Christopher Dye
- Published in print:
- 2015
- Published Online:
- October 2017
- ISBN:
- 9780691154626
- eISBN:
- 9781400866571
- Item type:
- book
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691154626.001.0001
- Subject:
- Biology, Disease Ecology / Epidemiology
Despite decades of developments in immunization and drug therapy, tuberculosis remains one of the leading causes of human mortality, and no country has successfully eradicated the disease. ...
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Despite decades of developments in immunization and drug therapy, tuberculosis remains one of the leading causes of human mortality, and no country has successfully eradicated the disease. Reenvisioning TB from the perspective of population biology, this book examines why the disease is so persistent and what must be done to fight it. Treating TB and its human hosts as dynamic, interacting populations, the book seeks new answers to key questions by drawing on demography, ecology, epidemiology, evolution, and population genetics. It uses simple mathematical models to investigate how cases and deaths could be reduced, and how interventions could lead to TB elimination. It reveals a striking gap between the actual and potential impact of current interventions, especially drug treatment, and suggests placing more emphasis on early case detection and the treatment of active or incipient TB. The book argues that the response to disappointingly slow rates of disease decline is not to abandon long-established principles of chemotherapy, but to implement them with greater vigor. Summarizing epidemiological insights from population biology, the book stresses the need to take a more inclusive view of the factors that affect disease, including characteristics of the pathogen, individuals and populations, health care systems, and physical and social environments. In broadening the horizons of TB research, the book demonstrates what must be done to prevent, control, and defeat this global threat in the twenty-first century.Less
Despite decades of developments in immunization and drug therapy, tuberculosis remains one of the leading causes of human mortality, and no country has successfully eradicated the disease. Reenvisioning TB from the perspective of population biology, this book examines why the disease is so persistent and what must be done to fight it. Treating TB and its human hosts as dynamic, interacting populations, the book seeks new answers to key questions by drawing on demography, ecology, epidemiology, evolution, and population genetics. It uses simple mathematical models to investigate how cases and deaths could be reduced, and how interventions could lead to TB elimination. It reveals a striking gap between the actual and potential impact of current interventions, especially drug treatment, and suggests placing more emphasis on early case detection and the treatment of active or incipient TB. The book argues that the response to disappointingly slow rates of disease decline is not to abandon long-established principles of chemotherapy, but to implement them with greater vigor. Summarizing epidemiological insights from population biology, the book stresses the need to take a more inclusive view of the factors that affect disease, including characteristics of the pathogen, individuals and populations, health care systems, and physical and social environments. In broadening the horizons of TB research, the book demonstrates what must be done to prevent, control, and defeat this global threat in the twenty-first century.
Geoffrey P Dunn and Alan G Johnson (eds)
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780198510000
- eISBN:
- 9780191730184
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198510000.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians ...
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This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access to techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections: the first deals with general issues, varying from quality-of-life measurement to spirituality; and the second illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms.Less
This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy, and other drugs. Surgery, with increasingly minimal access to techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The text is divided into two sections: the first deals with general issues, varying from quality-of-life measurement to spirituality; and the second illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms.
Sarah Darby, Christina Davies, and Paul McGale
- Published in print:
- 2005
- Published Online:
- September 2007
- ISBN:
- 9780198566540
- eISBN:
- 9780191718038
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198566540.003.0010
- Subject:
- Mathematics, Probability / Statistics
This chapter describes the collaborative efforts and statistical results obtained in four five-year cycles of collection and analysis of individual patient data concerning breast cancer mortality. ...
