[A case of a gastric cancer patient who obtained good treatment in spite of a nontreatment decision].
The patient was a 57-year-old male who had received schizophrenia and alcoholism treatments for ten years. Hospitalization and release was repeated many times over in the psychiatry department of the hospital up to the present time. He received an upper endoscopy because of a stomach ache in May, 2004. He was diagnosed as having gastric cancer (L, post, Type 2, T2 (SS), N2, stage IIIA). Neoadjuvant chemotherapy TS-1+CDDP was begun from the beginning. However, he refused the operation afterwards and we changed the treatment. The chemotherapy was maintained until January, 2005, to enforce seven courses of the treatment and to maintain the long NC for about ten months. Afterwards, he refused the treatment again and did not come to the hospital. After six months, he came to hospital again for pyloric stenosis due to a stomach cancer that developed. We placed a PEG to keep the route for access to the pylorus in August. And we used it to induce the self-expandable metal stent (EMS) to the pylorus. As a result, oral ingestion became possible. He was able to obtain a good QOL for three months until dying thereafter. It is thought that stenting is one of the most effective treatments to correspond to the diversification of the treatment policy.