The World Health Organization estimates that the number of new cases of tuberculosis will rise from 8 million in 1997 to 10.2 million in 2005. Frightening numbers, especially given the deadly synergy between tuberculosis and HIV infection.
This comprehensive new book covers all aspects of the disease. The introductory chapters cover epidemiology, microbiology, transmission and diagnosis. Next there are chapters on the clinical features of pulmonary and extra-pulmonary tuberculosis. The last eight chapters describe in detail the treatment of tuberculosis, the importance of adherence to therapy, the individualized care of patients, nurse-led case management, and infection control. The approach to treatment is holistic and there is good discussion of symptom control and palliative care.
Anyone involved in treating tuberculosis will benefit from this book, whether they live in rich countries or poor. Nurses and other health care professionals in developing countries may need to adapt some of the recommendations to suit local needs and the availability of resources, but the principles are the same. This book contains an enormous amount of information but is well organized and the material clearly explained.
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Health care professionals who work in both palliative care and medical oncology have long advocated the need for the principles of palliative care, with its multiprofessional holistic approach to all aspects of physical and psychosocial suffering, to be applied earlier in the course of the cancer illness and not reserved until the patient has advanced or terminal disease. The UK is now leading the way, introducing such care under the banner ‘Supportive Care’.
In the introduction, this book is described as ‘a guide for health care staff who support patients and their families through the many changes and challenges that cancer entails.’ ‘[It] is about the impact of cancer on people’s lives and the vital role that health care professionals play in shaping this experience and minimizing the distress involved.’
The approach used differs from traditional psycho-oncology, with its preoccupation with quantifying psychological and psychiatric morbidity, and underlines the need to understand people’s distress in the context of their personal, social and spiritual life. Various chapters describe the management of suffering in human context, in the personal context, in the context of the patient’s family and carers, in the social context, and in clinical context. The last two chapters deal with communication and with the care of the professional caregivers.
And in case you think this is all just more psychobabble, the authors note that ‘Psychosocial experts on their own have very little effect on the distress of cancer; it is the caring hands and the listening ears of doctors, nurses and radiographers that will always have the greatest impact on how people regard their illness.’ As one who works in both medical oncology and palliative care, the type of care outlined in this book is long overdue and, if it can be successfully introduced into busy oncology services, will be a quantum improvement in the care our patients receive.
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Note: The Table of Contents for each book reviewed is available in the Bookshop at 
