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Dr. Roger Woodruff
(Australia)


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QUALITY OF LIFE

Alison Carr, Irene Higginson, Peter Robinson (Eds). BMJ Books, 2003. 133pp. ISBN 0-7279-1544-4. RRP 24.95  $US39.95

Quality of Life (QOL) is a central tenet of palliative care.  Should we be measuring it routinely?  If so, how should we measure it?   The literature on measuring QOL is both vast and complex, and its use in day-to-day palliative care leads to questions of applicability (can the patient do the test?), interpretation (what have you measured? Is it patient-centered?), and usefulness (what does it mean?).

This short book provides a clear description of what QOL measures are, and how they should be used and interpreted.  The limitations and pitfalls of using QOL measures are equally well described.

If you want to advance your thinking about Quality of Life in palliative care, start with this excellent little book.


GERIATRIC PALLIATIVE CARE

R. Sean Morrison and Diane E. Meier (Eds). Oxford University Press, 2003. 430 pp. ISBN 019514191-1. RRP $US79.95, 55

This book is about how the principles and practices of palliative care can be woven into the care of older adults living with serious and chronic illness, to the benefit of all concerned. Palliative care in this population is likely to be of much longer duration than the end-of-life care that is customary for patients with advanced cancer, although one can argue that palliative care should be introduced earlier in patients with cancer. The appropriateness of the simultaneous use of life-prolonging therapy and palliative care, in the right balance for each individual patient at each particular stage of their illness, is stressed. The chapters on managing dementia, communication and advance care planning are particularly useful.

This book should be of great value to geriatricians as they strive to deliver optimal care for their patients. But I think it will also be very useful for palliative care professionals. Many of the patients we look after are older adults and this book provides useful insights as to how we might improve their overall care. It will certainly be on the library shelf at my palliative care service.


CANCER MANAGEMENT: A MULTIDISCIPLINARY APPROACH. Medical, Surgical and Radiation Oncology. 7th edition

Pazdur, Coia, Hoskins and Wagman (Eds). The Oncology Group, 2003. 1030 pp. ISBN 189148317X. RRP  $US59.95,  49.95, $AUD115.50

As many of the patients managed on palliative care services have advanced cancer, the question often comes up as to what is the best oncology textbook for the palliative care library.  This pocket-sized book is packed with information, which is clearly set out and easily accessed.  I used it for a couple of weeks in my day-to-day oncology work and did not find it wanting. And there is a 100-page section on Palliative and Supportive Care.

I think this would be an excellent oncology text for the Palliative Care Service library.  It provides more than enough detail about the management of cancer for palliative care professionals and it is up to date.  So whilst it may not be as comprehensive as De Vita, but it's size and price and strong recommendations. 


A GUIDE TO SYMPTOM RELIEF IN PALLIATIVE CARE.
                                            5th edition

Claud Regnard and Jo Hockley. Radcliffe Medical Press, 2004. 285pp. ISBN 1-85775-930-3. RRP 24.95

This is the expanded and up-dated fifth edition of this well known and highly regarded text.  It is a clinical decision guide for symptom relief in patients with advanced disease, both malignant and non-malignant.  The essential management advice in each section is set out in a table, forming a clinical decision algorithm that is based on patient information.  There is a lot of additional information about the diagnosis and management of symptoms given in the text, which is well referenced. 

The clinical decision tables in this book are an invaluable resource for moments when difficult or unusual problems are encountered, or symptoms respond poorly to apparently appropriate therapy.  As such, it deserves to be on the library shelf of every palliative care service.


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

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