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April 1986

Treatment Failure: The Importance of Context in Treating Head and Neck Cancer

Arch Otolaryngol Head Neck Surg. 1986;112(4):454. doi:10.1001/archotol.1986.03780040094020

To the Editor.—As a resident in otolaryngology—head and neck surgery, learning to manage aerodigestive tract malignancy is of considerable importance. Throughout the years of training, details concerning its diagnosis and treatment are well appreciated. Specifics regarding appropriate treatment modalities are garnered from available literature, conferences, attending staff, and other more-senior residents. The focus of this process is to understand and apply the most efficacious therapy for this type of cancer. Those patients in whom cancer is eradicated are considered therapeutic successes. Those patients who have persistent or recurrent cancer following treatment are labeled as treatment failures.

The focus of Western medicine is placed on the idealized "quick-fix" treatment. When a patient presents to you with a problem, he brings with him the expectation of a swift, one-staged solution. The problem could be hoarseness, with an underlying vocal cord cancer. A quick-fix solution might be laryngeal surgery or radiation therapy.