Supportive Oncology: (Expert Consult - Online and Print) (Expert Consult Title: Online + Print)

Supportive Oncology, by Drs. Davis, Feyer, Ortner, and Zimmermann, is your practical guide to improving your patients‘ quality of life and overall outcomes by integrating palliative care principles into the scope of clinical oncologic practice at all points along their illness trajectories. A multidisciplinary editorial team, representing the dual perspectives of palliative medicine and oncology, offers expert guidance on how to effectively communicate diagnoses and prognoses with cancer patients and their families, set treatment goals, and manage symptoms through pharmacological therapies, as well as non-pharmacological therapies and counselling when appropriate. The complete contents are available on www.expertconsult.com. • Integrate complementary palliative principles as early as possible after diagnosis with guidance from a multidisciplinary editorial team whose different perspectives and collaboration provide a well-balanced approach. • Effectively communicate diagnoses and prognoses with cancer patients and their families, set treatment goals, and manage symptoms through pharmacological therapies, as well as non-pharmacological therapies and counseling when appropriate. • Improve patients’ quality of life with the latest information on pain and symptom management including managing side effects of chemotherapy and radiotherapy, rehabilitating and counselling long-term survivors, and managing tumor-related symptoms and other complications in the palliative care setting. • Prescribe the most effective medications, manage toxicities, and deal with high symptom burdens. • Access the complete contents online at www.expertconsult.com. Improve quality of life at all points in a patient’s illness. 0......Page 1 Front matter......Page 2 Copyright......Page 4 Dedication......Page 5 Contributors......Page 6 Foreword......Page 11 Preface......Page 12 Definition......Page 13 Risk Factors Associated with the medical staff......Page 14 Flare reaction......Page 15 Cisplatinum......Page 16 Other Pharmaceutical Interventions......Page 17 Open questions......Page 18 References......Page 19 Types and Mechanisms of Allergic Reactions......Page 21 Cytotoxic Chemotherapy......Page 22 Diagnosis of Systemic Allergic Reactions to Chemotherapy......Page 23 Acute Management......Page 24 References......Page 25 Prophylaxis and treatment of chemotherapy-induced nausea and vomiting......Page 27 Neurotransmitters......Page 28 5-Ht3 Serotonin Receptor Antagonists (5-Ht3-Ras)......Page 29 Neurokinin-1-Receptor Antagonists (Nk-1-Ras)......Page 30 Antihistamines......Page 31 Low and minimally emetogenic chemotherapy......Page 32 Brief Summary: Practical Treatment Approach......Page 33 References......Page 34 Risk Groups......Page 35 Unexplained fever......Page 36 Microbiologically documented/defined infection with/without bacteremia......Page 37 Therapeutic Concepts......Page 38 Treatment of intermediate- and high-risk patients......Page 39 Additional Treatment Options......Page 40 References......Page 44 Radiotherapy-induced adverse events......Page 45 Individual Radiosensitivity......Page 46 Pathophysiology......Page 47 Hypopituitarism......Page 48 Symptoms and Management......Page 49 Symptoms and Management......Page 50 Female Sexual Function......Page 51 References......Page 52 Mechanism of Renal Injury......Page 55 Treatment Strategies......Page 57 Lenalidomide......Page 58 References......Page 59 Chemotherapy Regimens......Page 60 5-Fluorouracil/Leucovorin......Page 61 Irinotecan......Page 62 Bevacizumab......Page 63 Cetuximab......Page 64 References......Page 65 Platinum Compounds......Page 67 Oxaliplatin......Page 68 Methotrexate......Page 69 Docetaxel......Page 70 Identification of High-Risk Patients......Page 71 Calcium and Magnesium......Page 72 Glutathione......Page 73 Vitamin E......Page 74 References......Page 75 Management of cardiac and pulmonary treatment–related side effects......Page 78 Supportive Oncology Care......Page 79 Heart Failure......Page 80 Imatinib......Page 82 Treatment......Page 83 Fluorouracil (5-Fu)......Page 84 Interleukin......Page 85 Bevacizumab......Page 86 Arterial and Venous Thromboembolism......Page 87 Cisplatin......Page 88 VTE prevention......Page 89 Histone Deacetylase Inhibitors (Hdacs)......Page 90 Arsenic trioxide......Page 91 Radiation-Induced Cardiotoxicity......Page 92 Coronary Artery Disease......Page 93 Diagnosis......Page 94 Heart failure......Page 95 Radiation-Induced Pulmonary Toxicity (Pt)......Page 96 Supportive Oncology......Page 97 Acute Lung Injury......Page 98 Diagnosis......Page 99 References......Page 100 Males......Page 106 Chemotherapy......Page 107 Radiotherapy......Page 108 Radiotherapy......Page 109 Females......Page 110 References......Page 111 Clinical and Economic Impact......Page 113 Definition......Page 114 