This scenario presents a professional challenge due to the inherent vulnerability of patients undergoing complex oncologic surgery and the critical need for comprehensive psychosocial care, which is often overlooked in favor of purely clinical management. The complexity arises from balancing the immediate surgical needs with the long-term psychological impact of cancer diagnosis and treatment, requiring a nuanced understanding of patient well-being beyond physical recovery. Careful judgment is required to integrate psychological support seamlessly into the surgical care pathway, ensuring patient dignity, autonomy, and optimal outcomes. The best professional approach involves proactively integrating psychological support by screening for distress and offering resources as part of routine pre-operative and post-operative care. This aligns with ethical principles of beneficence and non-maleficence, ensuring patients receive holistic care that addresses their mental and emotional needs. Regulatory frameworks, such as those promoted by the American College of Surgeons (ACS) Commission on Cancer (CoC) standards, emphasize the importance of psychosocial distress screening and intervention as a core component of cancer care, recognizing its impact on treatment adherence, quality of life, and survival. This proactive integration ensures that support is available before distress escalates, empowering patients to cope effectively. An incorrect approach involves waiting for patients to explicitly express psychological distress before offering support. This fails to acknowledge that many patients may not feel comfortable or may not recognize their own psychological needs, leading to delayed or missed opportunities for intervention. Ethically, this approach falls short of the duty to provide comprehensive care and can be seen as a failure of proactive patient advocacy. Another incorrect approach is to delegate all psychological support solely to the surgical team without involving specialized mental health professionals. While surgeons play a vital role, they are not typically trained to provide in-depth psychological counseling. This can lead to inadequate support and potentially mismanaged psychological issues, violating the principle of providing competent care. Finally, an incorrect approach is to assume that patients are solely focused on physical recovery and do not require psychological support unless specifically requested. This paternalistic view disregards the profound emotional impact of a cancer diagnosis and surgery, failing to respect the patient’s overall well-being and autonomy. It overlooks the ethical imperative to treat the whole patient, not just the disease. Professionals should adopt a decision-making framework that prioritizes patient-centered care, integrating psychosocial assessment and support as a standard component of surgical oncology. This involves recognizing the interconnectedness of physical and mental health, utilizing validated screening tools, establishing clear referral pathways to mental health professionals, and fostering open communication with patients about their emotional well-being throughout their treatment journey.

The efficiency study reveals a critical juncture in surgical oncology practice: the interpretation and management of surgical margins. This scenario is professionally challenging because achieving clear margins is paramount for patient prognosis and oncologic control, yet it involves inherent complexities. Surgeons must balance the need for complete tumor extirpation with the preservation of vital structures and functional outcomes. The interpretation of margins is not always straightforward, especially in complex or multifocal disease, and can be influenced by intraoperative factors and pathologist reporting. Careful judgment is required to ensure optimal patient care while adhering to established standards and ethical obligations. The approach that represents best professional practice involves a comprehensive, multidisciplinary strategy for margin assessment and management. This includes meticulous gross examination of the specimen, judicious use of intraoperative margin assessment techniques when indicated and available, and clear communication with the pathology team regarding clinical context and specific concerns. Postoperatively, it necessitates a thorough review of the final pathology report, understanding the implications of any reported positive or close margins, and developing a tailored adjuvant treatment plan in conjunction with medical oncology and radiation oncology. This approach is correct because it prioritizes patient safety and oncologic efficacy by ensuring all available information is utilized to guide treatment decisions, aligning with the ethical imperative to provide the highest standard of care and the professional responsibility to achieve the best possible patient outcomes. It also reflects the principles of evidence-based medicine and the collaborative nature of modern cancer care. An incorrect approach involves solely relying on the final pathology report without considering the intraoperative findings or the clinical context. This fails to acknowledge the limitations of static pathology reporting and the potential for intraoperative factors to influence margin status. It can lead to delayed recognition of positive margins or an inadequate understanding of their significance, potentially compromising oncologic control and necessitating further interventions. Another incorrect approach is to disregard close or positive margins if the patient is otherwise clinically stable and appears to have had a complete gross resection. This overlooks the established correlation between positive margins and increased risk of local recurrence and distant metastasis. Ethically, it represents a failure to fully inform the patient of potential risks and to pursue all reasonable avenues for achieving oncologic cure. A further incorrect approach is to proceed with aggressive adjuvant therapy solely based on a single close margin without a thorough review of the entire specimen and consideration of the tumor biology and patient factors. This can lead to overtreatment, exposing the patient to unnecessary toxicity and side effects without a clear oncologic benefit, and does not reflect a nuanced, individualized approach to cancer management. Professional reasoning in such situations requires a systematic approach: first, thoroughly understand the patient’s clinical presentation and the specifics of the tumor. Second, critically evaluate all available data, including intraoperative observations and the final pathology report, recognizing the strengths and limitations of each. Third, engage in open and clear communication with the patient and the multidisciplinary team to discuss findings, risks, benefits, and treatment options. Finally, make a shared decision that is evidence-based, ethically sound, and tailored to the individual patient’s needs and goals.

