A Physician's Guide to Pain and Symptom Management in Cancer Patients

by Abrahm, Janet L., M.D.

• ISBN13: 9780801862465
• ISBN10: 0801862469
• Format: Paperback
• Copyright: 2000-03-02
• Publisher: Johns Hopkins Univ Pr

Summary

Cancer imposes severe physical, psychological, social, and spiritual burdens on patients and their families. In "A Physician's Guide to Pain and Symptom Management in Cancer Patients," Dr. Janet Abrahm argues that this suffering should be prevented or treated at all stages: at diagnosis, during curative therapy, in the event that cancer recurs, during the final months. To help primary care physicians, internists, and oncologists alleviate distress, she provides a detailed guide both for the difficult discussions and for the treatment of the symptoms that are likely to occur. In Part I, Dr. Abrahm reviews a variety of important issues facing cancer patients and their families, focusing particularly on the "unasked questions" they are afraid to raise but that weigh heavily on their minds. She reviews, for example, how to break bad news; how to discuss advance directives and living wills; how to answer requests for assisted suicide; how to overcome misconceptions and persuade patients to take theopioids they really need; and how to help patients and families cope when cure is no longer possible.Part II is a comprehensive guide to controlling pain, managing other symptoms, providing comfort during the patient's last days, and helping the bereaved survivors. This thorough and compassionate manual is symptom-oriented and patient-focused, featuring the input of all members of the health care and hospice teams, as well as useful case histories, extensive tables of medications, illustrations of pain assessment scales, "practice points" for easy reference, and bibliographies for physicians and for patients and their families.

Author Biography

Janet L. Abrahm, M.D., is an associate professor of medicine in the Hematology/Oncology Division of the University of Pennsylvania School of Medicine and is medical director of Wissahickon Hospice. She is also a faculty scholar of the Project on Death in America.

Table of Contents

List of Figures and Tables	ix
Acknowledgments	xi
Introduction	xiii
Part I. Hidden Concerns, Unasked Questions
Early Days	3	(29)
Helping Patients Accept Opioid Pain Medication	32	(14)
Approaching the End	46	(33)
Part II. Pain Control and Symptom Management
Assessing the Patient in Pain	79	(43)
Pharmacologic Management of Cancer Pain	122	(125)
Nonpharmacologic Strategies for Pain and Symptom Management	247	(35)
Managing Other Distressing Problems	282	(54)
The Last Days...and the Bereaved	336	(35)
Physician Bibliography	371	(14)
Patient and Family Bibliography	385	(14)
Index	399