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This chapter describes the collaborative efforts and statistical results obtained in four five-year cycles of collection and analysis of individual patient data concerning breast cancer mortality. The presentation and discussion of preliminary results in two types of trial at a meeting in London 1984 initiated the collaborative effort. This resulted in the combination of individual data from 28 trials comparing surgery to surgery plus an additional treatment believed to inhibit tumour growth, and from a further 40 trials comparing surgery to surgery with additional chemotherapy. In total, about 40,000 woman participated in the 68 fully randomized trials followed up until 1985. The fourth cycle, which added medication thought to inhibit tumour growth and further chemotherapy, established that treatments used since the 1980s substantially reduced not only 5-year age-standardized mortality rates, but also the 15-year rates.Less
This chapter describes the collaborative efforts and statistical results obtained in four five-year cycles of collection and analysis of individual patient data concerning breast cancer mortality. The presentation and discussion of preliminary results in two types of trial at a meeting in London 1984 initiated the collaborative effort. This resulted in the combination of individual data from 28 trials comparing surgery to surgery plus an additional treatment believed to inhibit tumour growth, and from a further 40 trials comparing surgery to surgery with additional chemotherapy. In total, about 40,000 woman participated in the 68 fully randomized trials followed up until 1985. The fourth cycle, which added medication thought to inhibit tumour growth and further chemotherapy, established that treatments used since the 1980s substantially reduced not only 5-year age-standardized mortality rates, but also the 15-year rates.
F. Bermúdez-Rattoni
- Published in print:
- 1998
- Published Online:
- January 2008
- ISBN:
- 9780198523475
- eISBN:
- 9780191712678
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198523475.003.0005
- Subject:
- Psychology, Neuropsychology
While the CTA eliciting stimuli are restricted to the gustatory modality, the same substance can also be used as the US when it is ingested, and it influences the gastrointestinal system. Many drugs ...
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While the CTA eliciting stimuli are restricted to the gustatory modality, the same substance can also be used as the US when it is ingested, and it influences the gastrointestinal system. Many drugs or treatments (chemotherapy or radiotherapy) triggering emesis may serve as the CTA eliciting US. The above development depends on species specific digestive processes, which explains why the same drug is well tolerated by some animals but entirely rejected by other animals. Similar mechanisms may explain CTA elicited by self-administered drugs (morphine, phencyclidine, cocaine, amphetamine), which may serve as aversive stimuli for CTA production. Another substance influencing food intake is cholecystokinine (CCK), a neuropeptide synthesized in the gut as a response to a meal, which may serve as a satiety factor. Injection of higher dosages of CCK (2μg/kg) may elicit CTA. CTA acquisition may be connected with poisoning induced stress or elicited by injection of cyclophosphamide.Less
While the CTA eliciting stimuli are restricted to the gustatory modality, the same substance can also be used as the US when it is ingested, and it influences the gastrointestinal system. Many drugs or treatments (chemotherapy or radiotherapy) triggering emesis may serve as the CTA eliciting US. The above development depends on species specific digestive processes, which explains why the same drug is well tolerated by some animals but entirely rejected by other animals. Similar mechanisms may explain CTA elicited by self-administered drugs (morphine, phencyclidine, cocaine, amphetamine), which may serve as aversive stimuli for CTA production. Another substance influencing food intake is cholecystokinine (CCK), a neuropeptide synthesized in the gut as a response to a meal, which may serve as a satiety factor. Injection of higher dosages of CCK (2μg/kg) may elicit CTA. CTA acquisition may be connected with poisoning induced stress or elicited by injection of cyclophosphamide.
Samia Mehrez
- Published in print:
- 2010
- Published Online:
- September 2011
- ISBN:
- 9789774163746
- eISBN:
- 9781617970399
- Item type:
- chapter
- Publisher:
- American University in Cairo Press
- DOI:
- 10.5743/cairo/9789774163746.003.0015
- Subject:
- Political Science, International Relations and Politics
After the Al–Khubz al–hafi crisis ended, Magda al–Nowaihi and the author organized a panel at MESA 2000 on Censorship and the Arab Literary Imaginary. Magda was ready for all the battles, having ...
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After the Al–Khubz al–hafi crisis ended, Magda al–Nowaihi and the author organized a panel at MESA 2000 on Censorship and the Arab Literary Imaginary. Magda was ready for all the battles, having fought yet another of her own battles against chemotherapy just before the scheduled panel. After the panel, she walked out of a full auditorium ready for commitments: list of contributors, areas to be covered, and joint editorial work for the book. However, the work remained unfinished. Magda passed away on June 2, 2002 after a long and courageous battle. This book serves as a tribute to her, a very similar project to what Magda and the author had planned.Less
After the Al–Khubz al–hafi crisis ended, Magda al–Nowaihi and the author organized a panel at MESA 2000 on Censorship and the Arab Literary Imaginary. Magda was ready for all the battles, having fought yet another of her own battles against chemotherapy just before the scheduled panel. After the panel, she walked out of a full auditorium ready for commitments: list of contributors, areas to be covered, and joint editorial work for the book. However, the work remained unfinished. Magda passed away on June 2, 2002 after a long and courageous battle. This book serves as a tribute to her, a very similar project to what Magda and the author had planned.
