Prognosis in Advanced Cancer

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Predicting survival and other outcomes is increasingly being recognized as an important skill for palliative care doctors and nurses, oncologists, and other healthcare professionals who treat patients with advanced cancer. Accurate prognosis is essential if we are to offer quality of care and 'a good death', as well as to aid decision-making. There is much prognostic information available that is scattered throughout the palliative care and oncological literature but this is the first time it has been gathered systematically in one place. Glare and Christakis, leaders in the field of prognosis, bring together a team of international contributors from across the fields of palliative care and oncology. This comprehensive but practical guide begins with the principles of prognostication, including formulating the prediction and then communicating it. Topics such as statistical issues, evidence-based medicine, and the ethics of prognostication are also covered. The second section addresses prognostication in 15 specific cancer sites once they have reached the advanced stage, following a standard template for consistency and easy access to the key information. The third section deals with prognostication in patients with a variety of common clinical conditions at the end of life, such as bowel obstruction, hypercalcaemia, and brain metastases. In addition, survival curves are provided within each chapter, palliative care conditions are examined for the first time, and a summary table of long and short term prognosis ensures this book remains practical.

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Editorial Reviews

Doody's Review Service
Reviewer: Marlene S. Foreman, BSN, MN (Hospice of Acadiana, Inc.)
Description: This is a very informative and necessary book for physicians working with patients at all stages of cancer. It begins with historical information and continues with chapters on specific cancers.
Purpose: The aim of the book is to improve physician skills in prognostication near the end of life in patients with advanced cancer. Accurate prognosis would assist patients and families in making legal, ethical, and medical decisions.
Audience: The book is primarily for practicing physicians in a variety of specialties including palliative care and hospice. Oncologists, internists, and family physicians also would be able to use this book. In addition, advanced practice nurses, researchers, and other medical personnel may find value. This edited book is written by a large group of qualified authors, which provides a broad perspective.
Features: Part I covers the early history of medical prognosis and moves to the present in a very interesting manner. It includes legal and ethical challenges to accurate prognosis and the effects on the patient and family. Chapters in part II are devoted to specific common cancers and prognoses based on the literature and evidence-based medicine. Part III focuses on prognostication in palliative care, describing metastatic difficulties, and pain and symptomatology suffered by patients that impact prognosis. It is very difficult to find one specific "best" in this book. As a clinical nurse specialist, I was fascinated and read the entire book cover to cover. A number of very obvious typographical errors should have been resolved before publication, but it was not difficult to determine what the word should have been.
Assessment: Overall, the quality of this book is outstanding. It is an informative and very necessary book for physicians and other medical personnel.
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Product Details

  • ISBN-13: 9780198530220
  • Publisher: Oxford University Press, USA
  • Publication date: 11/28/2007
  • Pages: 432
  • Product dimensions: 6.70 (w) x 9.60 (h) x 1.00 (d)

Meet the Author

Dr. Paul Glare has been a Fellow of the Royal Australian College of Physicians since 1990, a Fellow of the Chapter of Palliative Medicine since it was created in 2000 and is a Fellow of the Faculty of Pain Medicine. As well as maintaining a full clinical load, he is an active teacher and researcher. His principal research interests are prognostication and the anorexia cachexia syndrome. He was the inaugural Research Fellow in the Palliative Care Program at the Cleveland Clinic Foundation, Ohio USA, from 1989 until 1991. For more than 15 years he has taken a leadership role in the development of the specialty of palliative medicine, both locally and internationally, and is currently managing major initiatives in palliative care education and service delivery for the New South Wales Department of Health. Nicholas Christakis is an internist and social scientist who conducts research on social factors that affect health, health care, and longevity. His clinical work is in the field of palliative medicine. Dr. Christakis's past research has examined the accuracy and role of prognosis in medicine, ways of improving end of life care, and the determinants and outcomes of hospice use. He is currently concerned with health and social networks, and specifically with how ill health disability, health behavior, health care, and death in one person can influence the same phenomena in others in a person's social network, including issues related to caregiver burden. Dr. Christakis was the recipient of the Distinguished Researcher Award, National National Hospice and Palliative Care Organization, awarded for an "outstanding body of work contributing to the enhancement of hospice and palliative care" in 2006.