Scenario Analysis: This scenario presents a significant challenge due to the inherent risks associated with complex oncologic surgery, specifically the potential for intraoperative complications that could necessitate a deviation from the planned surgical approach. The surgeon must balance the immediate need to manage a critical event with the long-term oncologic goals and patient safety, all while adhering to established ethical and professional standards. This requires not only technical skill but also sound judgment and clear communication. Correct Approach Analysis: The best professional practice involves immediate, clear, and concise communication with the patient’s designated surrogate decision-maker or next of kin regarding the intraoperative complication and the proposed modification to the surgical plan. This approach is correct because it upholds the ethical principle of informed consent, even in emergent situations. While the initial consent covered the planned procedure, significant deviations due to unforeseen complications require re-engagement with the patient’s representatives to ensure their understanding and assent to the revised course of action, respecting patient autonomy and promoting transparency. This aligns with the principles of patient-centered care and the ethical obligations of physicians to communicate openly about significant changes in treatment. Incorrect Approaches Analysis: Proceeding with the modified surgical plan without any communication to the patient’s representatives is ethically unacceptable. This failure violates the principle of informed consent and patient autonomy, as it bypasses the opportunity for the patient’s voice, through their surrogate, to be heard regarding a significant alteration to their care. It also undermines trust in the physician-patient relationship. Delaying the surgical intervention to obtain formal, written consent for the modified procedure would be professionally detrimental and potentially harmful to the patient. In an intraoperative crisis, immediate action is often required to preserve life or prevent further morbidity. While consent is crucial, the urgency of the situation may preclude the lengthy process of obtaining a new, formal written consent, especially if the surrogate is not immediately available or reachable. However, this does not negate the need for immediate verbal communication. Performing the modified procedure and informing the patient’s representatives only after the surgery is completed is also ethically flawed. While it might be a necessary compromise if verbal communication is impossible during the critical phase, it still represents a failure to obtain assent for the deviation prior to its execution. This approach prioritizes expediency over the patient’s right to be informed and involved in decisions about their care as much as possible, even in emergent circumstances. Professional Reasoning: Professionals facing such a situation must first prioritize immediate patient safety and the management of the intraoperative complication. Simultaneously, they must initiate communication with the patient’s designated surrogate or next of kin as soon as feasible. The communication should clearly explain the complication, the rationale for the deviation from the original plan, the proposed modified approach, and the potential risks and benefits. The goal is to obtain verbal assent for the revised plan, acknowledging that in emergent situations, this may be the most practical form of consent. Documentation of the complication, the communication, and the assent obtained is critical. If the surrogate cannot be reached, the surgeon must document the attempts made and proceed based on the best clinical judgment, prioritizing the patient’s well-being, and then follow up with the surrogate as soon as possible.

