# A case report of an alcoholic with delirium tremens diagnosed with hypopharyngeal cancer: Psychiatrists played important roles in the smooth diagnosis and treatments

## TL;DR

A 59-year-old alcoholic man with delirium tremens was diagnosed with hypopharyngeal cancer and successfully treated through collaboration between psychiatrists and otolaryngologists.

## Contribution

Highlights the critical role of psychiatrists in the treatment of alcoholic patients with hypopharyngeal cancer through shared decision-making.

## Key findings

- Psychiatrists played a key role in assessing the patient's decision-making capacity and treatment risks.
- Shared decision-making led to a successful surgical treatment for hypopharyngeal cancer.
- Collaboration improved the patient's quality of life and treatment outcomes.

## Abstract

Alcohol use increases the risk of developing several types of cancer. Of these, hypopharyngeal cancer has one of the worst prognoses. Moreover, treating an alcoholic patient with hypopharyngeal cancer is often difficult. There are various treatments for hypopharyngeal cancer, including surgery, chemotherapy, and radiotherapy, depending on the state of the cancer and the patient's quality of life. Patients need physical, psychological, and social support in decision‐making and post‐treatment follow‐up. This is especially true for alcoholic patients.

A 59‐year‐old man was admitted to our hospital with complaints of fatigue, loss of appetite, and tremor of the upper limbs. He was single, alcoholic, and had no family. After treatment for delirium tremens, he complained of throat pain. After endoscopy, magnetic resonance imaging, and examination with 18F‐fluorodeoxyglucose positron emission tomography/computed tomography, he was diagnosed with Stage 4 A (T2 N2c M0) hypopharyngeal cancer. The psychiatrist and otolaryngologist discussed the patient's decision‐making capacity and the various risks associated with treatment. Shared decision‐making with the patient was considered most important in determining the treatment strategy. As a result, the patient decided to receive endoscopic laryngopharyngeal surgery in combination with lymphadenectomy, a challenging surgical treatment. The operation was successful, and the patient is now ready for a new life after discharge.

Psychiatrists have a significant role to play in the oncological treatment of patients with alcoholism and other psychiatric disorders.

A 59‐year‐old alcoholic man with delirium tremens was diagnosed as having hypopharyngeal cancer. Liaison and shared decision‐making between the patient, psychiatrist, and otolaryngologist ensured smooth diagnosis and treatments with consideration for the patient's quality of life.