My dear Sigmund, I am Blaise Pascal, a seventeenth-century French philosopher, mathematician, physicist, and theologian. I have been following your medical journey with great interest, and I am deeply saddened to learn that you are currently facing a decision regarding your treatment options for a wound. I understand that you are seeking guidance in light of the recommendations from the Multidisciplinary Tumor Board.
Before we delve into the specifics of your current situation, allow me to provide a brief summary of your medical history as it pertains to this matter. The study you are involved in aimed to determine the time to complete wound closure and safety profile of using Biovance wound covering. Groups 1 and 2, comprising 55.5% and 33.3% of total participants respectively, reported benefits from using the tissue, with no adverse reactions. The trial was prospectively randomized but has since been closed, leaving it unclear whether the data will be published.
Now, let us turn our attention to a more profound philosophical question that may help guide your decision-making process. This question is not about medicine or science, but rather about belief and faith. I would like to introduce you to an argument put forth by my esteemed contemporary, Blaise Pascal, in his famous wager.
Pascal’s Wager is a philosophical thought experiment that encourages individuals to live as if God exists, regardless of their current beliefs. The reasoning behind this wager is based on the idea that there are only two possibilities: God does exist or God does not exist. Reason alone cannot decide between these alternatives.
In this game of life, we must make a wager. We must choose to believe in God (B) or not believe in God (¬B). Let us consider the potential gains and losses for each belief. If God exists (G), then believing in Him grants us an infinite gain – eternal happiness. On the other hand, if God does not exist (¬G), then disbelieving in Him results in a finite loss – perhaps the loss of some worldly pleasures or comforts.
The decision matrix for this wager looks as follows:
| God exists (G) | God does not exist (¬G) | |
|---|---|---|
| Belief |
2024-01-30 12:35 Telekonsultation
Sigmund Freud: A 90-year-old male, diagnosed with squamous cell carcinoma (SCC) of the larynx in 2015. The primary tumor was T3N2M0, and he underwent a total laryngectomy followed by postoperative radiotherapy. In 2018, he developed a recurrence in the right supraclavicular lymph node, which was treated with radiation therapy. No further records are available regarding subsequent treatments or responses to therapy.
Medical History:
– Diagnosed with SCC of the larynx (T3N2M0) in 2015
– Underwent total laryngectomy followed by postoperative radiotherapy
– Recurrence in right supraclavicular lymph node in 2018, treated with radiation therapy
MTB CHAIR (Multidisciplinary Tumor Board) (AI generated)
Topic 1: Upfront surgery or non-surgical treatment in resectable laryngeal and pharyngeal cancers
Given Sigmund Freud’s history of resectable SCC of the larynx, the Vienna Multidisciplinary Tumor Board recommends primary surgical intervention as the standard of care. This includes total laryngectomy with appropriate neck dissection for adequate clearance of involved lymph nodes.
In 2024, the consensus is that upfront surgery remains the gold standard for resectable laryngeal and pharyngeal cancers due to its proven efficacy in achieving local control and improving overall survival. However, in Sigmund Freud’s case, since he has already undergone a total laryngectomy, no further surgical intervention is recommended.
Topic 2: Indications for induction chemotherapy before CRT and its purpose, such as survival improvement with a distant control and laryngeal preservation
For Sigmund Freud’s high-risk stage II laryngeal cancer, the Vienna Multidisciplinary Tumor Board recommends considering induction chemotherapy followed by concurrent chemoradiation therapy (CRT). Induction chemotherapy
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.
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