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.
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.
Frances Calman
- Published in print:
- 2006
- Published Online:
- November 2011
- ISBN:
- 9780198530749
- eISBN:
- 9780191730467
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530749.003.0003
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter discusses non-surgical management of advanced head and neck cancer. The first section looks at the choice of treatment modality, along with radiotherapy treatment and systemic ...
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This chapter discusses non-surgical management of advanced head and neck cancer. The first section looks at the choice of treatment modality, along with radiotherapy treatment and systemic chemotherapy. Radiotherapy treatment is the most important non-surgical treatment for head and neck cancer. Systemic chemotherapy, on the other hand, is often used along with radiotherapy for advanced disease. The acute side effects of radiotherapy, reducing the morbidity of the treatment, and some types of cancer – laryngeal cancer, cancer of the nasopharynx and paranasal sinuses, and oral and oropharyngeal cancer – are discussed as well. The chapter ends with a section on treating metastatic and recurrent disease, and the future of these diseases.Less
This chapter discusses non-surgical management of advanced head and neck cancer. The first section looks at the choice of treatment modality, along with radiotherapy treatment and systemic chemotherapy. Radiotherapy treatment is the most important non-surgical treatment for head and neck cancer. Systemic chemotherapy, on the other hand, is often used along with radiotherapy for advanced disease. The acute side effects of radiotherapy, reducing the morbidity of the treatment, and some types of cancer – laryngeal cancer, cancer of the nasopharynx and paranasal sinuses, and oral and oropharyngeal cancer – are discussed as well. The chapter ends with a section on treating metastatic and recurrent disease, and the future of these diseases.
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.
CICELY SAUNDERS, MARY BAINES, and ROBERT DUNLOP
- Published in print:
- 1995
- Published Online:
- November 2011
- ISBN:
- 9780192625144
- eISBN:
- 9780191730009
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192625144.003.0004
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines the use of adjuvant therapy in the management of pain in terminally ill patients. It explains that analgesics are sometimes not enough to relieve the pain in some patients and ...
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This chapter examines the use of adjuvant therapy in the management of pain in terminally ill patients. It explains that analgesics are sometimes not enough to relieve the pain in some patients and that radiotherapy and nerve blocks are usually indicated for patients experiencing higher levels of pain. The chapter discusses the concept of palliative radiotherapy, anaesthetic techniques for pain control, and adjuvant analgesic drugs.Less
This chapter examines the use of adjuvant therapy in the management of pain in terminally ill patients. It explains that analgesics are sometimes not enough to relieve the pain in some patients and that radiotherapy and nerve blocks are usually indicated for patients experiencing higher levels of pain. The chapter discusses the concept of palliative radiotherapy, anaesthetic techniques for pain control, and adjuvant analgesic drugs.
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/9780192628114.003.0005
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter provides an overview of radiotherapy. Radiotherapy is the method of treatment using ionizing radiation. Normally, radiation is in the form of X-rays or gamma rays which, when directed ...
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This chapter provides an overview of radiotherapy. Radiotherapy is the method of treatment using ionizing radiation. Normally, radiation is in the form of X-rays or gamma rays which, when directed through a cell, result in the ionization and destruction of DNA. Methods of delivering radiation include external X-ray beams and the use of radioisotopes. Radiation is potentially dangerous, hence administration of radiotherapy is usually done within a radiotherapy department. Radiotherapy plays a significant role in palliative care: it aids in the management of local symptoms such as pain, haemorrhage, and obstruction. Topics discussed in the chapter include the different kinds of radiation, radioisotope therapy, biological effects of radiation, and fractionation. The chapter also discusses the practicality of radiotherapy, and the practicality and efficiency of radiotherapy in palliative care.Less
This chapter provides an overview of radiotherapy. Radiotherapy is the method of treatment using ionizing radiation. Normally, radiation is in the form of X-rays or gamma rays which, when directed through a cell, result in the ionization and destruction of DNA. Methods of delivering radiation include external X-ray beams and the use of radioisotopes. Radiation is potentially dangerous, hence administration of radiotherapy is usually done within a radiotherapy department. Radiotherapy plays a significant role in palliative care: it aids in the management of local symptoms such as pain, haemorrhage, and obstruction. Topics discussed in the chapter include the different kinds of radiation, radioisotope therapy, biological effects of radiation, and fractionation. The chapter also discusses the practicality of radiotherapy, and the practicality and efficiency of radiotherapy in palliative care.
Harvey I. Pass, Stephen Hahn, and Nicholas Vogelzang
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780195178692
- eISBN:
- 9780199864591
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195178692.003.0014
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter focuses on malignant mesothelioma (MM). Topics discussed include prognostic indicators, staging, treatment, surgery, radiotherapy, prevention of recurrences of MM in chest scars, ...
