Fatigue in Cancer provides a comprehensive review of the key issues involved in the research and practical application of current evidence and best practice guidelines for addressing cancer-related fatigue. An international group of contributors draw together core topics relating to this complex area of cancer management, focusing on issues of definition, patho-physiology, treatment related variables and the psychological, social and emotional impact on patients, families and carers. Critical reviews of practical management strategies for both adults and children are included, as are the current approaches to the measurement of cancer-related fatigue in clinical and research contexts. The book contributes a multi-disciplinary overview of a problem increasingly overlooked by cancer scientists, researchers, and clinicians.
This book demonstrates the considerable capacity of cancer-related fatigue to impact on quality of life. Its multi-disciplinary focus and consideration of prioritised areas of future research will ensure that it will prove invaluable for all health professionals and researchers in oncology and palliative care.

Palliative Care Consultations in Haemato-oncology is the first book in a new international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. Patients with haematological malignancy often undergo the most rigorous treatments, usually requiring long inpatient stays at tertiary referral centres far removed from friends, families and everyday life. The treatment for some malignancies is palliative, although aggressive, from diagnosis and there can be a number of difficult symptom-control problems all of which are covered in this book. This volume draws on the expertise of the haematologist who is vital if the patient is to have optimal care and provides practical advice in an easily accessible form so that the book can be read and referred to on the ward, or before a domiciliary visit.

Specialists in palliative care and oncology settings, working in the acute sector and in hospices, will find this book invaluable. It will also appeal to consultants as well as specialist registrars, clinical nurse specialists and nurse practitioners in palliative care, oncology and haematology.

ABOUT THE PALLIATIVE CARE CONSULTATIONS SERIES: This series is aimed at those individuals working in a acute hospital cancer centre and/or tertiary referral centre. They are designed to give the busy clinician advice on clinical problems which may be relatively rarely encountered or very common but which are often very difficult to manage. The volumes are site specific and every volume encompasses a review of the current oncological or haemato-oncological management of advanced disease with symptom control advice. The aim of these volumes is to give excellent medical symptom control advice, but also to put the medical advice in the context of palliative care. The books will also be of use and interest to other professions, with the focus on giving first-rate medical help.

Patient participation and user involvement are central to current thinking about the effective delivery of desired healthcare outcomes. Working with the person who lies behind every patient is core to palliative care. A voice can only become significant when it is listened to and acted upon. With palliative care increasingly addressing the needs of people with a variety of conditions in a range of settings, as well as with advances in research, technology, and information, the challenge to be 'a voice for the voiceless' is greater than ever.

This book addresses key aspects in the provision of patient-centred palliative care and tracks significant developments in user involvement. It sets the philosophy within the cultural, social and political context of modern healthcare, particularly addressing issues of quality, standards, education and bereavement. A key component in the delivery of high quality palliative care is the multi-professional team. Following a discussion of teamwork, five core professions present a critical analysis of their working practices. The book concludes with a commentary from a palliative care user and a bereaved carer.

It is often somewhat glibly asserted that the patient is, or should be, at the centre of care. There have been few attempts to examine how to keep him or her there without professional needs and protocols crowding him or her out. This book asks how we listen and why we listen. The book focuses on the challenges of how professionals can keep the needs of the patient central in clinical care and how the patient can influence the direction of that care.

One in 70 children are admitted to paediatric intensive care (PIC) at some time during childhood. Most paediatric junior doctors will rotate through PIC, and will be involved in organising acute intensive care for critically ill children. The range of children and their illnesses going through PIC is vast, making it a hugely diverse specialty. A critically ill child will end up there regardless of their underlying disease, and as a result consultants in PIC must be true generalists and need to acquire knowledge and skills in all areas of paediatrics, as well as acquiring significant knowledge of anaesthesia and surgery. From setting up the ventilator, to managing low cardiac output, Paediatric Intensive Care gives practical and realistic advice for children's doctors and nurses in intensive care. Information is presented in easily-accessible '5 minute chunks' to enable you to quickly get the answers you need, with extensive cross-referencing ensuring that different aspects of a particular clinical problem are fully covered. With detailed answers to specific problems and expert guidance on how to manage the complex issues faced in PIC, this handbook is an indispensible guide for all those who provide care to sick children.

In our society, the overwhelming majority of people die in later life. They typically die slowly of chronic diseases, with multiple co-existing problems over long periods of time. They spend the majority of their final years at home, but many will die in hospitals or care homes. This book explores the possibilities for improving the care of older people dying in residential care and nursing homes. It argues that there are aspects of palliative care that, given the right circumstances, are transferable to dying people in settings that are not domestic or hospice based.

End of Life in Care Homes describes what happens in nursing and residential care homes when a resident is dying, how carers cope, and the practical, health and emotional challenges that carers face on top of their day-to-day work. Based on detailed research from both the UK and US, the book shows how the situation can be improved.