Fabrizio Benedetti
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780199559121
- eISBN:
- 9780191724022
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199559121.003.0009
- Subject:
- Neuroscience, Molecular and Cellular Systems
Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer ...
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Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer chemotherapy session, with a basic mechanism of classical conditioning. In sports medicine, physical performance in sports activities is boosted by placebos and this poses some important ethical questions about doping. Placebo surgery may induce improvement as well. However, surgical clinical trials with placebos raise many ethical questions. Some alternative and complementary therapies, like acupuncture, have both a specific effect and a big placebo component. It is also important to realize that placebo and placebo-related effects represent a good model for the better understanding of the mechanisms underlying the patient-provider interaction.Less
Cancer progression is not affected by placebo treatments; however symptoms can be reduced by placebos. Nocebo effects are crucially involved in anticipatory nausea and vomiting before a cancer chemotherapy session, with a basic mechanism of classical conditioning. In sports medicine, physical performance in sports activities is boosted by placebos and this poses some important ethical questions about doping. Placebo surgery may induce improvement as well. However, surgical clinical trials with placebos raise many ethical questions. Some alternative and complementary therapies, like acupuncture, have both a specific effect and a big placebo component. It is also important to realize that placebo and placebo-related effects represent a good model for the better understanding of the mechanisms underlying the patient-provider interaction.
Timothy E. Quill
- Published in print:
- 2001
- Published Online:
- November 2011
- ISBN:
- 9780195139402
- eISBN:
- 9780199999859
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195139402.003.0004
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine and Older People
This chapter relates a case of individualized decision making in a patient named Diane who was diagnosed with acute leukemia. In the author's conversation with Diane and her family about her ...
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This chapter relates a case of individualized decision making in a patient named Diane who was diagnosed with acute leukemia. In the author's conversation with Diane and her family about her condition and options, she remained very adamant about her wish not to undergo chemotherapy and to live whatever time she had left outside the hospital. Being an advocate of informed patient choice, the author agreed to Diane's wishes despite the possibility of having to face legal and professional problems.Less
This chapter relates a case of individualized decision making in a patient named Diane who was diagnosed with acute leukemia. In the author's conversation with Diane and her family about her condition and options, she remained very adamant about her wish not to undergo chemotherapy and to live whatever time she had left outside the hospital. Being an advocate of informed patient choice, the author agreed to Diane's wishes despite the possibility of having to face legal and professional problems.
Irvine Loudon
- Published in print:
- 2000
- Published Online:
- October 2011
- ISBN:
- 9780198204992
- eISBN:
- 9780191676444
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198204992.003.0011
- Subject:
- History, History of Science, Technology, and Medicine
This chapter chronicles the discovery of the cure for puerperal disease. It discusses the contributions of German scientist Paul Ehrlich who worked in immunotherapy and coined the term chemotherapy, ...
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This chapter chronicles the discovery of the cure for puerperal disease. It discusses the contributions of German scientist Paul Ehrlich who worked in immunotherapy and coined the term chemotherapy, British bacteriologist Almroth Wright, English chemist William Perkin, and English physician Leonard Colebrooke. It highlights the introduction of sulphonamides in the mid-1930s as the first effective treatment of puerperal fever. Sulphonamides, which later became known as penicillin, was discovered by Scottish scientist Alexander Fleming.Less
This chapter chronicles the discovery of the cure for puerperal disease. It discusses the contributions of German scientist Paul Ehrlich who worked in immunotherapy and coined the term chemotherapy, British bacteriologist Almroth Wright, English chemist William Perkin, and English physician Leonard Colebrooke. It highlights the introduction of sulphonamides in the mid-1930s as the first effective treatment of puerperal fever. Sulphonamides, which later became known as penicillin, was discovered by Scottish scientist Alexander Fleming.
