caa a22 4500 465752365 CHVBK 20180323111837.0 cr unu---uuuuu 170327e19900301xx s 000 0 eng 10.1007/BF01576280 doi (NATIONALLICENCE)springer-10.1007/BF01576280 Refusal of cancer therapy in testicular cancer: Recognizing and preventing a significant problem [Elektronische Daten] [Judd Moul, David Paulson, Philip Walther] Summary: Of 244 patients with testicular cancer who were treated at our medical center between 1970 and 1987, 7 (2.9%) refused all or a portion of their cancer therapy. All refusers died of cancer, and 6 of the 7 deaths were directly attributable to the refusal. Refusers were compared with the remaining patients; whereas there was no significant difference in age, race, and pathology of the tumor between the two groups, the more advanced initial stage of disease in the refusers approached significance (P=0.073), and the history of untreated cryptorchidism was more prevalent in that group (P=0.034). Combination chemotherapy was the treatment modality most often refused; however, refusal was not simply due to chemotherapeutic side effects but was a multifactorial problem. Characteristics common in the refusers included lower educational and employment status, higher religiosity, a more dependent personality and life-style, as well as other character deficits. In the current era of high cure rates in testicular cancer patients, refusal and refusal deaths are highly clinically significant and efforts to identify likely refusers and thus avert refusal episodes are necessary. Springer-Verlag, 1990 Moul Judd Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut Paulson David Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut Walther Philip Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut World Journal of Urology Springer-Verlag 8/1(1990-03-01), 58-62 0724-4983 8:1<58 1990 8 345 https://doi.org/10.1007/BF01576280 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01576280 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Moul Judd Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Paulson David Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut NATIONALLICENCE 700 1- Walther Philip Division of Urology, Department of Surgery, Duke University Medical Center, Box 3707, 27710, Durham, NC, USA aut NATIONALLICENCE 773 0- World Journal of Urology Springer-Verlag 8/1(1990-03-01), 58-62 0724-4983 8:1<58 1990 8 345 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer