2011; Volume 12, No 02, February

Roger Woodruff, MD


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Palliative Care Book of the Month and other Book Reviews

Palliative Care Book of the Month

Lessons for Caregivers

Richard P. McQuellon and Michael A. Cowan

Oxford University Press, 2010
144 pp
ISBN 978-0-19-538922-7
RRP $US15.95, £9.99

This is a remarkable little book.  Following the introduction, there are sections on the Many Meanings of Mortal Time, Hope from Conversation, and Guidance for Caregivers.  Written by experienced counsellors, it provides a lot of common sense guidance about how we should deal with the terminally ill and those with life-threatening conditions.  It provides a clear outline of the different ways people may react to hearing such a diagnosis and how the caregiver should (and shouldn’t) respond. 

It is written for both lay and professional caregivers, although I felt the former would have to have an above-average educational standard to benefit.  For health care professionals, particularly those who work in palliative care, it is manna from heaven.  It is clearly written and informative, and you can read it in a few hours; however, I think you would be coming back to read bits of it again.  For people coming to work on a palliative care service, or for students studying palliative care, this book would be an excellent introduction to these difficult inter-personal relationships and conversations.

Roger Woodruff
(January 2011)


Other Book Reviews

From Advanced Disease to Bereavement

Rocker, Puntillo, Azoulay and Nelson (Eds)

Oxford University Press, 2010
375 pp
ISBN 978-0-19-923924-5
RRP  £37.95, $US 75.00

Dora was 15 and dying of lymphoma.  We had worked assiduously with her family for many weeks, trying to help them come to terms with the inevitable.  But when she developed respiratory failure, she was whisked off to ICU where real doctors with tubes and machines and central lines said they were going to save her.  The family were left outside for hours, only spoken to by a kind nurse who felt guilty the doctor couldn’t make the time.  When the condition failed to respond, the family members were allowed in but the resident was nowhere to be seen.  Fortunately, the staff who had looked after Dora and her family before she went to ICU were there to provide the appropriate support.

That was probably more than 25 years ago, when ICU cases were categorised as ‘cures’ or ‘medical failures’.  It is a source of considerable professional pleasure to see books such as this, applying the principles and practices of palliative care to dying patients and their families in the ICU.  The opening chapter is about the care of the dying patient in the ICU and the challenges it presents.  There are chapters on symptom control, caring for families, cultural and spiritual issues, legal issues, and withholding and withdrawal of life support. 

This pocket-sized book is one of the Oxford Specialist Handbooks in End-of-Life Care.  It has a wealth of information, much of it in bullet-point lists.  If you are involved in palliative care in the acute hospital setting, and the ICU does not have a copy of this book, I suggest the palliative care service buys a copy for them.


A creative partnership—a teenager, her doctor and cancer

Hetty Rodenburg

Steele Roberts, Aotearoa, NZ, 2010
169 pp
ISBN 978-1-877-448843
RRP Not listed on Amazon. Available from fishpond.com.au $A36.99

Hetty Rodenburg is a retired GP who specialises in supportive counselling, having trained with Elisabeth Kubler-Ross and Gurumayi Chidvilasasnanda (Siddha Yoga).  This book is about her dealings with Wendy, a teenager with recalcitrant Hodgkin’s disease. 

This is the story—narrative, poetry and drawings—of an evolving therapeutic relationship or partnership over a period of four years.  One cannot help but be impressed by the way in which Wendy’s wish to preserve her identity and maintain some sense of control are facilitated.  For anyone who works in palliative care, particularly those of us without special training in counselling skills, this book provides plenty of food for thought and reflection.



Del Fabbro, Baracos, Demark-Wahnefried, Bowling, Hopkinson and Bruera (Eds)

Oxford University Press, 2010
519 pp
ISBN 978-0-19-955019-7
RRP $US139.95, £69.00

This is an up-to-date, well-referenced review of just about all we know about nutrition and the cancer patient. It includes all stages of the disease trajectory—patients receiving active therapy, patients with advanced disease needing palliative care, and cancer survivors. There are a total of 35 chapters, written by more than 50 international contributors.

The opening section is about physiology and metabolism and I was impressed by the progress that has been made in the basic science. The second section is about the epidemiology and pathophysiology of the anorexia-cachexia syndrome. This is followed by detailed chapters on each of the various treatments—appetite stimulants, anabolic hormones, immune modulators, and autoimmune system modulators. Other syndromes that can affect nutrition (secondary nutrition, impact symptoms such as oral complications, nausea and vomiting, disordered bowel function, and depression) are dealt with in the next section. There follows sections on nutritional counselling, artificial nutritional support, ethics, the effects of cultural and religious factors, complementary and alternative medicine, and exercise.

This book will be a useful reference for anybody involved with the nutritional state of cancer patients, wherever they are on the disease trajectory. I was impressed by the non-pharmacological material that was presented, both in terms of assessment and therapy. There would appear to have been no major pharmacological advances in the last few years, although the advances in our knowledge of the basic science bodes well.

I certainly think it has a place on the shelf in any Cancer Unit library.



A Festschrift for Robert Twycross

Radcliffe Medical Press, 2003
58 pp
ISBN 978-1-857-758405
RRP £19.95

Review copy supplied by Elsevier Australia www.elsevier.com.au

Everyone in my generation who has worked in palliative care owes a debt to the outstanding teacher and prolific author, Robert Twycross. The Festschrift has many interesting anecdotes and asides and will be of particular interest to any student of the history of modern palliative care.

Roger Woodruff
(January 2011) 

Dr. Woodruff is a Lifetime Member of the IAHPC Board and lives in Australia. His biography is at:

View over 100+ IAHPC hospice & palliative care book reviews

Note for authors: If you wish to have your book reviewed, please send to:

Dr Roger Woodruff
IAHPC Bookshop Editor
210 Burgundy St, Suite 9
Heidelberg, Victoria 3084

Note: Review copies become property of IAHPC and are not returned to the author. Only palliative care related books which are previously approved will be reviewed. Due to the large number of requests, we can't provide exact dates of when books will be reviewed.

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