Jennifer Chard, Peter Hoskin, and Sam H. Ahmedzai
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199591763
- eISBN:
- 9780191739149
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199591763.003.0020
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
Supportive care is a major component in the management of malignant diseases that affect the respiratory system. It should be included in the overall management plan for the patient from the very ...
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Supportive care is a major component in the management of malignant diseases that affect the respiratory system. It should be included in the overall management plan for the patient from the very outset. Many patients who present with new respiratory or systemic symptoms of lung cancer will need urgent palliation of these problems, even before a definitive histological diagnosis can be made. Indeed, some patients who present late with advanced disease may be too ill for invasive diagnostic investigations, and palliative interventions will be planned on the basis of a working diagnosis of lung cancer, guided on radiological findings and clinical history. This chapter discusses the prevalence of symptoms in cancer, causes and assessment of symptoms in cancer, approaches to symptom management, technical advances in radiotherapy delivery, chemotherapy, comprehensive palliation of symptoms, and management of effusions.Less
Supportive care is a major component in the management of malignant diseases that affect the respiratory system. It should be included in the overall management plan for the patient from the very outset. Many patients who present with new respiratory or systemic symptoms of lung cancer will need urgent palliation of these problems, even before a definitive histological diagnosis can be made. Indeed, some patients who present late with advanced disease may be too ill for invasive diagnostic investigations, and palliative interventions will be planned on the basis of a working diagnosis of lung cancer, guided on radiological findings and clinical history. This chapter discusses the prevalence of symptoms in cancer, causes and assessment of symptoms in cancer, approaches to symptom management, technical advances in radiotherapy delivery, chemotherapy, comprehensive palliation of symptoms, and management of effusions.
David J. Bearison and Raymond K. Mulhern
- Published in print:
- 1994
- Published Online:
- November 2011
- ISBN:
- 9780195079319
- eISBN:
- 9780199999804
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195079319.003.0002
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
This chapter discusses the medical aspects of pediatric cancer, valuable to readers with little or no background in biomedical sciences and medical practice. It considers the etiology, clinical ...
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This chapter discusses the medical aspects of pediatric cancer, valuable to readers with little or no background in biomedical sciences and medical practice. It considers the etiology, clinical symptoms, diagnostic procedures, and different kinds of treatments of childhood cancers, and discusses the characteristics and late effects of the most common kinds of pediatric malignancies, including leukemias, brain tumors, lymphomas, and bone tumors. It helps those who are relatively unfamiliar with medical issues in pediatric oncology to better appreciate the nature of this disease and to establish a context for the discussion of psychological issues in the chapters that follow.Less
This chapter discusses the medical aspects of pediatric cancer, valuable to readers with little or no background in biomedical sciences and medical practice. It considers the etiology, clinical symptoms, diagnostic procedures, and different kinds of treatments of childhood cancers, and discusses the characteristics and late effects of the most common kinds of pediatric malignancies, including leukemias, brain tumors, lymphomas, and bone tumors. It helps those who are relatively unfamiliar with medical issues in pediatric oncology to better appreciate the nature of this disease and to establish a context for the discussion of psychological issues in the chapters that follow.
David J. Bearison and Raymond K. Mulhern
- Published in print:
- 1994
- Published Online:
- November 2011
- ISBN:
- 9780195079319
- eISBN:
- 9780199999804
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195079319.003.0004
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
Problems associated with pain and symptom management among children undergoing treatment for cancer is a major area of concern for clinicians. This chapter discusses methods of assessing and treating ...
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Problems associated with pain and symptom management among children undergoing treatment for cancer is a major area of concern for clinicians. This chapter discusses methods of assessing and treating chemotherapy-induced nausea and vomiting, pain secondary to invasive procedures, and other distressing symptoms. It also reviews methods of evaluating individual differences among pediatric cancer patients in their vulnerability to pain symptoms, managing children's procedure-related pain and distress according to the needs of the individual child, and relationships between children's acute and chronic pain reactions. Focusing on acute pain, the chapter builds a framework for understanding variation in symptoms across children undergoing the same procedure or chemotherapy and variation in symptoms for the same child at different points in time. It also provides a brief review of the anatomy and physiology of pain transmission and inhibition.Less
Problems associated with pain and symptom management among children undergoing treatment for cancer is a major area of concern for clinicians. This chapter discusses methods of assessing and treating chemotherapy-induced nausea and vomiting, pain secondary to invasive procedures, and other distressing symptoms. It also reviews methods of evaluating individual differences among pediatric cancer patients in their vulnerability to pain symptoms, managing children's procedure-related pain and distress according to the needs of the individual child, and relationships between children's acute and chronic pain reactions. Focusing on acute pain, the chapter builds a framework for understanding variation in symptoms across children undergoing the same procedure or chemotherapy and variation in symptoms for the same child at different points in time. It also provides a brief review of the anatomy and physiology of pain transmission and inhibition.