This book will be an invaluable resource for GPs, counsellors, managers and others in primary care who seek to understand the debates about counselling and play a part in its future as part of health care. Its authors discuss the nature of counselling in this setting and the contribution it can make in improving the care of patients with a variety of health problems. The authors include practitioners and academics, service providers and counselling clients, supporters and sceptics. Overall they offer a comprehensive and thought provoking guide to those responsible for commissioning, working with and providing counselling services in a health service that seeks to be increasingly primary care led and evidence based.

This book discusses the establishment and evaluation of counselling services in primary care and the need to consider the most appropriate forms of service for different groups. It describes the specialist counselling services that are available to back up what can be provided as part of primary care and the variety of organisations that can be approached for information and advice, and assesses the research evidence on the efficacy and cost effectiveness of counselling.

A GP writes: 'If ever there was a subject guaranteed to generate debate, often heated, it's counselling. Does it work? Who's it for? What does it cost? How can we set up a service? Well, this book has the answers. And not just the positive ones - in the spirit of true balance, it even gives the sceptical view. A bit like turkeys voting for Christmas you might think? Nothing of the kind. The chapters cover just about everything GPs or Primary Care Organisations (PCO) might want to know about counselling in a primary care setting. In amongst the practical pointers on how to deal with thorny clinical counselling problems in specific situations, it even covers cost-effectiveness. Even the most sceptic, hard-hearted PCO clinical director will find the arguments in this book persuasive. The chapters on managed counselling, services for young people, substance misuse, trauma and sexual abuse could easily stand alone. But they don't. They are all in this little gem of a book. If not one for your doctor's bag, it's definitely one for your shelf!'

Day care for people with advanced diseases is one of the most rapidly expanding components of palliative care in the UK, and is increasingly a focus of new service development throughout the world. Many benefits, in terms of quality of life, holistic care for the patient and family and increased time at home are claimed by day care.

Palliative Day Care in Practice provides a comprehensive overview of the current philosophy, patterns and policies of palliative day care. It places emphasis on the need to evaluate performance in palliative day care and describes in detail aspects such as audit, hea;th economics, research and their associated problems and pitfalls.

For readers new to the field it aims to survey the broad concepts and components of palliative day care and the philosophies and practical issues that relate to them. For those more experienced in the field, it seeks to highlight some of the questions, challenges and dilemmas that palliative day care services face and which will need to be addressed in the years ahead. It will prove valuable to specialist palliative care practitioners, researchers and purchasers interested in establishing or evaluating palliative day care.

Also published by Oxford University Press

Palliative Care in the Home Derek Doyle & David Jeffrey

Chronic and terminal illness - new perspectives on caring and carers Sheila Payne & Caroline Ellis-Hill

Anyone suffering from a terminal illness faces huge challenges, not only emotionally and physically, but also in the range of practical decisions they need to make. In your own time guides the patient through the choices that exist in the current system of medical care, helping them decide on the kind of care they want, and where they receive it - in the hospice or the home. It includes chapters on coming to terms with their situation, the help available to them at home, how to choose between a hospice and home, and advice on coping with the inevitable feelings and emotions of both patient and carer. Written by a GP with extensive experience in this area, the book is unique in presenting both a compassionate and practical guide for anyone affected by serious illness, one that will empower them with the information they need to maintain the highest possible quality of life in their final days.

The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer. Few non-cancer patients receive hospice in-patient, home care or day care although a good proportion of hospices say that their services are available to non-cancer patients. As a result, the importance of palliative care for non-cancer patients is now being increasingly recognized internationally, and in the UK a committee reporting to the Department of Health recommended that palliative care should be accessible to all patients who need such care. Palliative Care for Non-Cancer Patients considers the needs and experiences of patients dying from, for example, stroke, heart disease or dementia by,drawing on a range of disciplines and specialties in medicine. The provision of palliative care for patients dying from causes other than cancer raises a number of important questions for policy makers and purchasers. This book summarizes what is known about the needs of and appropriate service provision for people dying of causes other than cancer and begins to set a research agenda. Other books of interest from OUP: Palliative care in ALS, David Oliver, Gian Borsio & Declan Walsh

Most people with far-advanced illness wish to be cared for at home for as long as possible. The challenge of providing good palliative care at home is therefore of major importance for family doctors, nurses and all those committed to maintaining the highest possible quality of life for the dying person. As modern specialist palliative care has raised both standards of care and also public expectations of family doctors and community nurses, this book helps to place specialist care in context. As palliative care is a major responsibility for teams providing palliative care at home, this book provides a definitive guide on how to provide effective care for people with far-advanced disease. Written by two palliative medicine specialists, both of whom have been family doctors, this book deals with all the physical, emotional, spiritual and social problems likely to be encountered by family doctors and community nurses caring for a patient and relatives at home. It deals in detail with emergencies, communications, ethical issues and emphasises throughout the importance of team work. 'It provides a wealth of information and advice on all aspects of palliative care at home'. Elaine Coleridge Smith Information Exchange, No. 13, 1995

