Characteristics and Management of a Cancer Patient with Stroke: A Case Report

BACKGROUND: The onset of stroke in patients with cancer worsens their performance status and affects the treatment strategy for cancer. Nonetheless, intensive rehabilitation may be able to restore the once-lost therapeutic indications of cancer patients who have suffered a stroke. However, because the mechanism of stroke in patients with cancer varies widely, it is necessary to understand the patient background, including the cause of stroke, the control of the primary cancer, and the patient’s overall condition, so as to determine the appropriate rehabilitation regimen. CASE: A 65-year-old man presented with cerebral infarction. He was suspected of having recurrence or metastasis of bladder cancer just before the stroke. Because the patient’s performance status worsened with the onset of stroke, it was judged that there was no indication for further investigation and treatment of the bladder cancer, and priority was given to improving his physical function through rehabilitation. Rehabilitation improved the patient’s physical function, but in the meantime, the cancer progressed, and he died of cancerous pleural effusion. DISCUSSION: Intensive rehabilitation can be an effective treatment for patients with stroke associated with cancer, but in convalescent rehabilitation wards, it is not possible to combine rehabilitation and cancer treatment. Therefore, for patients whose physical function takes a long time to recover or whose cancer is not under control, it is necessary to make a careful decision on whether intensive rehabilitation is the optimum approach. To facilitate informed decision making, it is important to share information across departments.