Scenario Analysis: This scenario is professionally challenging because it requires the surgeon to integrate complex, multi-modal staging information for a patient with a rare malignancy. The challenge lies not only in accurately interpreting the available data but also in translating that interpretation into a universally understood and actionable staging classification that guides subsequent treatment and prognosis. Misinterpretation or misapplication of staging criteria can lead to inappropriate therapeutic decisions, impacting patient outcomes and potentially violating ethical obligations to provide evidence-based care. Correct Approach Analysis: The best professional approach involves meticulously applying the most current, consensus-based staging guidelines relevant to the specific tumor type, such as the AJCC Cancer Staging Manual. This entails systematically evaluating all available pathological and radiological data against the defined criteria for tumor size (T), nodal involvement (N), and distant metastasis (M), as well as considering prognostic factors like grade and molecular markers if incorporated into the staging system. The AJCC staging system is the standard of care in the United States for cancer staging, providing a common language for oncologists, facilitating research, and informing treatment protocols. Adherence to these established guidelines ensures consistency, accuracy, and comparability of staging information across institutions and over time, fulfilling the ethical imperative of providing the highest standard of care. Incorrect Approaches Analysis: One incorrect approach is to rely solely on the initial pathology report’s descriptive assessment without cross-referencing it with imaging findings and established staging manuals. This fails to account for the comprehensive nature of modern staging, which integrates both pathological and radiological evidence. Such an approach risks under- or over-staging due to limitations in either modality alone and deviates from the standardized, evidence-based methodology mandated by professional oncology bodies. Another incorrect approach is to extrapolate staging from similar, but not identical, tumor types without specific evidence or guidelines supporting such an extrapolation. While some principles may overlap, the nuances of T, N, and M classifications, as well as prognostic factors, can differ significantly between malignancies. This practice lacks the rigorous scientific validation required for accurate staging and can lead to significant clinical errors, potentially violating the principle of non-maleficence by exposing the patient to inappropriate treatment. A third incorrect approach is to assign a staging based on a subjective assessment of the tumor’s aggressiveness without a systematic application of defined grading criteria. While clinical intuition is valuable, staging requires objective classification based on established parameters like histological grade (e.g., differentiation, nuclear pleomorphism, mitotic rate) as defined by the relevant grading system (e.g., Gleason for prostate cancer, Nottingham for breast cancer). Failing to use these objective criteria introduces variability and reduces the reliability of the staging, undermining the scientific basis of cancer management. Professional Reasoning: Professionals should approach tumor staging by first identifying the specific cancer type and then consulting the most recent edition of the relevant staging manual (e.g., AJCC). They must then systematically gather and integrate all available data, including pathology reports, imaging studies (CT, MRI, PET), and any relevant molecular or genetic testing. Each component of the staging (T, N, M, and grade) should be assessed independently against the manual’s criteria before assigning the overall stage. This systematic, evidence-based process ensures accuracy, consistency, and adherence to professional standards, ultimately benefiting patient care.

Scenario Analysis: This scenario presents a professional challenge due to the inherent complexity of interpreting novel research findings in the context of established clinical practice and patient care. The surgeon must balance the potential benefits of a new therapeutic strategy with the risks of adopting unproven treatments, all while adhering to ethical obligations and regulatory expectations for evidence-based medicine. The pressure to offer cutting-edge treatments can conflict with the imperative to ensure patient safety and the responsible use of healthcare resources. Correct Approach Analysis: The best professional practice involves a thorough, critical appraisal of the research, including its methodology, statistical rigor, and the generalizability of its findings to the patient’s specific clinical context. This approach prioritizes evidence-based decision-making, aligning with the ethical principles of beneficence and non-maleficence, and the regulatory expectation that medical interventions are supported by robust scientific data. It necessitates consultation with multidisciplinary teams and consideration of established treatment guidelines before proposing novel approaches. This ensures that any deviation from standard care is well-justified and undertaken with full informed consent. Incorrect Approaches Analysis: Proposing the experimental therapy solely based on preliminary in vitro data without further validation in clinical trials represents a significant ethical and regulatory failure. This approach disregards the established requirement for rigorous clinical evidence to support therapeutic interventions, potentially exposing the patient to unknown risks and foregoing treatments with proven efficacy. It violates the principle of non-maleficence and falls short of the standard of care expected in oncological practice. Adopting the experimental therapy without a comprehensive discussion of its investigational nature, potential risks, and the availability of standard-of-care options is a breach of informed consent. This failure to fully apprise the patient of the uncertainties surrounding the treatment, including its lack of established clinical benefit and potential for harm, is ethically unacceptable and may have regulatory implications regarding patient autonomy and disclosure. Implementing the experimental therapy without seeking input from colleagues or tumor board review bypasses crucial peer review and multidisciplinary consensus-building processes. This isolated decision-making can lead to suboptimal patient management and fails to leverage the collective expertise necessary for complex oncological cases, potentially contravening institutional policies and professional guidelines that emphasize collaborative care. Professional Reasoning: Professionals facing such dilemmas should employ a structured decision-making process. This involves: 1) Thoroughly understanding the patient’s specific clinical situation and prognosis. 2) Critically evaluating the available scientific literature, distinguishing between preclinical and clinical data, and assessing the quality of evidence. 3) Consulting established clinical practice guidelines and expert opinion. 4) Engaging in open and honest communication with the patient, ensuring comprehensive informed consent that addresses all uncertainties and alternatives. 5) Seeking multidisciplinary input through tumor boards or peer consultation. 6) Documenting the rationale for all treatment decisions.

