Discussion Question

You are a visiting health care provider in an Asian country. You are seeing a 74 year old male who presents with hoarseness, pain and mild dysphagia that has been slowly progressive over 4 months. You can see a large mass in the posterior pharynx and palpate enlarged nodes in the right neck. You suspect laryngeal cancer, likely squamous cell carcinoma. Chemo-radiation is not an option in this setting, but you feel that there is a good chance of cure with a total laryngectomy and selective neck dissection. Before you talk to the patient, his three daughters who flew in from Australis ask you not to tell their father that he has cancer, as it will make him depressed and he will give up.

What would you tell his daughters?
What would you tell the patient?
What things would you consider in making your decision on what to tell the patient and family?