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Paeds Caseshaematology-oncology-and-transfusion

Paeds Cases · haematology-oncology-and-transfusion

Counsel an adolescent and family on a new diagnosis of osteosarcoma — OSCE

OSCE communication and shared decision-making station: explaining a new diagnosis of a distal femoral osteosarcoma to a fourteen-year-old boy and his parents, addressing the diagnosis and the radiograph, the biopsy and the staging, the neoadjuvant chemotherapy and the limb-salvage surgery, the fertility implications, the prognosis, and the survivorship in plain language.

osce communication and shared decision-making2 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
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Study tools

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
A fourteen-year-old boy and his parents are in clinic after a magnetic resonance imaging scan confirmed a high-grade osteosarcoma of the distal femur, following three months of night pain and a palpable mass. The family has read online that he will lose his leg and that the chemotherapy will make him infertile, and they are frightened. They do not understand why the biopsy cannot be done at their local hospital tomorrow. Counsel them.

Candidate brief

You have eight minutes to counsel a fourteen-year-old boy and his parents following a new diagnosis of a high-grade osteosarcoma of the distal femur, confirmed by magnetic resonance imaging after three months of night pain and a palpable mass. Use a structured, honest, empathic approach that names the diagnosis, explains the biopsy and staging, addresses the online fears about amputation and infertility, and builds a shared plan. [1][2]

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References2ShowHide
  1. [1]Isakoff MS, Bielack SS, Meltzer P, Gorlick R Osteosarcoma: Current Treatment and a Collaborative Pathway to Success. J Clin Oncol, 2015.PMID 26304877
  2. [2]Strauss SJ, Frezza AM, Abecassis N, Bajpai J, et al. Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol, 2021.PMID 34500044
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