preserving quality of life.
Radiotherapy (September 1939)
The radiotherapy advised by Dr. Finzi would be delivered with precision to spare healthy tissue, and supportive care would be provided to manage any side effects.
ORTHOFORM Pain Relief
In 2024, pain management would involve a multidisciplinary approach, including the use of opioids under strict supervision, adjuvant analgesics, and non-pharmacological interventions.
Euthanasia (September 21, 1939)
End-of-life care in 2024 respects patient autonomy and focuses on palliative care to provide comfort, with ethical considerations guiding the use of medications to alleviate suffering.
The Obturator Prosthesis
Today, the design and fabrication of obturator prostheses have benefited from digital technologies, allowing for more precise and comfortable fittings. The use of advanced materials would also improve the functionality and aesthetics of the prosthesis.
In conclusion, while the principles of cancer treatment that guided your care remain foundational, the advancements in medical science and technology would have provided additional options for management and potentially improved outcomes. Your case continues to inform and inspire the medical community in the ongoing battle against oral cancer.
Sincerely,
Hans Pichler (1877 – 1949)
Head of the Maxillofacial Surgery Department
First Surgical University Clinic
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
Ein verbindlicher Behandlungsplan und Heilkostenplan wird gemäß den Vorgaben der Zahnärztekammer erst nach einer Konsultation in der Praxis erstellt.
© 2023 Eurodoc Telemedizin ForschungsgesellschaftmbH
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