Abstract
Introduction: Oral cancer is a public health challenge in Brazil. Squamous cell carcinoma in the tongue is associated with late diagnosis and unfavorable outcomes. Palliative care aims to improve the patient's quality of life and involves shared decision-making between healthcare professionals and patients.
Case Report: A 65-year-old patient with a history of tongue cancer since 2006 underwent a total glossectomy. Tumor progression occurred leading to exposure of the oral cavity, resulting in a stage 4 oncological lesion with an extraoral oral communication. Due to the patient's loss of functionality and frailty, curative treatment became unfeasible. The patient expressed a desire to resume oral feeding despite the possibility of an unfavorable outcome.
Discussion:Despite the risks, it is considered relevant to accommodate the patient's wishes regarding feeding. During the offering of food a significant coughing episode with gastric secretion leakage, food egress through the tracheostomy, and vessel rupture in the ulcer region occurred during lesion cleaning after feeding. Initially, the severity of the condition was communicated to the patient and family, followed by manual compression with adrenaline and tranexamic acid to control bleeding. Given the bleeding location's severity, the patient's religious support was enlisted, and they chose to offer prayers and religious songs while the medical team attempted to address the complication.
Conclusion: The importance of balancing technical decisions and values in the care of terminal patients was evident, prioritizing the wishes of the patient and involving a multidisciplinary approach to assess discomforts and symptoms of the underlying disease.