Cancer related pain can be successfully managed in the majority of patients by the use of medication. Some patients, however, have pain that does not respond to opioids, and require more specialised pain management techniques. Examples of such treatments are nerve blocks, radiotherapy, acupuncture and physiotherapy. This is the first book to provide detailed information on these and other methods of pain management. The Editors are experienced clinicians who have brought together an international, multi-professional team of pain specialists, palliative medicine practitioners and oncologists to provide a practical, comprehensive guide to the overall management of cancer pain. By effectively covering many different aspects of care, this book will appeal to all health care professionals involved with the frontline of cancer related pain.

Caring for patients with acute pain problems can present a considerable challenge to junior doctors and nursing staff. Too often, the problems are inappropriately managed, resulting in the patient suffering unnecessary pain. The Management of Acute Pain provides simple, practical guidelines for those who prescribe and administer drugs for acute pain relief, particularly junior medical and nursing staff. The new edition has been extensively revised to take account of drug developments in recent years. Featuring easy to follow flowcharts, and clear concise descriptions, the book will be a valuable reference for House officers, SHO's, physiotherapists, and palliative care nurses.

From reviews of 1st edition: 'This book possesses the qualities of being practical, easy to read and relevant to virtually all medical nursing staff. It should be made widely available on wards and in departments.' Postgraduate Medicine Journal

As someone approaches the end of their life, it is vitally important that they receive quality care and support, that their wishes are met, and that they are treated with dignity and respect. Pathways through Care at the End of Life is a comprehensive guide to providing excellent, person-centred end of life care. Following a pathway from initial conversations about end of life to care in the last days of life and after death, it covers assessing need and planning care, co-ordinating care between different agencies, and ensuring quality in different settings, such as at home, in a hospice, or in hospital. Good practice guidance on communication, ensuring the person's needs are met, support for their family and how to facilitate a good death is given. Case studies illustrate real life practice, and questions throughout each chapter encourage reflective practice. This book will be essential reading for all those working with people at the end of life, such as nurses, social workers, GPs and home carers, as well as students in these fields.

Palliative care is a rapidly growing area within health care and one in which there are many ethical dilemmas. Chronically and terminally ill patients increasingly wish to take control of their own lives and deaths, resources are scarce and technology has created controversial life-prolonging treatment. This book has been written by a clinician and a teacher and writer of health care ethics to provide all those who care for the terminally ill - doctors, nurses, social workers, physiotherapists, clergy and other carers - with the concepts and principles to assist them in difficult decisions. A central theme, that technical expertise must be controlled by humane, non-technical judgements, runs through the challenging and thoughtful text. Palliative Care Ethics, in this second edition, is now more user- friendly and includes genuine case histories to illustrate ethical issues in the real world. The authors have expanded the section on rationing in respnse to the changing health care environment and confront the issues of patient rights to a far greater extent..There is also a new chapter covering terminally ill children. As the philosophy of palliation is increasingly recognised to be important from diagnosis, the coverage of more general cancer care ethics has been much increased. 'An excellent book' Palliative Medicine 'A thorough reference for practitioners of palliative care' Toronto Medical Journal 'The authors tackle many delicate concerns with professional and human integrity' Journal of Medical Ethic

Bladder cancer represents a significant cause of morbidity and mortality worldwide and presents major problems in detection and management. This book will review comprehensively the current understanding of the biology, pathophysiology and urological oncology of the disease, looking at the
problems and potential solutions. Fully illustrated including a colour plate section, it will include chapters on both the scientific and clinical principles, emphasizing molecular biology, pathogenesis, detection and experimental therapeutics, and focusing on new developments in clinical research.
The contributors are international and well known in the area.

When the first edition of this book (Terminal Care Support Teams: the hospital-hospice interface, 1990) was written, there were only a few advisory palliative care teams working in hospitals. Since then the number of teams has grown rapidly. The concept of these teams in now widely accepted but there is an increased need for information about setting up a team, how they work and how effective they are. This book looks at the need for hospital- based palliative care teams and the challenges of bringing palliative care into the acute hospital setting. It reviews the needs of patients, their families and their professional carers, and also looks at the theoretical and practical problems which may be encountered. For example there is practical advice on setting up hospital-based palliative care teams, the selection of team members as well as coverage of team dynamics, and the role of the pain clinic and palliation oncology.

