Topics in Palliative Care Volume 1

by Portenoy, Russell K.; Bruera, Eduardo

• ISBN13: 9780195102444
• ISBN10: 0195102444
• Format: Hardcover
• Copyright: 1997-03-27
• Publisher: Oxford University Press

Summary

Palliative care focuses on the management of disease symptoms that produce discomfort and pain, compromise function, or otherwise undermine the quality of life of patients with progressive medical disorders. It is a fundamental part of clinical practice, the necessary companion to therapiesdirected at the prolongation of life and the cure of disease. As a clinical specialty, palliative care is just beginning to define itself in the United States. The appearance of Topics in Palliative Care meets the growing need for information in this rapidly evolving field. This first volume in this series concentrates in four crucial areas: pharmacotherapy of pain, psychosocial adjustment to cancer, management of delirium, and gastrointestinal disorders. Contributors at the forefront of their fields come from varied medical backgrounds to address the controversiesand clinical relevance of these topics from the viewpoint of their respective disciplines. They summarize the rapidly advancing scientific foundation of palliative care and discuss the methods necessary to meet patient needs, always keeping in mind practitioners at the bedside. Every volume of Topics in Palliative Care explores many interdisciplinary concerns in the area of palliative care, including the management of physical symptoms, psychosocial and spiritual concerns, and ethical issues. The in-depth treatment will be sure to appeal to professionals in a wide rangeof medical fields. Each author selected for inclusion presents the most up-to-date research and places it within the clinical context in a highly readable manner. All clinicians who treat patients with chronic life-threatening diseases will benefit from the numerous insights this bookprovides.

Author Biography

Russell K. Portenoy, M.D., is Co-Chief, Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center. He is also Associate Professor of Neurology at Cornell University Medical College, and the Editor-in-Chief of the Journal of Pain and Symptom Management.
Eduardo Bruera, M.D., is Professor of Oncology, Alberta Cancer Foundation Chair in Palliative Care, and the Director of the Palliative Care Program at the Grey Nuns Community Health Center and the Cross Cancer Institute.

Table of Contents

Contributors	xi
I Delirium in Cancer Patients	3	(54)
Introduction: Critical Issues in the Assessment of Delirium	3	(4)
Russell K. Portenoy
1. Epidemiology and Clinical Features of Delirium	7	(14)
Jane Ingham
William Breitbart
2. Assessment and Management of Reversible Delirium	21	(24)
Noemi D. de Stoutz
Fritz Stiefel
3. Counseling the Confused Patient and the Family	45	(12)
Claudia Borreani
Augusto Caraceni
Marcello Tamburini
II Gastrointestinal Disorders in Patients with Advanced Cancer	57	(76)
Introduction: A Call for Research to Elucidate Causes, Assessment, and Management of Common Gastrointestinal Symptoms	57	(4)
Eduardo Bruera
4. Gastrointestinal Motility Disorders in Patients with Advanced Cancer	61	(34)
Carla Ripamonti
Carlos Rodriguez
5. Assessment and Management of Opioid-Induced Constipation	95	(18)
Susan Derby
Russell K. Portenoy
6. Assessment and Management of Mechanical Bowel Obstruction	113	(20)
Sebastiano Mercadante
III Advances in the Pharmacotherapy of Pain	133	(74)
Introduction: What Might the Future Hold for Opioid Pharmacotherapy?	133	(4)
Russell K. Portenoy
7. Pharmacology of Opioid Drugs: Basic Principles	137	(26)
Arthur G. Lipman
Michael E. Gauthier
8. Clinical Implications of Morphine Metabolites	163	(14)
Per Sjogren
9. The Emerging Role of the Fentanyl Series in the Treatment of Chronic Cancer Pain	177	(18)
Michael E. Gauthier
Perry G. Fine
10. Intraindividual Variability in Opioid Response: A Role for Sequential Opioid Trials in Patient Care	195	(12)
Sharon Watanabe
IV Psychosocial Adaptation to Cancer	207	(84)
Introduction: Psychopathology in Patients with Progressive Medical Disorders: What Is "Normal"?	207	(6)
Mary Jane Massie
11. "Normal" Adjustment to Cancer: Characteristics and Assessment	213	(32)
Linda J. Beeney
Phyllis N. Butow
Stewart M. Dunn
12. The Family as a Unit of Treatment	245	(18)
Linda J. Kristjanson
13. Denial, Misinformation, and the "Assault of Truth,"	263	(16)
Phyllis N. Butow
Stewart M. Dunn
Martin H. N. Tattersall
14. Clinical Response to Spiritual Issues	279	(12)
Michael J. McCabe
Index	291