Andrew Davies and Ilora Finlay
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780192632432
- eISBN:
- 9780191730375
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192632432.003.0015
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Cancer therapy can lead to complex oral and dental problems. These complications vary by patient, the individual's oral and dental status, the type of cancer, and the type of cancer therapy ...
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Cancer therapy can lead to complex oral and dental problems. These complications vary by patient, the individual's oral and dental status, the type of cancer, and the type of cancer therapy administered. In most cases, oral complications are influenced by the pre-existing conditions of the patient. Oral complications caused by cancer treatment can cause fatal effects and can hinder the progression of a treatment. Nevertheless, in some cases oral complications can be minimized and eliminated. This chapter describes the oral complications resulting from chemotherapy and head and neck radiation therapy. The chapter also presents a philosophy for preventing and addressing oral complications.Less
Cancer therapy can lead to complex oral and dental problems. These complications vary by patient, the individual's oral and dental status, the type of cancer, and the type of cancer therapy administered. In most cases, oral complications are influenced by the pre-existing conditions of the patient. Oral complications caused by cancer treatment can cause fatal effects and can hinder the progression of a treatment. Nevertheless, in some cases oral complications can be minimized and eliminated. This chapter describes the oral complications resulting from chemotherapy and head and neck radiation therapy. The chapter also presents a philosophy for preventing and addressing oral complications.
Peter Hoskin and Wendy Makin
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780192628114
- eISBN:
- 9780191730115
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192628114.003.0006
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter discusses the different methods of systematic therapy, with stress on the importance of chemotherapy, hormone therapy, and biological therapy in palliative care. Systemic therapy is ...
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This chapter discusses the different methods of systematic therapy, with stress on the importance of chemotherapy, hormone therapy, and biological therapy in palliative care. Systemic therapy is advantageous compared to local treatment such as surgery and radiotherapy because of its ability to deliver tumouridical therapy throughout the body so that all sites are exposed to therapy. However, it can increase exposure of normal tissues to tumour cells. While this puts a negative light on the efficacy of systemic therapy for the alleviation and palliation of cancer, the chapter affirms that systemic therapy can play a major role in palliation by employing drugs that have limited toxicity and considerable efficacy. Those drugs that are significant in systemic therapy and in palliation are discussed in the chapter, together with the methods and administration of chemotherapy and hormone therapy, the management of patients undergoing chemotherapy, and the biological agents that can be used in the management of diseases.Less
This chapter discusses the different methods of systematic therapy, with stress on the importance of chemotherapy, hormone therapy, and biological therapy in palliative care. Systemic therapy is advantageous compared to local treatment such as surgery and radiotherapy because of its ability to deliver tumouridical therapy throughout the body so that all sites are exposed to therapy. However, it can increase exposure of normal tissues to tumour cells. While this puts a negative light on the efficacy of systemic therapy for the alleviation and palliation of cancer, the chapter affirms that systemic therapy can play a major role in palliation by employing drugs that have limited toxicity and considerable efficacy. Those drugs that are significant in systemic therapy and in palliation are discussed in the chapter, together with the methods and administration of chemotherapy and hormone therapy, the management of patients undergoing chemotherapy, and the biological agents that can be used in the management of diseases.
Russell K. Portenoy and Eduardo Bruera
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195130652
- eISBN:
- 9780199999842
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195130652.003.0005
- Subject:
- Palliative Care, Palliative Medicine Research, Patient Care and End-of-Life Decision Making
Nausea and vomiting are reported to occur in up to 62% of terminally ill patients, with 40% experiencing these symptoms in the last six weeks of life. Most of the existing research on antiemetics ...
