Book reviews

Cancer Palliative care
Volume 188 - Issue 8

Advanced cancer care

Author:  Raymond M Lowenthal

Med J Aust 2008; 188 (8): 468. || doi: 10.5694/j.1326-5377.2008.tb01719.x
Published online: 21 April 2008
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Handbook of advanced cancer care.
Raphael Catane, Nathan Cherny, Marianne Kloke, et al, editors. Oxford: Taylor & Francis, 2006 (ix + 278 pp). ISBN 978 0 415 37530 6.

As it discusses issues that lie at the interface of oncology and palliative care in this country, the Handbook of advanced cancer care is more useful than its title might suggest. It will be valuable not only to specialists but also to nurses, general practitioners and doctors in training.

The book was commissioned by the European Society for Medical Oncology and describes many situations that would be familiar to Australian cancer specialists. The treatments too are familiar and readily available. Overall, the text is pleasingly comprehensive for a small book, up to date and practical.

The authors begin by making the important point that even in advanced cancer, specific anticancer treatments (chemotherapy, radiotherapy) can be the best way of improving quality of life, and in some far advanced cases can even still be curative: think, for example, of disseminated germ cell tumours.

In addition to the expected topics (such as pain, constipation, and hypercalcaemia), there are useful entries concerning fungating wounds, hiccups, sweating and pressure sores. Modern drugs such as buprenorphine are included.

For this older oncologist, it was comforting to read that ‘‘[o]lder patients in overall good health are able to tolerate chemotherapy as well as their younger counterparts...”. This is a statement that might not have been made a few years ago. There are useful chapters about communication for the health professional, the place of psycho-oncology, and how to handle bereavement. In the latter chapter, I particularly endorse the advice that medical practitioners should routinely indicate to the relatives that they are available for a visit after the patient’s death to discuss “leftover” questions.

There is limited repetition — Tables 1.1 and 7.1 are identical and Tables 1.2 and 7.2 virtually so. Although the idea of providing algorithms is useful for clinical practice, the deep colours chosen for the various boxes make it difficult to read the text within. There is a description of massive terminal haemoptysis but not of catastrophic terminal haematemesis. Perhaps the most serious shortcoming, though, is that the chapter on pain glosses over the need to make a diagnosis of its cause before considering symptomatic treatment options.

In summary, this is a useful, concise handbook which would soon be well thumbed if made available on the oncology and palliative care wards. In days gone by, it would have fit neatly into the pocket of a white coat, but who wears those any more?

Author

  • Raymond M Lowenthal1
  • 1. Royal Hobart Hospital, Hobart, TAS
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