Several medical options in palliative care can have complex moral, religious, cultural, medical and legal issues. These treatment options, such as assisted suicide, rehydration, parenteral nutrition and cardiopulmonary resuscitation have been heavily debated in the literature. Physician-assisted suicide is a controversial topic for debate, with growing pressure from advocacy groups for legalisation in regions that have yet to decide. Currently, there is substantial opposition from concerned medical professionals. However, a school of medical professionals acknowledges that physician-assisted suicide may have a role in terminal care. The debate over the use of artificial nutrition and hydration (ANH) in terminal illness is also contentious despite extensive ethical and empirical research. Advocates for and against ANH both agree that the most compassionate and humane option for patients near the end of life is hospice and/or palliative care. However, many of those who support ANH do not seem to appreciate that the standard palliative practice is to avoid the use of ANH in almost all instances. These topics remain heavily disputed in the medical community. In formulating a satisfactory answer, we need to remind ourselves that we cannot generalise a treatment as a correct or incorrect option. Rather, we need to consider each case individually, weigh the risks and benefits of each treatment, and individually consider treatment options in a multidisciplinary care model.

Many cancer patients experience a variety of distressing symptoms, adversely affecting their functional status and quality of life (QOL). Subjective symptoms such as pain, fatigue and depression are common among cancer patients, with approximately 33-55% of cancer patients experiencing pain during the course of their illness. Previous literature commonly examined a single symptom and its effect on patients' functional status and QOL, but patients often experience multiple symptoms simultaneously. Since individual symptoms are often associated with decreased QOL, the assumption that symptom clusters might have a greater effect on QOL is logical. The coexistence of symptoms provides an insight into the importance of assessing clusters of symptoms rather than focusing on individual symptoms. Although the focus of single symptoms has advanced the understanding of those particular symptoms, it may not be as helpful to health care professionals in guiding practice when patients present several concurrent symptoms. It is important for clinicians to address and ultimately treat all concurrent symptoms. Symptom cluster research will help our understanding and treatment of multiple symptoms.

In Canada over the past fifteen years, there has been a 39% rise in new cancer patients, necessitating the expansion of current oncological facilities. The population is getting older and larger, which in turn is translating into more cases of cancer. Other reports projecting cancer growth across different countries found similar results. With the prevalence of cancer expected to increase in the future, it is important to properly allocate resources towards cancer research to better serve the population. Patients with cancer continue to live longer; as such, more elderly individuals will live with cancer. In fact, cancer has been classified as a chronic illness alongside diabetes, hypertension, and heart disease. This may translate to an increased demand for oncologists, specialist-trained nurses, diagnostic services, cancer centres, cancer therapies and palliative care. More importantly, this will translate to an increased necessity for cancer research to decrease the mortality and morbidity associated with cancer while improving the quality of care.

With effective systemic therapy and comprehensive supportive care, patients with metastases can live longer. Breast cancer patients with only or predominantly bone metastases have a median survival of 2.3 years following diagnosis, while metastatic prostate cancer patients have a median survival time of 11.3 months. With recent advances in research, the overall survivorship of metastatic patients has increased. The improved quality of care for metastatic cancer patients has resulted in longer survivorship. Living longer can lead to a higher chance of development for skeletal-related events (SREs), which are defined as either spinal cord compression, hypercalcemia, pathological fractures or a need for palliative radiation therapy or surgery for bone pain. To try to reduce pathological fractures, it is important to detect impending fractures earlier and to administer prophylactic surgery as needed. Longer survivorship also allows time for the development of brain metastases. Recent advances incorporating stereotactic radiosurgery (SRS) have been favored over conventional whole-brain radiation therapy (WBRT) in the preservation of neurocognitive functions and survival benefit in patients less than 50 years of age. Multidisciplinary clinics for brain metastases are again desirable with the joint input of the radiation oncologists and neurosurgeons.

Sport and recreation is a positive influence on the lives of children and youths. Bicycling is great for human health and getting/keeping in shape. It can be a part of physical activities or it can be a means of transportation. However, there are also risks, and bicycle accidents happen and can cause serious injury. Helmet use can substantially reduce the risks associated with bicycle injuries, as these protective devices can prevent an array of serious facial and cranial injuries. In this book, the authors present survey studies conducted in various settlements around the world, looking into the bicycle and helmet use of adolescents and young adults.