Incidence of oral and oropharyngeal mucositis in patients receiving head and neck radiation with or without concurrent chem .........Page 115 Incidence of oral and gastrointestinal mucositis in patients undergoing hematopoietic cell transplantation (HCT)......Page 116 Pathobiology......Page 118 Treatment of Mucositis......Page 120 Future Directions for Mucositis Research and Clinical Translation......Page 123 References......Page 124 Papulopustular (Acneiform) Rash......Page 126 Stevens Johnson Syndrome and Toxic Epidermal Necrolysis......Page 129 Onycholysis......Page 130 References......Page 131 Cancer pain......Page 132 N-Methyl-D-Aspartate Receptors......Page 133 Opioids......Page 134 Neuropathic Pain......Page 135 Pain Assessment......Page 136 Liver Metastases......Page 137 Opioid Titration......Page 138 Opioid Route Conversion......Page 139 Adjuvant Analgesics......Page 141 Radioisotopes......Page 142 References......Page 143 Cancer-related fatigue......Page 146 Subjective Perception And Impact on Functioning......Page 147 Underlying Mechanisms......Page 148 Provider Assessment......Page 149 General Treatment Principles For The Provider......Page 150 Comorbidity-related patient/family education......Page 151 Exercise barriers......Page 152 Nutrition......Page 153 Symptom Clusters......Page 154 Provider Assessment......Page 155 Sleep-Related Treatment......Page 156 References......Page 157 Cancer anorexia and cachexia......Page 160 Mechanisms of Cancer Anorexia-Cachexia Syndrome......Page 161 Implications in advanced cancer......Page 162 Skeletal Muscle Loss......Page 164 Nutritional Assessment......Page 166 Validated nutrition assessment tools......Page 167 Barriers to nutritional intake......Page 168 Anorexia......Page 169 Is There a Role for Enteral or Parenteral Nutrition?......Page 170 References......Page 171 Magnitude And Severity of Dyspnea......Page 174 Assessing Dyspnea......Page 175 Medical Gases......Page 176 Pharmacologic Interventions......Page 177 Current Evidence-Based Therapeutic Options......Page 178 References......Page 179 Diagnosis......Page 181 Feeding tubes......Page 182 Esophageal stents......Page 183 References......Page 185 Diagnosis......Page 187 Intestinal Fluid Handling......Page 189 Causes of Constipation......Page 190 Factors Associated With The Illness But Not Directly Due to It......Page 191 Softening Laxatives......Page 192 Conclusion......Page 194 References......Page 195 Longitudinal studies......Page 197 Objective Measures......Page 198 Predisposing Factors......Page 199 Precipitating Factors......Page 200 Perpetuating Factors......Page 201 Sleep apnea syndromes......Page 202 Efficacy......Page 203 Insomnia comorbid with cancer......Page 204 Sleep Restriction......Page 205 Cognitive Restructuring......Page 206 Conclusion......Page 207 References......Page 208 Classification of Itch......Page 210 Epidemiology of Itch In Malignant Diseases......Page 211 Dry Skin (Xerosis)......Page 212 Serotonin receptor antagonists......Page 213 Neuropathic Itch......Page 214 Drug-Induced Itch......Page 215 Pruritus induced by systemic opioids......Page 216 References......Page 217 Prevalence......Page 221 History and physical examination......Page 223 Differential diagnosis......Page 224 Static Compression......Page 225 Combination Nonoperative Therapy......Page 226 Microsurgery......Page 227 Charles procedure......Page 228 References......Page 229 Prevalence......Page 231 Pathophysiology......Page 232 Newer antidepressants......Page 233 Paroxetine......Page 234 Gabapentin......Page 235 Vitamin E......Page 236 Acupuncture......Page 237 Physical Measures......Page 238 References......Page 239 Symptoms Of Salivary Gland Hypofunction......Page 242 Clinical Examination......Page 243 Strategies to reduce radiation injury to salivary gland tissue......Page 245 Pilocarpine During Radiotherapy......Page 246 Stimulation Of Residual Function......Page 247 Insufficient effect of stimulation......Page 248 Epilogue......Page 249 References......Page 250 Bone Metastases......Page 253 Treatment With Bisphosphonates......Page 254 Bisphosphonates for anti-osteolytic treatment of bone metastases......Page 255 Acute Phase Reaction and Gastrointestinal Side Effects......Page 258 Research on Prevention of Skeletal Metastases......Page 259 Development of Antibodies Against Rankl......Page 261 Dose-Finding Studies with Denosumab in Oncology......Page 262 Denosumab in the treatment of breast cancer with skeletal metastasis......Page 263 Denosumab for the treatment of bone metastases from prostate cancer......Page 264 References......Page 265 Definitions of Nausea and Vomiting in Advanced Cancer......Page 267 Causes of Nausea And Vomiting in Patients With Cancer......Page 268 Outcomes of Comprehensive Nausea Assessment......Page 269 Approaches to the Pharmacologic Treatment of Nausea In Patients with Cancer......Page 270 Evidence For Efficacy