Scenario Analysis: This scenario presents a professional challenge due to the inherent uncertainty surrounding germline genetic mutations in the context of a newly diagnosed malignancy. The surgeon must balance the immediate need for treatment planning with the ethical and practical implications of genetic testing, particularly concerning incidental findings and the potential for familial implications. The patient’s autonomy, informed consent, and the potential for psychological distress associated with genetic information are paramount considerations. Correct Approach Analysis: The best professional practice involves a comprehensive pre-test genetic counseling session. This session should thoroughly explain the rationale for germline genetic testing, including the specific oncogenes and tumor suppressor genes being evaluated (e.g., BRCA1/2, TP53, APC), the potential implications of positive and negative results for the patient’s treatment and prognosis, and the possibility of identifying hereditary cancer syndromes. Crucially, it must also address the implications for at-risk family members and the patient’s right to privacy and the option to decline testing. This approach ensures that the patient can make a truly informed decision, aligning with the principles of patient autonomy and beneficence, and adhering to guidelines from professional bodies like the American Society of Clinical Oncology (ASCO) regarding genetic testing in cancer care. Incorrect Approaches Analysis: Proceeding with germline genetic testing without dedicated pre-test genetic counseling is professionally unacceptable. This failure violates the principle of informed consent, as the patient may not fully comprehend the scope, limitations, and potential consequences of the testing. It also neglects the ethical obligation to address the psychosocial impact of genetic information, potentially leading to undue anxiety or a false sense of security. Ordering germline genetic testing solely based on the presence of a specific oncogene mutation identified in the tumor tissue, without considering the germline implications or offering counseling, is also problematic. While tumor genetic profiling is essential for treatment selection, it does not automatically equate to a germline mutation. This approach risks misinterpreting somatic mutations as hereditary predispositions, leading to unnecessary patient and family anxiety and potentially inappropriate cascade testing. Initiating germline genetic testing and then informing the patient of the results without prior counseling is a significant ethical and professional failing. This reactive approach bypasses the crucial opportunity for the patient to understand the implications before receiving potentially life-altering information. It can lead to distress, confusion, and a compromised ability to make informed decisions about subsequent management or family communication. Professional Reasoning: Professionals should adopt a structured decision-making process that prioritizes patient autonomy and comprehensive understanding. This begins with a thorough clinical assessment to determine the likelihood of a hereditary predisposition. If indicated, the next step is to offer dedicated genetic counseling, which serves as the cornerstone for informed consent. This counseling should be delivered by qualified professionals who can explain complex genetic concepts, discuss potential outcomes, and address psychosocial concerns. The decision to proceed with testing should be a shared one, made by the patient after receiving all necessary information. Post-test counseling is equally vital to interpret results and guide further management and family communication.