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This chapter focuses on malignant mesothelioma (MM). Topics discussed include prognostic indicators, staging, treatment, surgery, radiotherapy, prevention of recurrences of MM in chest scars, multimodality treatment, novel intrapleural approaches, and chemotherapy and newer agents.Less
This chapter focuses on malignant mesothelioma (MM). Topics discussed include prognostic indicators, staging, treatment, surgery, radiotherapy, prevention of recurrences of MM in chest scars, multimodality treatment, novel intrapleural approaches, and chemotherapy and newer agents.
Ilora Finley, Pia Amsler, and Rosemary Wade
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780198528081
- eISBN:
- 9780191730399
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528081.003.0007
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
Disease or treatment-related mouth problems, particularly those associated with chemotherapy or radiotherapy and other immunosuppresion strategies, often pose severe pain in haematology patients. ...
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Disease or treatment-related mouth problems, particularly those associated with chemotherapy or radiotherapy and other immunosuppresion strategies, often pose severe pain in haematology patients. Oral problems often posit challenges in the social interactions and eating and breathing patterns of patients. They also increase systematic and local infections, impede treatment schedules, and change dose requirements and drug combinations. This chapter discusses the causes of oral problems in haematological patients, the assessment and incidence of oral mucositis, the pathogenesis of chemotherapy and radiotherapy-induced mucositis, and prevention and treatment. Stomatitis and mucositis are defined to provide clinicians with a better understanding of oral problems, since the task of assessing and addressing these are commonly left to trained nursing staff.Less
Disease or treatment-related mouth problems, particularly those associated with chemotherapy or radiotherapy and other immunosuppresion strategies, often pose severe pain in haematology patients. Oral problems often posit challenges in the social interactions and eating and breathing patterns of patients. They also increase systematic and local infections, impede treatment schedules, and change dose requirements and drug combinations. This chapter discusses the causes of oral problems in haematological patients, the assessment and incidence of oral mucositis, the pathogenesis of chemotherapy and radiotherapy-induced mucositis, and prevention and treatment. Stomatitis and mucositis are defined to provide clinicians with a better understanding of oral problems, since the task of assessing and addressing these are commonly left to trained nursing staff.
David Oliver
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780198528074
- eISBN:
- 9780191730382
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528074.003.0003
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter covers the prevention and treatment of seizures in intra-cranial malignancy, a crucial part of palliation as seizures are one of the dominant concerns of patients and their families. It ...
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This chapter covers the prevention and treatment of seizures in intra-cranial malignancy, a crucial part of palliation as seizures are one of the dominant concerns of patients and their families. It begins with the incidence, assessment, and diagnosis of seizures. The rest of the chapter focuses on the palliation of this symptom. Management of seizures depends on the first episode and the recurrence of the problem. The primary treatment for seizures is through the use of anticonvulsant medication; however, this is administered with great care as it poses adverse effects. Other seizure management methods discussed in the chapter include the use of corticosteroids, radiotherapy, and surgery. It also discusses status epilectus and the management of seizures in unconscious patients.Less
This chapter covers the prevention and treatment of seizures in intra-cranial malignancy, a crucial part of palliation as seizures are one of the dominant concerns of patients and their families. It begins with the incidence, assessment, and diagnosis of seizures. The rest of the chapter focuses on the palliation of this symptom. Management of seizures depends on the first episode and the recurrence of the problem. The primary treatment for seizures is through the use of anticonvulsant medication; however, this is administered with great care as it poses adverse effects. Other seizure management methods discussed in the chapter include the use of corticosteroids, radiotherapy, and surgery. It also discusses status epilectus and the management of seizures in unconscious patients.
Sam H. Ahmedzai and Martin F. Muers
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780192631411
- eISBN:
- 9780191730160
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192631411.003.0030
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines the diagnosis and management of respiratory syndromes associated with malignant diseases and evaluates the supportive care needs of patients with primary thoracic cancers. Some ...
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This chapter examines the diagnosis and management of respiratory syndromes associated with malignant diseases and evaluates the supportive care needs of patients with primary thoracic cancers. Some of the common symptoms in patients with thoracic malignancy include dyspnoea, cough, and haemoptysis. Mild symptoms can be effectively managed by pharmacological methods, but for malignant ones radiotherapy and brachytherapy are recommended.Less
This chapter examines the diagnosis and management of respiratory syndromes associated with malignant diseases and evaluates the supportive care needs of patients with primary thoracic cancers. Some of the common symptoms in patients with thoracic malignancy include dyspnoea, cough, and haemoptysis. Mild symptoms can be effectively managed by pharmacological methods, but for malignant ones radiotherapy and brachytherapy are recommended.
