The new global cancer data suggests that the global burden has
risen to 18.1 million new cases per year and 9.6 million cancer
deaths per year. A number of factors appear to be driving this
increase, in particular, a growing and aging global population and
an increase of exposure to cancer risk factors linked to social and
economic development. For rapidly-growing economies, the data
suggests a shift from poverty- or infection-related cancers to
those associated with lifestyles more typical in industrialized
countries. There is still large geographical diversity in cancer
occurrence and variations in the magnitude and profile of the
disease between and within world regions. There are specific types
of cancer that dominate globally: lung, female breast and
colorectal cancer, and the regional variations in common cancer
types signal the extent to which societal, economic and lifestyle
changes interplay to deferentially impact on the profile of this
most complex group of diseases. Unfortunately, despite advances in
cancer care, a significant proportion of patients at home,
experience sub-optimal outcomes. Barriers to successful treatment
outcomes include, but are not limited to: access to oncologists in
the primary health centers, non-adherence, lack of experienced
oncology and palliative care nurses in the community, inadequate
monitoring and the lack of training of family and pediatric
physicians. Telemedicine approaches, including telephone
triage/education, telemonitoring, teleconsultation and status
tracking through mobile applications, have shown promise in further
improving outcomes, in particular for chronic cancer patients
following their hospitalization. Lessons can be learned from
existing hospices in North America, the United Kingdom, Australia,
Centers of Excellence in African (Uganda) and modern community
services in India (Kerala). An important goal of this book is to
describe and encourage professionals to develop new community
programs in palliative care, which include training and empowering
physicians and nurses in the community on the principles of
palliative care. The Middle East Cancer Consortium (MECC) together
with the American Society of Clinical Oncology (ASCO) and the
American Oncology Nursing Society (ONS) have conducted multiple
courses ranging from basic palliative care to more specialized
training in palliative care for multiple nationalities in Europe,
Asia and Africa. Our experience clearly indicates that, to promote
such activities, one needs strong leadership and confirmed
political will to support the endeavor. The new book will emphasize
the importance of having a core of multiple stakeholders including
community leaders, government, NGOs and media to be actively
involved in advocating for the cause and generating public
awareness. This text will provide the reader with a comprehensive
understanding of the outside-of-the-hospital treatment of cancer
patients by medical, paramedical and volunteer personnel. In doing
so, this text will encourage the creation of new palliative care
services improving upon the existing ones and stimulate further
research in this field. Part 1 of the text will begin with an
overview of the current state of affairs of services provided to
cancer patients while being cared for by primary health centers. It
will also review the current literature regarding medical and
psychological-based therapy options in the community for cancer
patients at different stages of their disease. Part 2 will address
the unique role of the community nurse, within the framework of the
multidisciplinary team treating the patient, in the attempt to
provide optimal evaluation and care in very challenging situations
(such as with terminal patients). Part 3 will provide insightful
models of this new discipline and serve as a valuable resource for
physicians, nurses, social workers and others involved in the care
of cancer patients. The book will take a multidisciplinary
approach, integrating clinical and environmental data for practical
management to enhance the efficacy of treatment while relieving
suffering. Part 4 will also discuss the application of modern
technological approaches to track symptoms, quality of life, diet,
mobility, duration of sleep and medication use (including pain
killers) in chronic cancer patients in the community. Part 5 of the
book will also be devoted to modes of developing a collaborative
program between governmental and non-governmental organization
sectors. This includes volunteer workers in close collaboration
with medical professionals for providing emotional and spiritual
support, nursing care, nutritional support and empowering family
caregivers. Such a model makes palliative care in the community a
"people's movement", thus transferring part of the responsibility
and ownership to the community.
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