Palliative Care For People With Cancer

Palliative care provides comprehensive support for severely affected patients with any life-limiting or life-threatening diagnosis. To do this effectively, it requires a disease-specific approach as the patients’ needs and clinical context will vary depending on the underlying diagnosis. Experts in the field of palliative care and oncology describe in detail the needs of patients with advanced cancer in comparison to those with non-cancer disease and also identify the requirements of patients with different cancer entities. Basic principles of symptom control are explained, with careful attention to therapy for pain associated with either the cancer or its treatment and to symptom-guided antineoplastic therapy. Complex therapeutic strategies for palliative cancer patients are highlighted that involve both cancer- and symptom-directed options and address a range of therapeutic aims. Issues relating to drug use in palliative cancer care are fully explored, and a separate section is devoted to care in the final phase. A range of organizational and policy issues are also discussed, and the book concludes by considering likely future developments in palliative care for cancer patients. Palliative Care in Oncology will be of particular interest to palliative care physicians who are interested in broadening the scope of their disease-specific knowledge, as well as to oncologists who wish to learn more about modern palliative care concepts relevant to their day-to-day work with cancer patients.

In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.

Palliative Care for People with Cancer describes the kind of care needed towards the end of life or at any point on what has been called "the cancer journey," Its focus is on the highest quality of life for the person with cancer and it includes care of the family before, at and after thedeath. The third edition is a comprehensive guide for nurses and other members of the multidisciplinary team who work with people with cancer and their families. Key Features: * Fully revised, restructured and updated * New chapters on disease modifying treatments, breathlessness, palliative nursing, reflective practice and palliative care on the internet * Addresses the key areas of symptom management, meeting needs and palliative nursing

This open access book provides a valuable resource for hospitals, institutions, and health authorities worldwide in their plans to set up and develop comprehensive cancer care centers. The development and implementation of a comprehensive cancer program allows for a systematic approach to evidence-based strategies of prevention, early detection, diagnosis, treatment, and palliation. Comprehensive cancer programs also provide a nexus for the running of clinical trials and implementation of novel cancer therapies with the overall aim of optimizing comprehensive and holistic care of cancer patients and providing them with the best opportunity to improve quality of life and overall survival. This book's self-contained chapter format aims to reinforce the critical importance of comprehensive cancer care centers while providing a practical guide for the essential components needed to achieve them, such as operational considerations, guidelines for best clinical inpatient and outpatient care, and research and quality management structures. Intended to be wide-ranging and applicable at a global level for both high and low income countries, this book is also instructive for regions with limited resources. The Comprehensive Cancer Center: Development, Integration, and Implementation is an essential resource for oncology physicians including hematologists, medical oncologists, radiation oncologists, surgical oncologists, and oncology nurses as well as hospitals, health departments, university authorities, governments and legislators.

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.

As a society, we have made amazing gains in being able to detect and treat cancer. Even so, about half the people who are told by their doctors that they have cancer will die within a few years. This means that every year about one million people find out that they have cancer and are treated, and about one-half million people die of cancer nationwide. So far, most cancer research and treatment has focused on trying to cure cancer. There hasn't been much attention paid to other important issues, such as pain control and taking care of other troubling symptoms. Now more and more people are aware that there are cancer care needs beyond just trying to cure it. Attention is now being paid to helping people with cancer cope better with the problems that may arise when people are being treated or as they approach death.

The book covers the basic concept of surgical and oncosurgical disciplines as a whole, as well as the management of surgical patients from pre-op preparation to discharge, i.e., all the basics needed for a successful outcome for oncosurgical patients. It covers surgical safety, the consumer protection act, medico-legal aspects, the importance of documentation, research and publications, and managing complications. The respective chapters cover pre-operative, intra-operative, and ICU management of cancer patients, based on a multi-disciplinary approach. Additionally, they highlight recent advances in surgical oncology and so-called incurable cancers. Edited and written by an interdisciplinary team of experts in oncology and palliative care, the book is intended as a clinically useful guide to the overlapping topics of pain management in cancer patients and the treatment of cancer in patients with multiple co-morbidities like cardiovascular, respiratory disease, hypertension and diabetes mellitus. Given its scope, it will benefit multi-disciplinary oncologists, pain, palliative and intensive care experts, as well as students of surgical disciplines, from MBBS, MS and DNB, to MRCS, MCh and FRCS.

In 2005, 7.6 million people died of cancer. More than 70% of those deaths occured in low and middle income countries. WHO has developed a series of six modules that provides practical advice for programme managers and policy-makers on how to advocate, plan and implement effective cancer control programmes, particularly in low and middle income countries.The WHO guide is a response to the World Health Assembly resolution on cancer prevention and control (WHA58.22), adopted in May 2005, which calls on Member States to intensify action against cancer by developing and reinforcing cancer control programmes.

Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.

It is innately human to comfort and provide care to those suffering from cancer, particularly those close to death. Yet what seems self-evident at an individual, personal level has, by and large, not guided policy at the level of institutions in this country. There is no argument that palliative care should be integrated into cancer care from diagnosis to death. But significant barriers-attitudinal, behavioral, economic, educational, and legal-still limit access to care for a large proportion of those dying from cancer, and in spite of tremendous scientific opportunities for medical progress against all the major symptoms associated with cancer and cancer death, public research institutions have not responded. In accepting a single-minded focus on research toward cure, we have inadvertently devalued the critical need to care for and support patients with advanced disease, and their families. This report builds on and takes forward an agenda set out by the 1997 IOM report Approaching Death: Improving Care at the End of Life, which came at a time when leaders in palliative care and related fields had already begun to air issues surrounding care of the dying. That report identified significant gaps in knowledge about care at the end of life and the need for serious attention from biomedical, social science, and health services researchers. Most importantly, it recognized that the impediments to good care could be identified and potentially remedied. The report itself catalyzed further public involvement in specific initiatives-mostly pilot and demonstration projects and programs funded by the nonprofit foundation community, which are now coming to fruition.