The management of patients with learning difficulties and testicular cancer: overcoming barriers to improve care.

Cancer-specific survival rates in patients with learning difficulties (LD) are poorer than the general population. Issues such as delayed diagnosis, compliance, consent and needs for individualised care and support requirements can make it more demanding to manage these patients in a busy clinical environment. Our case highlights a patient with learning disabilities who presented with advanced testicular cancer due to delayed detection, and the challenges needing consideration to ensure such patients receive good care. This report also highlights an example of adapting curative intent treatment to an individual with complex needs, and the importance of patient and family involvement in decision-making to ensure these vulnerable patients receive safe and effective healthcare. The practicalities of multidisciplinary team working in the context of key legislation and existing frameworks to guide practice in the management of LD patients are also discussed.

BMJ case reports. 2019 Nov 13*** epublish ***

Charlotte Emily Mott, Kenrick Ng, Constantine Alifrangis

Department of Medical Oncology, St Bartholomew's Hospital, London, UK., Department of Medical Oncology, St Bartholomew's Hospital, London, UK .