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Nausea and vomiting are reported to occur in up to 62% of terminally ill patients, with 40% experiencing these symptoms in the last six weeks of life. Most of the existing research on antiemetics involves chemotherapy-induced or radiation-induced nausea and vomiting and may not be relevant to the treatment of symptoms resulting from advanced disease. Prospective studies with symptomatology documented at entrance to a palliative care program or hospice care and careful reporting of symptoms and treatment thereafter are needed. There are numerous problems inherent in the study of people with advanced disease. Such patients have a myriad of symptoms interacting with each other and each requiring treatment. Treating one symptom may exacerbate or improve another or cause entirely new problems. Determining whether improvement or exacerbation is part of the disease process, the treatment, or another emerging problem is often very difficult.Less
Nausea and vomiting are reported to occur in up to 62% of terminally ill patients, with 40% experiencing these symptoms in the last six weeks of life. Most of the existing research on antiemetics involves chemotherapy-induced or radiation-induced nausea and vomiting and may not be relevant to the treatment of symptoms resulting from advanced disease. Prospective studies with symptomatology documented at entrance to a palliative care program or hospice care and careful reporting of symptoms and treatment thereafter are needed. There are numerous problems inherent in the study of people with advanced disease. Such patients have a myriad of symptoms interacting with each other and each requiring treatment. Treating one symptom may exacerbate or improve another or cause entirely new problems. Determining whether improvement or exacerbation is part of the disease process, the treatment, or another emerging problem is often very difficult.
R.J. DUNLOP and J.M. HOCKLEY
- Published in print:
- 1998
- Published Online:
- November 2011
- ISBN:
- 9780192629807
- eISBN:
- 9780191730061
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192629807.003.0008
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
There are three services that a palliative care team may be specifically involved with: the pain clinic, radiotherapy, and medical oncology. This chapter reviews the contribution of these services to ...
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There are three services that a palliative care team may be specifically involved with: the pain clinic, radiotherapy, and medical oncology. This chapter reviews the contribution of these services to the care of patients with advanced cancer. The pain clinic and oncology services have an important role in treating pain and other symptoms of advanced cancer. Obviously, the role of the palliative care team can overlap with these services. There is the potential for misunderstanding and conflict; although such services may feel threatened by a palliative care team, the problem is not one-sided. If palliative care team members have not worked in a pain clinic or oncology ward, they may be ignorant of the benefits these services can offer. The chapter also considers the available techniques, hormone and chemotherapy, and working with oncology services.Less
There are three services that a palliative care team may be specifically involved with: the pain clinic, radiotherapy, and medical oncology. This chapter reviews the contribution of these services to the care of patients with advanced cancer. The pain clinic and oncology services have an important role in treating pain and other symptoms of advanced cancer. Obviously, the role of the palliative care team can overlap with these services. There is the potential for misunderstanding and conflict; although such services may feel threatened by a palliative care team, the problem is not one-sided. If palliative care team members have not worked in a pain clinic or oncology ward, they may be ignorant of the benefits these services can offer. The chapter also considers the available techniques, hormone and chemotherapy, and working with oncology services.
Beverley de Valois
- Published in print:
- 2007
- Published Online:
- November 2011
- ISBN:
- 9780199297559
- eISBN:
- 9780191730023
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199297559.003.0008
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Acupuncture is a therapeutic technique that evolved from ancient Oriental theories and practices of medicine. Since the 1970s, it has become increasingly popular in the West as a means of preventing ...