This scenario presents a professionally challenging situation because it requires balancing the immediate need for definitive treatment with the complex ethical and logistical considerations of involving multiple specialists in a patient’s care. The patient’s rapid deterioration and the potential for a life-threatening condition necessitate swift action, yet a rushed decision without proper multidisciplinary input could lead to suboptimal treatment, patient harm, or ethical breaches. Careful judgment is required to ensure the patient receives the most appropriate and comprehensive care while respecting their autonomy and the expertise of various medical professionals. The best approach involves convening a multidisciplinary tumor board meeting, even if expedited, to discuss the case. This approach is correct because it directly addresses the core principle of multidisciplinary cancer care, which is mandated by guidelines for optimal patient outcomes. By bringing together surgical oncology, medical oncology, radiation oncology, pathology, radiology, and other relevant specialists, a consensus can be reached on the most appropriate diagnostic and therapeutic strategy. This collaborative decision-making process ensures that all available expertise is leveraged, potential treatment pathways are thoroughly evaluated, and the patient’s best interests are prioritized. This aligns with ethical principles of beneficence and non-maleficence, as well as professional standards that emphasize evidence-based, team-oriented care. Proceeding with a treatment plan solely based on the initial surgical oncologist’s assessment without consulting other specialties represents a significant regulatory and ethical failure. This approach neglects the fundamental requirement for multidisciplinary input in complex cancer cases, potentially leading to overlooking crucial diagnostic information from radiology or pathology, or failing to consider alternative or adjuvant therapies best managed by medical or radiation oncology. It risks violating professional standards of care and could result in a treatment plan that is not comprehensive or optimal for the patient. Initiating a treatment plan based on a quick informal discussion with only one other specialist, such as a radiologist, while excluding other key disciplines like medical oncology or pathology, is also professionally unacceptable. While some consultation is better than none, this approach is insufficient for a complex oncological diagnosis. It fails to incorporate the full spectrum of expertise necessary for comprehensive cancer management, potentially leading to an incomplete or biased treatment recommendation. This falls short of the established standard of care for multidisciplinary cancer management. Deciding to defer any further multidisciplinary discussion until after the patient is stabilized, even if the initial surgical intervention is deemed urgent, is problematic. While stabilization is paramount, completely postponing the multidisciplinary review until an unspecified later date risks delaying critical treatment decisions that might be informed by other specialties. It can lead to a fragmented care plan and may not adequately address the long-term oncological needs of the patient, potentially compromising the overall effectiveness of treatment. The professional reasoning framework for such situations should prioritize patient safety and optimal outcomes. This involves recognizing the urgency of the situation while simultaneously understanding the indispensable role of multidisciplinary collaboration in complex cancer care. When faced with rapid deterioration, the first step should be to assess the feasibility of an expedited multidisciplinary discussion. If a full tumor board meeting is not immediately possible, a focused consultation with key representatives from relevant specialties should be sought. The decision-making process should be iterative, allowing for adjustments as more information becomes available and as the patient’s condition evolves, always with the goal of comprehensive, evidence-based, and ethically sound care.

The evaluation methodology shows that the surgeon’s role in cancer treatment extends beyond surgical intervention to encompass comprehensive patient management and ethical considerations. This scenario is professionally challenging because it requires the surgeon to balance the immediate needs of the patient with long-term treatment goals, potential resource limitations, and the complexities of shared decision-making with a vulnerable patient. Careful judgment is required to ensure that all treatment options are explored and that the patient’s autonomy is respected while providing expert medical guidance. The best approach involves the surgeon initiating a thorough discussion with the patient and their family about all available treatment modalities, including surgical, medical, and radiation oncology options, and their respective risks, benefits, and expected outcomes. This approach is correct because it aligns with the ethical principles of informed consent and patient autonomy, as mandated by professional medical ethics and guidelines that emphasize shared decision-making. The surgeon, as the primary point of contact and expert in surgical management, has a responsibility to present a comprehensive overview of treatment, facilitating the patient’s ability to make an informed choice that aligns with their values and preferences. This also respects the collaborative nature of cancer care, ensuring that other specialists are involved appropriately. An approach where the surgeon solely focuses on recommending surgery without a detailed discussion of alternative or adjuvant therapies fails to uphold the principle of comprehensive care and informed consent. It risks presenting a biased perspective and may not adequately address the patient’s overall oncological needs, potentially leading to suboptimal outcomes. Another unacceptable approach is for the surgeon to defer all treatment decisions to other specialists without providing their surgical expertise and recommendations. While collaboration is crucial, the surgeon’s unique knowledge of surgical feasibility, risks, and benefits is essential for the patient’s decision-making process. This abdication of responsibility can leave the patient feeling unsupported and uninformed about a critical aspect of their care. Furthermore, an approach where the surgeon proceeds with surgery based on assumptions about the patient’s wishes or without ensuring a clear understanding of the rationale and alternatives is ethically unsound. This bypasses the fundamental requirement for informed consent and undermines patient trust. Professionals should employ a decision-making framework that prioritizes open communication, patient-centered care, and interdisciplinary collaboration. This involves actively listening to the patient’s concerns, clearly explaining complex medical information in an understandable manner, and facilitating shared decision-making by presenting all viable options with their associated risks and benefits. The surgeon must act as a patient advocate, ensuring that the patient’s voice is central to the treatment plan.

