The other type of situation where it is not always possible for you to be in control is the emergency one. Say a person suddenly develops severe abdominal pain, bloating, and vomiting and can’t pass anything through the back passage. Clinical examination and X-rays show that the bowel is completely blocked and that it has burst, leaking air and bowel contents into the abdominal cavity. The underlying problem could be cancer, but it would be dangerous to spend time trying to make a definite diagnosis before operating. This is one situation where there is no real alternative to letting the surgeon combine the diagnosis and initial treatment in one procedure. It is only once the person is opened up and the cause of the problem discovered, that decisions can be made on how best to deal with it. This isn’t so bad when you realise that emergency surgery is rarely more than the first step in the treatment of any cancer. Once the emergency situation has been dealt with, there should be plenty of time to get all the information you need to make a considered decision on the best follow-up treatment for the cancer itself.
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