Nurses are positioned on healthcare's front line, intimately connected to individuals, families, and communities. How can they leverage this position to work for the common good? In Toward a Better World, Mark Lazenby, a philosopher and a nurse, presents a plan of action. He argues that nurses advance the good society when they fulfill fundamental obligations. Promoting equality, peace and respect, providing assistance and safety, and safeguarding the health of our planet are among these obligations. By acting upon them, nurses become a force for social change in their communities. But through the collective power of more than 20 million nurses worldwide, nurses become a global force for making the world a better place-in the present and for the future. A companion to Caring Matters Most, Lazenby's ethics book, Toward a Better World challenges readers to lead good lives of service to others. This book will invigorate all, nurses and non-nurses alike, who wish to spend their lives making the world a better place.

This book is a comprehensive guide to Targeted Drug Delivery (TDD), also known as Intrathecal Drug Delivery (IDD), and offers an overview to this unique form of treatment. The medication is delivered by intrathecal pumps and is less common than some other techniques for interventional pain management, but is essential in conditions such as refractory pain, cancer pain, multifocal pain, severe spasticity, and in patients who are not candidates for surgical correction of their underlying condition. This book is the first source to describe both the optimal surgical implantation and patient management aspect of this therapy, and thus will be a valuable single reference guide for interventional radiologists, anesthesiologists, physiatrists, oncologists, neurologists, spine surgeons, palliative care physicians, and primary care physicians.

Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.

The third edition of Hospice and Palliative Care is the essential guide to the hospice and palliative care movement both within the United States and around the world. Chapters provide mental-health and medical professionals with a comprehensive overview of the hospice practice as well as discussions of challenges and the future direction of the hospice movement. Updates to the new edition include advances in spiritual assessment and care, treatment of prolonged and complicated grief, provision of interdisciplinary palliative care in limited-resource settings, significant discussion of assisted suicide, primary healthcare including oncology, and more. Staff and volunteers new to the field along with experienced care providers and those using hospice and palliative care services will find this essential reading.

This book presents a timely and multidisciplinary update on the modalities currently available for treating the most feared symptom of patients diagnosed with cancer. The various cancer pain syndromes are explored in detail, covering those related directly to malignancy and those due to the after-effects of cancer therapy. Treatment modalities, including pharmacologic approaches, interventional procedures, and palliative surgical options, are discussed clearly and concisely, with provision of recommendations for the practitioner. Further topics include new and emerging treatments for cancer pain, survivorship considerations, pain management in special populations, and implementation of systems-based pain programs. The book has been written by a multidisciplinary group of experts, reflecting the evolution in pain and symptom management that has occurred in parallel with progress toward more targeted oncologic treatments. Oncologists, palliative care physicians, allied health professionals, and other practitioners involved in caring for cancer patients will find Fundamentals of Cancer Pain Management to be a rich source of evidence-based insights into effective pain management.

Every one of us will die, and the processes we go through will be our own unique to our own experiences and life stories. It is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and inured patients. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. He discusses three types of end-of-life patient populations adults with decision-making capacity, adult without capacity, and children (with a strong focus on infants) to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.

Pain is something that everyone feels but has always been difficult to understand and investigate due to its subjective nature. Practical Pain Management is written for all those involved in the care of people suffering from pain. The authors explain why pain is so often disregarded and poorly managed by clinicians. With an emphasis on the practical management of both chronic and acute pain, the book explores the mechanisms involved in pain percepetion, the use of analgesic drugs, local anesthetics, nerve blocks and stimulation techniques. The rehabilitation and care of patients whose pain cannot be adequately relieved is also considered and some ways in which specialist pain services can help with chronic pain syndromes are described. This comprehensive guide will help all those caring for patients in pain to have a better understanding of pain and to work more effectively towards its management.

This volume considers the specific medical, psycho-social and practical issues involved in caring for children dying from chronic diseases. The author, a consultant paediatrician in palliative care at the Hospital for Sick Children, London, recognizes the special needs of terminally ill children and their families. She confronts the problems and issues surrounding this emotive subject in order to help paediatricians and other professionals provide the very best possible care for such patients. A range of contributors experienced in palliative care for children provide comprehensive coverage of the subject including: consideration of the magnitude of the problem and the provision of services pain control symptom management family support and communication with children spiritual issues bereavement and stress.

Palliative care affirms the value of holistic support for persons facing death from advanced disease. Increasingly the approach of palliative care is seen as relevant not only to terminal cancer (its initial concern), but also to many other incurable conditions. To date, the major emphasis of specialist neurology has been on diagnosis, and the continuing long term management of the many major diseases has received far less attention. This handbook aims to provide succinct and practical advice on the management of major neurological disorders in both their supportive and terminal phases, recognizing that these conditions are increasing in prevalence in virtually every society as the proportion of elderly persons grows. It demonstrates how the discomforts encountered in dementia, stroke, Parkinson's disease, ALS, Huntington's disease, muscular dystrophies, and multiple sclerosis can benefit from the same comprehensive approach to palliation as has evolved in specialist care for cancer.