Synopses & Reviews
Palliative care focuses on the management of disease symptoms that produce discomfort and pain, compromise function, or otherwise undermine the quality of life of patients with progressive medical disorders. It is a fundamental part of clinical practice, the necessary companion to therapies directed at the prolongation of life and the cure of disease. As a clinical specialty, palliative care is just beginning to define itself in the United States. The appearance of
Topics in Palliative Care meets the growing need for information in this rapidly evolving field.
This first volume in this series concentrates in four crucial areas: pharmacotherapy of pain, psychosocial adjustment to cancer, management of delirium, and gastrointestinal disorders. Contributors at the forefront of their fields come from varied medical backgrounds to address the controversies and clinical relevance of these topics from the viewpoint of their respective disciplines. They summarize the rapidly advancing scientific foundation of palliative care and discuss the methods necessary to meet patient needs, always keeping in mind practitioners at the bedside.
Every volume of Topics in Palliative Care explores many interdisciplinary concerns in the area of palliative care, including the management of physical symptoms, psychosocial and spiritual concerns, and ethical issues. The in-depth treatment will be sure to appeal to professionals in a wide range of medical fields. Each author selected for inclusion presents the most up-to-date research and places it within the clinical context in a highly readable manner. All clinicians who treat patients with chronic life-threatening diseases will benefit from the numerous insights this book provides.
About the Author
Russell K. Portenoy, M.D., is Co-Chief, Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center. He is also Associate Professor of Neurology at Cornell University Medical College, and the Editor-in-Chief of the
Journal of Pain and Symptom Management.
Eduardo Bruera, M.D., is Professor of Oncology, Alberta Cancer Foundation Chair in Palliative Care, and the Director of the Palliative Care Program at the Grey Nuns Community Health Center and the Cross Cancer Institute.
Table of Contents
I. Delirium in Cancer Patients Introduction: Critical Issues in Delirium
1. Epidemiology and Clinical Features of Delirium
2. Assessment and Management of Reversible Delirium
3. Counseling the Confused Patient and the Family
II. Gastrointestinal Disorders in Patients with Advanced Cancer
Introduction: A Call for Research to Elucidate Causes, Assessment, and Management of Common Gastrointestinal Symptoms
4. Gastrointestinal Motility Disorders in Advanced Cancer
5. Assessment and Management of Opioid-Induced Constipation
6. Assessment and Management of Mechanical Bowel Obstruction
III. Advances in the Pharmacotherapy of Pain
Introduction: What Might the Future Hod for Opioid Pharmacotherapy?
7. Pharmacology of Opioid Drugs: Basic Principles
8. Clinical Implications of Morphine Metabolites
9. The Emerging Role of the Fentanyl Series in Chronic Cancer Pain
10. Intraindividual Variability in Opioid Response: A Role for Sequential Opioid Trials in Patient Care
IV. Normal Adjustments to Cancer
Introduction: Psychopathology in Patients with Progressive Medical Disorders: Where Does "Normal" End?
11. "Normal" Adjustment to Cancer: Characteristics and Assessment
12. The family as a Unit of Treatment
13. Denial, Misinformation, and the "Assault of Truth"
14. Clinical Response to Spiritual Issues
Index