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In Reply.—We realize that our approach to in situ vocal cord carcinoma (VCC) is controversial, and we did not intend at this time to imply strong advocacy of a watchful waiting policy outside the confines of a research setting. The main purpose of our article was to present data—gathered from patients with VCC who were supervised by one group of physicians within a controlled environment—to illuminate the natural course of in situ laryngeal carcinoma and to note advantages and disadvantages of both the immediate treatment and watchful waiting approaches.
We did not discuss psychological issues in the original article, however. Anyone who deals with patients can appreciate the great psychosocial difficulties inherent in leaving noninvasive lesions untreated after the referring physician has already told the patient that he has cancer. It is certainly less stressful for the physician—and for the patient—to engage in immediate, definitive therapy for in situ lesions.
HINTZ BL, KAGAN AR, NUSSBAUM H, CHAN PYM, MILES J. Vocal Cord Carcinoma-Reply. Arch Otolaryngol. 1983;109(1):62. doi:10.1001/archotol.1983.00800150066015
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