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Dr. Roger Woodruff
(Australia)


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PALLIATIVE CARE CONSULTATIONS IN
HAEMATO-ONCOLOGY


Sara Booth and Eduardo Bruera (Eds). Oxford University Press, 2003. 254 pp. ISBN 0-19-852808-6. RRP 29.95  $US45

This is the first volume in Oxford's new Palliative Care Consultations Series, dedicated to the palliative care of patients in the acute setting.  It is intended to give practical advice on difficult symptom control problems, which are seen in the context of hospital palliative care.  As the divide between haemato-oncology and palliative care continues to blur, there is an increasing need for people in the two fields to know more about what the other does, and how they do it.

For those who work in palliative care, this is a very useful guide to the palliation of symptoms in patients with haematological disease and provides useful background information about the disease processes.  For those who work in haematology, there is useful information about symptom palliation and also about the palliative approach to patient care, stressing teamwork and communication.  The chapter on "Changing the emphasis from active curative care to active palliative care in haematology patients" should be required reading for haematologists and their trainees.  The coverage is good except there is no chapter on symptom palliation for patients with the chronic myeloproliferative syndromes.

This is a useful book that should be available both in the haematology department and in the palliative care ward.



CANCER PAIN: ASSESSMENT AND MANAGEMENT


Eduardo Bruera and Russell Portenoy (Eds). Cambridge University Press, 2003. 485 pp. ISBN 0-521-77332-6.  RRP $US160,  90, $AUD399

The purpose of this book "is to provide a comprehensive, clinically oriented, and scholarly review of all aspects of this complex and multidimensional problem."  And the systematic review in chapter 2 emphasises the magnitude of the problem 74% (range 53-100%) of patients with advanced cancer have pain.  

The coverage is comprehensive.  There are sections on the biology and prevalence of pain in cancer, the assessment of cancer pain and cancer pain syndromes, and pharmacological and non-pharmacological therapy.  These are followed by discussions of the role of antineoplastic therapy, pain in special populations and difficult pain problems.

This is a well-organized book with a distinguished list of contributors.  It achieves the editors' goals and would be a worthwhile addition to the library of Oncology units and palliative care services.



ONCOLOGY FOR PALLIATIVE MEDICINE 2nd edition

Peter Hoskin and Wendy Makin. Oxford University Press, 2002. 379 pp. ISBN 0-19-262811-9. RRP 29.95, $US45

This book sets out to provide a comprehensive description of the management of cancer for health care professionals working in palliative care.  The initial chapters describe the various modalities of anticancer therapy and there are useful discussions of the principles involved in deciding if and when such treatments are appropriate for patients with advanced cancer or, alternatively, when not to use them.

The second section provides an overview of the management of all the common cancers, with an emphasis on the treatment of advanced disease.  There are useful algorithm-like tables describing the "patient journey" which help illustrate the therapeutic decision making through the course of the disease.

The final section deals with the management of metastatic disease at common sites and with pain and other tumour-associated problems.

Overall, this is a well-written book, but might have been improved by the provision of some key references or suggestions of where to look if you want to know more about a particular topic.  There is no doubt that specialists in palliative care now need to know more about anticancer therapy, as palliative medicine becomes integrated with oncology at an earlier stage of the patient's "journey".  The chapters on anticancer therapy and the management of the common tumours (which comprise three-quarters of this book) will undoubtedly be useful for palliative care professionals who have no formal training in oncology.


HIV & AIDS.  A foundation for nursing and
health care practice. 5th edition


Robert J. Pratt. Arnold, 2003. 464 pp. ISBN 0 340 70639 2. RRP 18.99
$US 34.95

This fifth edition of HIV & AIDS has been extensively revised and updated.  It provides a comprehensive account of the pathology and management of the disease from prevention to palliative care.  There are chapters dealing with special aspects of the infection (HIV-related tuberculosis, viral hepatitis and neurological disease) as well as special populations (women, children, and neonatal transmission).  Antiretroviral therapy, and the means to improve adherence with it, are discussed in detail.

The book is clearly written, with many useful diagrams illustrating the principles of immunopathology.  There is a list of learning objectives at the beginning of each chapter, enhancing its usefulness as a course text.  It is well referenced and there are useful lists for further reading and how to tap into the resources available on the Internet.  Whilst written as a nursing text, this book would be equally useful to junior doctors and certainly should be available on any ward that deals with patients with HIV and AIDS.

Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia

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