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Acupuncture is a therapeutic technique that evolved from ancient Oriental theories and practices of medicine. Since the 1970s, it has become increasingly popular in the West as a means of preventing and treating a variety of disorders. In cancer care, it is used to complement conventional management, helping to control cancer symptoms and the side effects of treatment, as well as being used in the supportive care of cancer patients. It is suitable at any stage of the cancer experience, from diagnosis through active treatment, in palliative and end of life care, and to support survivors in re-establishing their lives. This chapter focuses primarily on the use of needling and moxibustion, as used in traditional forms of acupuncture. First, it defines acupuncture and discusses its history as well as modes of action. It also examines the evidence base on the effectiveness of acupuncture in managing cancer pain, chemotherapy-induced nausea and vomiting, breathlessness (dyspnoea), dry mouth (xerostomia), hot flushes and night sweats, anxiety and depression, immune function, and in treating overall well-being. The contraindications of acupuncture are also considered.Less
Acupuncture is a therapeutic technique that evolved from ancient Oriental theories and practices of medicine. Since the 1970s, it has become increasingly popular in the West as a means of preventing and treating a variety of disorders. In cancer care, it is used to complement conventional management, helping to control cancer symptoms and the side effects of treatment, as well as being used in the supportive care of cancer patients. It is suitable at any stage of the cancer experience, from diagnosis through active treatment, in palliative and end of life care, and to support survivors in re-establishing their lives. This chapter focuses primarily on the use of needling and moxibustion, as used in traditional forms of acupuncture. First, it defines acupuncture and discusses its history as well as modes of action. It also examines the evidence base on the effectiveness of acupuncture in managing cancer pain, chemotherapy-induced nausea and vomiting, breathlessness (dyspnoea), dry mouth (xerostomia), hot flushes and night sweats, anxiety and depression, immune function, and in treating overall well-being. The contraindications of acupuncture are also considered.
Natalia L. Komarova and Dominik Wodarz
- Published in print:
- 2007
- Published Online:
- April 2010
- ISBN:
- 9780199207466
- eISBN:
- 9780191728167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199207466.003.0022
- Subject:
- Biology, Evolutionary Biology / Genetics
Mathematical models of cancer evolution can provide helpful insights. This chapter describes a way to model cancer in which carcinogenesis is a microevolutionary process inside an organ. It uses both ...
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Mathematical models of cancer evolution can provide helpful insights. This chapter describes a way to model cancer in which carcinogenesis is a microevolutionary process inside an organ. It uses both stochastic methods and methods of evolutionary population dynamics and focuses on two particular problems: (a) the role of genetic instability in cancer initiation and progression; and (b) the problem of resistance in cancer treatment with small molecule inhibitors. The dynamics are generated by cell reproduction and mutation, and by the selection pressures that act on the different cell variants. These dynamics can be captured in equations which yield insights into the outcome of these complex processes that would otherwise not be possible. The general message of this review is that population dynamics and evolutionary thinking can provide a new dimension to cancer research, which complements the molecular and cell-focused approach that is primarily used.Less
Mathematical models of cancer evolution can provide helpful insights. This chapter describes a way to model cancer in which carcinogenesis is a microevolutionary process inside an organ. It uses both stochastic methods and methods of evolutionary population dynamics and focuses on two particular problems: (a) the role of genetic instability in cancer initiation and progression; and (b) the problem of resistance in cancer treatment with small molecule inhibitors. The dynamics are generated by cell reproduction and mutation, and by the selection pressures that act on the different cell variants. These dynamics can be captured in equations which yield insights into the outcome of these complex processes that would otherwise not be possible. The general message of this review is that population dynamics and evolutionary thinking can provide a new dimension to cancer research, which complements the molecular and cell-focused approach that is primarily used.
Bristi Basu, Cheryl Palmer, Jean Abraham, and Helena Earl
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780198528067
- eISBN:
- 9780191730351
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528067.003.0002
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
Ovarian cancer is the seventh most-common cancer of women worldwide. Although it is generally regarded as a chemo-sensitive malignancy, the majority of women afflicted with this disease develop ...
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Ovarian cancer is the seventh most-common cancer of women worldwide. Although it is generally regarded as a chemo-sensitive malignancy, the majority of women afflicted with this disease develop chemo-resistance and eventually die of their disease. Of the women diagnosed with ovarian cancer, only 15–20 per cent are curable with a combination of chemotherapy and surgery. However, when patients relapse, the prospect of cure diminishes, and the aims of treatment change to palliation of symptoms and prolongation of life. This chapter highlights some of the evidence-based treatment for decisions facing oncologists in the management of women with advanced or recurring ovarian cancer. It places emphasis on the role of chemotherapy in this setting. The aims of treatment in these patients differ considerably based on the progression of the disease, performance status of the patient, co-morbid illnesses, and the patient's individual wishes. Included in the chapter are three cases that highlight some of the clinical scenarios and different management decisions.Less
Ovarian cancer is the seventh most-common cancer of women worldwide. Although it is generally regarded as a chemo-sensitive malignancy, the majority of women afflicted with this disease develop chemo-resistance and eventually die of their disease. Of the women diagnosed with ovarian cancer, only 15–20 per cent are curable with a combination of chemotherapy and surgery. However, when patients relapse, the prospect of cure diminishes, and the aims of treatment change to palliation of symptoms and prolongation of life. This chapter highlights some of the evidence-based treatment for decisions facing oncologists in the management of women with advanced or recurring ovarian cancer. It places emphasis on the role of chemotherapy in this setting. The aims of treatment in these patients differ considerably based on the progression of the disease, performance status of the patient, co-morbid illnesses, and the patient's individual wishes. Included in the chapter are three cases that highlight some of the clinical scenarios and different management decisions.
