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“To the clinician and the biologist the preservation of functions that

are essential to life would seem of paramount importance. But to

the patient, the obligation to live a long and painful existence may

be worse than death itself. The economic consequence of being

unable to work, and even more, being utterly dependent on others

for day to day activities like feeding, dressing and washing are not

easy for a third person to appreciate

. Similarly facial disfigurement

and anal or bladder incontinence may impose such social

consequences on the patient that may become effectively

housebound even though their other vital organs function, motor

activities and pain threshold are virtually unimpaired.”

Pavy et al., Late effects toxicity scoring: the SOMA scale. Radiother Oncol.

1995; 35:11-15