The evaluation methodology shows that managing patients with locally advanced rectal cancer presents a significant professional challenge due to the complex interplay of oncologic principles, patient factors, and evolving treatment paradigms. Determining the optimal timing and modality of systemic therapy requires careful consideration of potential benefits versus risks, including toxicity, impact on surgical feasibility, and patient quality of life. The decision-making process is further complicated by the need to adhere to established guidelines and evidence-based practices while individualizing treatment for each patient. The best professional approach involves a multidisciplinary tumor board discussion that synthesizes all available clinical, pathological, and radiological data. This collaborative evaluation ensures that all relevant perspectives, including surgical, medical oncology, radiation oncology, and pathology, are considered. This approach aligns with ethical principles of shared decision-making and patient-centered care, as well as regulatory expectations for evidence-based treatment planning. The consensus reached through such a board provides a robust foundation for recommending neoadjuvant therapy when indicated by staging and tumor characteristics, aiming to downstage the tumor, improve resectability, and potentially enhance local control and survival outcomes. An approach that solely relies on surgical assessment without comprehensive staging information before deciding on neoadjuvant therapy is professionally unacceptable. This failure to obtain adequate staging data violates the principle of informed decision-making and could lead to inappropriate treatment, potentially exposing the patient to unnecessary toxicity or delaying definitive treatment. Similarly, proceeding with adjuvant therapy without a clear indication based on pathological findings post-surgery, or without considering the potential benefits of neoadjuvant treatment in downstaging, represents a deviation from evidence-based practice and could result in suboptimal patient outcomes. Finally, initiating neoadjuvant therapy based on patient preference alone, without a thorough oncologic evaluation and discussion of risks and benefits within a multidisciplinary setting, disregards the professional responsibility to provide evidence-based and ethically sound care. Professionals should employ a systematic decision-making process that begins with comprehensive staging and risk stratification. This should be followed by a thorough review of current evidence-based guidelines and clinical trial data. The information gathered should then be presented and discussed within a multidisciplinary team to formulate a personalized treatment plan. Patient values and preferences must be integrated into this plan through shared decision-making, ensuring that the chosen course of action is both oncologically sound and aligned with the patient’s goals.

This scenario is professionally challenging due to the inherent tension between aggressive cancer treatment and the patient’s quality of life, compounded by the need to adhere to established clinical guidelines and ethical principles. The surgeon must balance the potential benefits of chemotherapy with the management of its debilitating side effects, ensuring the patient’s well-being and informed consent are paramount. Careful judgment is required to individualize care and navigate complex patient preferences. The best approach involves a multidisciplinary team discussion to develop a personalized management plan for the patient’s chemotherapy-induced nausea and vomiting (CINV). This plan should integrate evidence-based antiemetic regimens, supportive care measures, and open communication with the patient regarding their symptom burden and treatment goals. This aligns with ethical principles of beneficence and non-maleficence, ensuring the patient receives optimal symptom control to tolerate necessary treatment. It also reflects the professional standard of care in oncology, which emphasizes a holistic approach to patient management, including symptom management as a critical component of treatment success. An approach that solely relies on escalating antiemetic doses without reassessing the patient’s overall treatment goals or exploring alternative supportive measures fails to adequately address the complexity of CINV. This could lead to unnecessary drug toxicity and may not be the most effective strategy for symptom relief, potentially violating the principle of providing appropriate and individualized care. Another unacceptable approach would be to dismiss the patient’s symptoms as an expected part of chemotherapy without actively seeking solutions. This neglects the surgeon’s ethical obligation to alleviate suffering and maintain the patient’s quality of life, potentially leading to treatment non-adherence and a poorer overall outcome. It also fails to uphold the professional responsibility to stay abreast of and implement best practices in supportive care. A further incorrect strategy involves making unilateral decisions about chemotherapy dose reduction or cessation solely based on the presence of CINV, without a thorough assessment of the patient’s response to antiemetics, their treatment goals, or consultation with the oncology team. This bypasses essential collaborative decision-making and may compromise the efficacy of the cancer treatment. Professionals should employ a systematic decision-making process that begins with a comprehensive assessment of the patient’s symptoms and their impact on quality of life. This should be followed by a review of current evidence-based guidelines for CINV management. Collaborative discussion with the patient and their family, as well as other members of the healthcare team (e.g., oncologists, palliative care specialists, nurses), is crucial for developing a tailored and effective management plan. Regular reassessment of the patient’s response to interventions and adjustment of the plan as needed are also vital components of high-quality care.