Mahesh Iddawela, Athar Ahmad, Karen McAdam, and Helena Earl
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780198530756
- eISBN:
- 9780191730481
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530756.003.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter discusses the current management of advanced breast cancer. It examines the treatments available to the patients: targeted therapy, endocrine therapy, and chemotherapy. Each treatment is ...
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This chapter discusses the current management of advanced breast cancer. It examines the treatments available to the patients: targeted therapy, endocrine therapy, and chemotherapy. Each treatment is only applied in special cases. Targeted therapy is directed at specific molecular targets and is less toxic, thus providing palliation without greatly affecting the quality of life. Chemotherapy is applied to patients who progressed on endocrine treatment or who have symptomatic visceral disease. Endocrine therapy, on the other hand, has become an important modality of treatment for metastatic breast cancer. The chapter also presents two case studies of patients who went through certain treatments for breast cancer.Less
This chapter discusses the current management of advanced breast cancer. It examines the treatments available to the patients: targeted therapy, endocrine therapy, and chemotherapy. Each treatment is only applied in special cases. Targeted therapy is directed at specific molecular targets and is less toxic, thus providing palliation without greatly affecting the quality of life. Chemotherapy is applied to patients who progressed on endocrine treatment or who have symptomatic visceral disease. Endocrine therapy, on the other hand, has become an important modality of treatment for metastatic breast cancer. The chapter also presents two case studies of patients who went through certain treatments for breast cancer.
Ghulam Mufti and Kavita Raj
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780198528081
- eISBN:
- 9780191730399
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528081.003.0004
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter discusses myelodysplastic syndromes (MDS), which are a spectrum of pre-leukaemic disorders that manifest in the elderly and can have a prolonged course. Patients afflicted with MDS ...
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This chapter discusses myelodysplastic syndromes (MDS), which are a spectrum of pre-leukaemic disorders that manifest in the elderly and can have a prolonged course. Patients afflicted with MDS require regular monitoring for evidence of disease progression, infections, and cytopenias that may be alleviated through proper treatment. Decision and administration of interventions such as high-dose chemotherapy or bone marrow transplantation should be guided by the IPSS scoring system. In younger patients, the timing of the administration of such interventions should involve a delicate balance between the risk of progression and their current life situation. In adults, meanwhile, palliation of symptoms and appropriate supportive care should be given more attention, as intensive interventions are not appropriate due to their medical conditions and performance status. In addition to discussing the pathology and aetiology of MDS, the chapter also discusses the classification of MDS, such as the FAB and WHO classifications; the overlapping features of MDS syndromes with other stem cell disorders; and the prognostic factors of MDS.Less
This chapter discusses myelodysplastic syndromes (MDS), which are a spectrum of pre-leukaemic disorders that manifest in the elderly and can have a prolonged course. Patients afflicted with MDS require regular monitoring for evidence of disease progression, infections, and cytopenias that may be alleviated through proper treatment. Decision and administration of interventions such as high-dose chemotherapy or bone marrow transplantation should be guided by the IPSS scoring system. In younger patients, the timing of the administration of such interventions should involve a delicate balance between the risk of progression and their current life situation. In adults, meanwhile, palliation of symptoms and appropriate supportive care should be given more attention, as intensive interventions are not appropriate due to their medical conditions and performance status. In addition to discussing the pathology and aetiology of MDS, the chapter also discusses the classification of MDS, such as the FAB and WHO classifications; the overlapping features of MDS syndromes with other stem cell disorders; and the prognostic factors of MDS.