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Table of Contents

Pt. 1 The science of prognostication

1 Overview: Advancing the clinical science of prognostication Paul Glare Glare, Paul Nicholas A. Christakis Christakis, Nicholas A. 3

2 Differences in prognostication between early and advanced cancer William J. Mackillop Mackillop, William J. 13

3 Foreseeing: Formulating an accurate prognosis Elizabeth B. Lamont Lamont, Elizabeth B. 25

4 Foretelling: Communicating the prognosis Phyllis Butow Butow, Phyllis Rebecca Hagerty Hagerty, Rebecca Martin Tattersall Tattersall, Martin Martin Stockler Stockler, Martin 33

5 Statistical concepts and issues related to prognostic models Phyllis A. Gimotty Gimotty, Phyllis A. 55

6 Evidence-based medicine Paul Glare Glare, Paul Marco Maltoni Maltoni, Marco Cinzia Brunelli Brunelli, Cinzia 63

7 Tools for formulating prognosis Jay F. Piccirillo Piccirillo, Jay F. Anna Vlahiotis Vlahiotis, Anna 79

8 Ethical perspectives Bert Broeckaert Broeckaert, Bert Paul Glare Glare, Paul 89

Pt. 2 Prognostication in specific cancers

9 Lung cancer C. Martin Tammemagi Tammemagi, C. Martin 97

10 Colorectal cancer Tony Geoghegan Geoghegan, Tony Michael J. Lee Lee, Michael J. 111

11 Breast cancer Fabio Efficace Efficace, Fabio Laura Biganzoli Biganzoli, Laura 123

12 Bladder cancer Luigi Schips Schips, Luigi Richard Zigeuner Zigeuner, Richard 133

13 Prostate cancer Timothy Gilligan Gilligan, Timothy 143

14 Pancreatic cancer Moritz Koch Koch, Moritz Jurgen Weitz Weitz, Jurgen Markus W. Buchler Buchler, Markus W. 151

15 Hepatoma Kelvin K. Ng Ng, Kelvin K. Ronnie T. Poon Poon, Ronnie T. 161

16 Head and neck cancer Ceri Hughes Hughes, Ceri Steven J. Thomas Thomas, Steven J. 175

17 Gynaecologicalcancer Jonathan Carter Carter, Jonathan 187

18 Brain cancer Hiroko Ohgaki Ohgaki, Hiroko 201

19 Non-Hodgkin's lymphoma Charles Dumontet Dumontet, Charles Catherine Thieblemont Thieblemont, Catherine 215

20 Leukaemia and myeloma Paul Glare Glare, Paul 225

21 Sarcoma Katherine T. Morris Morris, Katherine T. Murray F. Brennan Brennan, Murray F. 239

22 Unknown primary Jonathan E. Dowell Dowell, Jonathan E. 249

23 Melanoma Anne Hamilton Hamilton, Anne Katherine Clark Clark, Katherine 257

Pt. 3 Prognosis in palliative care

24 Bone secondaries Edward Chow Chow, Edward Albert Yee Yee, Albert 269

25 Brain secondaries Andrew Broadbent Broadbent, Andrew George Hruby Hruby, George 285

26 Leptomeningeal disease Vicki Jackson Jackson, Vicki Lida Nabati Nabati, Lida 295

27 Liver metastases Angela Byrne Byrne, Angela Michael J. Lee Lee, Michael J. 301

28 Lung secondaries David Currow Currow, David Christine Sanderson Sanderson, Christine 311

29 Hypercalcaemia Niklas Zojer Zojer, Niklas Martin Pecherstorfer Pecherstorfer, Martin 319

30 Spinal cord compression Nora Janjan Janjan, Nora Anita Mahajan Mahajan, Anita Eric L. Chang Chang, Eric L. Ian McCutcheon McCutcheon, Ian Edward Lin Lin, Edward Prajnan Das Das, Prajnan Sunil Krishnan Krishnan, Sunil Edward Chow Chow, Edward 329

31 Pain relief Maria Montoya Montoya, Maria Eduardo Bruera Bruera, Eduardo 345

32 Malignant bowel obstruction Sebastiano Mercadante Mercadante, Sebastiano 361

33 Breathlessness Lara Alloway Alloway, Lara Vaughan Keeley Keeley, Vaughan Irene Higginson Higginson, Irene 371

34 Delirium Miriam Friedlander Friedlander, Miriam David Kissane Kissane, David 381

35 Weight loss Aminah Jatoi Jatoi, Aminah Phuong L. Nguyen Nguyen, Phuong L. 395

36 Cancer-related fatigue Tugba Yavuzsen Yavuzsen, Tugba Mellar P. Davis Davis, Mellar P. 401

37 Prognostication in the imminently dying patient James Stevenson Stevenson, James John Ellershaw Ellershaw, John 411

Index 433

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