Parkinsons disease, first described by the English surgeon James Parkinson (1755-1824) in 1817 as shaking palsy, is a neurodegenerative disorder that manifests symptoms such as resting tremor, muscular rigidity, bradykinesia and postural instability. These motor disorders have been extensively researched resulting in improved diagnostic accuracy and the development of robust rating scales and treatment strategies for symptoms. The treatment options for Parkinsons disease are similar to those for Alzheimers disease, meaning that at this moment in time there does not exist a definitive cure that can reverse the progression of the disease. Young adults seem to be well aware of Alzheimers disease, but are they aware of Parkinsons disease? Both of these diseases will become increasingly more prevalent in our aging world and young adults need to be prepared to care for family members who are struck by one, or both, diseases. In this book we document the assessment of the knowledge of young adults with respect to Parkinsons disease across the globe.

People with autism spectrum disorder (ASD) display deficits/unusual behaviour in one of the three domains: Reciprocal social interaction, communication and restricted/repetitive interests/behaviours. The cause of ASD is still unknown, with etiological theories continuing to change as research progresses. It was once proposed that child-rearing was a major determinant, but more recent studies have suggested that the cause is multi-factorial, with genetics playing a substantial part in aetiology. Since awareness seems to be a precursor of increased prevalence, it would be interesting to note the awareness amongst young adults, who are the future parents of society. The awareness of these individuals may allow for the extrapolation of predicting whether the future prevalence of ASD will increase or decrease. In this book, the authors describe the awareness of young adults from Canada, United States, United Kingdom and Asia with respect to ASD.

Helmet use can substantially reduce the risks associated with bicycle injuries, as these protective devices can prevent an array of serious facial injuries. A meta-analysis was carried out looking to summarise studies into the helmet use of adolescents and young adults, where the authors found a U-trend between age and helmet use, with the proportion of individuals regularly wearing a helmet declining first and then rising with reference to the progression of age. The increasing trend in young adults has been well-documented in the literature, but few studies have looked into helmet use among adolescents. In this book, produced in collaboration with the Bicycle Safety and Awareness Club in Ontario, Canada, the authors present survey studies conducted in independent schools in North America, looking into bicycle and helmet use of adolescents.

Cancer is a term that describes a constellation of diseases that affect a large proportion of the global population. By 2020, it is estimated there will be 15 million new cancer cases worldwide and a corresponding 12 million cancer-related deaths. There are many efficacious treatments for cancer with both curative and palliative intents, which regardless of efficacy, can result in distressing symptoms including pain, fatigue, nausea, vomiting, and reduced function. Compounded with very similar symptoms from the disease itself, toxicities can ultimately lead to diminished quality of life (QOL). In recent years, the use of biomarkers in cancer research and practice has become a widely discussed topic of exploration for researchers and clinicians alike. A biomarker is a biological property that can be measured and used as a tool in the prevention, diagnosis, and treatment of specific illnesses, including cancer. In this book, the authors synthesize existing biomarker research in the literature related to cancer and the potential effect it may have on future treatment, drug metabolism, symptom burden, radiation response, susceptibility to radiation related toxicities, and prognosis.

In early stages of cancer, patients are often presented with treatment options and encouraged to have shared treatment decisions with their oncologists. Shared decision making becomes particularly important, as several treatment options with different possible outcomes and adverse events exist. For example, women with early breast cancer are counseled on the options of mastectomy versus lumpectomy and radiation. The same principle should also apply in late stages of cancer, where cure is usually not possible in patients with widespread metastases. In these cases, the aim of treatment should be to relieve symptoms and suffering. Improving quality of life (QOL) rather than tumor control takes priority in palliative care. QOL has also been identified as an important endpoint for new cancer drugs, as determined by the Food and Drug Administration (FDA); as such, cancer drug approval can be based on improvement of QOL. The use of patient-reported QOL instrument tools help clinicians determine if certain treatments improve QOL. The research of palliative interventions should have QOL assessment to assist clinicians, patients and their family members in shared decision making.

Alzheimers disease will become more prevalent in the upcoming decades. With no cure on the horizon, it is important that close relatives and family members of affected patients become knowledgeable about the disease; they can be more conscientious caregivers and improve quality of life. Awareness and knowledge of the disease are especially important for the young adult population, as they will be heavily relied upon in the future to care for those with the disease. In this book, we present studies that looked into the awareness level of young adults by geographical location, age, sex, and familial ties to the disease.