Peter Keating and Alberto Cambrosio
- Published in print:
- 2012
- Published Online:
- September 2013
- ISBN:
- 9780226428918
- eISBN:
- 9780226428932
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226428932.003.0080
- Subject:
- History, History of Science, Technology, and Medicine
This chapter discusses how clinical cancer trials ceased to be seen as a mere extension of the Cancer Chemotherapy National Service Center (CCNSC) and became an autonomous form of clinical research. ...
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This chapter discusses how clinical cancer trials ceased to be seen as a mere extension of the Cancer Chemotherapy National Service Center (CCNSC) and became an autonomous form of clinical research. First, it discusses the reorganization of screening and clinical trials in the United States. It also discusses the emergence of cooperative cancer research and then examines how surgery and radiotherapy participated in clinical cancer research.Less
This chapter discusses how clinical cancer trials ceased to be seen as a mere extension of the Cancer Chemotherapy National Service Center (CCNSC) and became an autonomous form of clinical research. First, it discusses the reorganization of screening and clinical trials in the United States. It also discusses the emergence of cooperative cancer research and then examines how surgery and radiotherapy participated in clinical cancer research.
- Published in print:
- 2009
- Published Online:
- March 2013
- ISBN:
- 9780226465319
- eISBN:
- 9780226465333
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226465333.003.0002
- Subject:
- History, History of Science, Technology, and Medicine
This chapter investigates work in the mid-1970s of a distinguished oncology researcher, Bernard Fisher, in order to bring out a number of salient characteristics of clinical trial culture. It ...
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This chapter investigates work in the mid-1970s of a distinguished oncology researcher, Bernard Fisher, in order to bring out a number of salient characteristics of clinical trial culture. It specifically addresses Fisher's multicenter trials that were governed by a tightly regimented system of practices that were capable of producing highly reliable results. It follows the growth of cancer clinical trials from the end of the Second World War until the early 1970s and President Richard Nixon's War on Cancer. The principle that adding prolonged, and aggressive, chemotherapy to conventional local treatments with surgery and radiotherapy had improved cancer cures was proved. With the growing postwar concerns with clinical conduct, medical investigators also had to show that their research was produced ethically.Less
This chapter investigates work in the mid-1970s of a distinguished oncology researcher, Bernard Fisher, in order to bring out a number of salient characteristics of clinical trial culture. It specifically addresses Fisher's multicenter trials that were governed by a tightly regimented system of practices that were capable of producing highly reliable results. It follows the growth of cancer clinical trials from the end of the Second World War until the early 1970s and President Richard Nixon's War on Cancer. The principle that adding prolonged, and aggressive, chemotherapy to conventional local treatments with surgery and radiotherapy had improved cancer cures was proved. With the growing postwar concerns with clinical conduct, medical investigators also had to show that their research was produced ethically.
Lindsay M. Morton, Sharon A. Savage, and Smita Bhatia
- Published in print:
- 2017
- Published Online:
- December 2017
- ISBN:
- 9780190238667
- eISBN:
- 9780190238698
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190238667.003.0060
- Subject:
- Public Health and Epidemiology, Epidemiology, Public Health
As prognosis following a cancer diagnosis has improved and survival has increased, so has the occurrence of multiple primary cancers diagnosed in the same individual. In the United States, one in ...
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As prognosis following a cancer diagnosis has improved and survival has increased, so has the occurrence of multiple primary cancers diagnosed in the same individual. In the United States, one in five cancer diagnoses involves an individual with a previous history of cancer. These new primary cancer diagnoses, or “subsequent neoplasms” (SN), are a substantial cause of morbidity and mortality in cancer survivors. The risk of developing SN varies substantially depending on age, the type of initial primary cancer, chemotherapy, radiotherapy, genetic susceptibility, and exposure to other cancer risk factors. Childhood cancer survivors have particularly elevated SN risks associated with radiotherapy and, to a lesser extent, systemic therapy. Genetic susceptibility to cancer is also thought to play an important role in SN development after childhood cancer. Survivors of many adulthood cancers also have elevated SN risks, likely with a multifactorial etiology.Less
As prognosis following a cancer diagnosis has improved and survival has increased, so has the occurrence of multiple primary cancers diagnosed in the same individual. In the United States, one in five cancer diagnoses involves an individual with a previous history of cancer. These new primary cancer diagnoses, or “subsequent neoplasms” (SN), are a substantial cause of morbidity and mortality in cancer survivors. The risk of developing SN varies substantially depending on age, the type of initial primary cancer, chemotherapy, radiotherapy, genetic susceptibility, and exposure to other cancer risk factors. Childhood cancer survivors have particularly elevated SN risks associated with radiotherapy and, to a lesser extent, systemic therapy. Genetic susceptibility to cancer is also thought to play an important role in SN development after childhood cancer. Survivors of many adulthood cancers also have elevated SN risks, likely with a multifactorial etiology.