of Prokinetics In Chronic Nausea of Advanced Cancer......Page 272 Pharmacology......Page 273 Pharmacology of the D2 Antagonists......Page 274 Corticosteroids......Page 275 Novel Prokinetic Agents......Page 276 Draining percutaneous endoscopic gastrostomy (PEG) tubes......Page 277 Gastric electrical stimulation......Page 278 References......Page 279 Pathophysiology......Page 283 Role of Microparticles......Page 284 Treatment-Dependent Risk Factors......Page 285 Risk Assessment......Page 286 Low-Molecular-Weight Heparins......Page 287 Initial Treatment......Page 288 Anticoagulation In Thrombopenic Patients......Page 289 References......Page 290 Neuromuscular complications......Page 292 Brachial plexopathy......Page 293 Surgery Related Neuropathy......Page 294 Cisplatin And Carboplatin......Page 295 Lambert-Eaton myasthenic syndrome (LEMS)......Page 296 Neuromyotonia (Isaac's Syndrome)......Page 297 Vasculitic Neuropathy......Page 298 References......Page 299 Complications of bone metastases—long bone fractures, spinal cord compression, vertebral augmentation......Page 301 Pathophysiology......Page 302 Long Bone and Acetabular Fractures......Page 303 Impending Fractures of Long Bones......Page 304 Radiotherapy......Page 305 Vertebral Augmentation......Page 306 Stereotactic Spinal Radiotherapy......Page 308 Complications of Vertebral Metastases—Spinal Cord Compression......Page 309 Radiotherapy......Page 310 Combined Radiotherapy and Surgery......Page 311 Radiotherapy Dose Fractionation for Spinal Cord Compression......Page 312 Predicting Outcomes In Patients With Spinal Cord Compression......Page 313 References......Page 315 Chemotherapy-Related Lung Toxicity......Page 318 Bleomycin......Page 319 Nitrosoureas And Alkylators......Page 320 Epidemiology......Page 321 Etiology......Page 322 Chest X-ray......Page 323 Endoscopy......Page 324 Management......Page 325 Electrocautery......Page 327 Photodynamic Therapy......Page 328 Airway Stents......Page 329 Radiation-Induced Lung Injury......Page 331 References......Page 332 Malignant bowel obstruction......Page 335 Pathophysiology......Page 336 Clinical Manifestations......Page 337 Investigations......Page 338 Conservative (Best Supportive Care)......Page 339 Nutritional considerations......Page 340 Octreotide......Page 342 Interventional Procedures......Page 343 Colorectal Stents......Page 344 Cecostomy Tubes......Page 345 Surgical Procedures......Page 346 Further Research......Page 347 References......Page 348 Management of malignant wounds and pressure ulcers......Page 351 Epidemiology and Pathophysiology......Page 352 Management......Page 355 Pain......Page 356 Prognosis......Page 357 Prevention......Page 358 Management......Page 359 References......Page 360 Clinical Manifestations......Page 363 Diagnostic Criteria......Page 364 Indwelling catheter......Page 365 Clinical Manifestations......Page 366 Surgical approaches......Page 367 References......Page 368 Prevalence and Pathophysiology......Page 371 Diagnosis......Page 372 Intraperitoneal Radiotherapy......Page 373 Therapeutic Paracentesis......Page 374 Management of Symptomatic Malignant Ascites......Page 375 References......Page 377 Mechanical Complications......Page 378 Thrombotic Complications......Page 379 Pathogens......Page 380 Management......Page 381 References......Page 382 Esophageal Cancer......Page 384 Gastric Outlet Obstruction......Page 385 Distal Obstruction......Page 386 Echoendoscopically Guided Hepaticogastrostomy for Biliary Drainage......Page 387 Colorectal Obstruction......Page 388 References......Page 389 Superior Vena Cava Syndrome......Page 391 Lung Cancer......Page 392 Cytoreduction......Page 393 Gastrointestinal Obstruction: Enteral Stent Placement......Page 395 Genitourinary Hemorrhage......Page 396 References......Page 397 Palliative Surgery Defined......Page 399 Principles and Patient Assessment for Palliative Surgery......Page 400 Measurement of Surgical Outcomes and Palliative Surgery......Page 402 Future of Outcomes Assessment in Palliative Surgery......Page 404 Summary......Page 405 References......Page 406 Setting the Stage......Page 407 How to Determine When Someone is Entering the Last Few Days of Life......Page 408 Reviewing Medications......Page 409 Respiratory Symptoms......Page 410 Seizures......Page 411 Sedation at the End of Life......Page 412 References......Page 413 Rehabilitation Team......Page 414 Basic Rehabilitation Principles......Page 415 Neuromuscular Complications of Cancer......Page 416 Lymphedema......Page 418 Pain......Page 419 Radiation-Related Injuries......Page 420 References......Page 421 Exercise interventionsin supportive oncology......Page 422 Effects of Physical Activity on Supportive Care Outcomes......Page 423 Colorectal Cancer......Page 425 Lung Cancer......Page 426 Disease Endpoints......Page 428 Summary/Clinical Implications......Page 429 PA Determinants......Page 430 Determinants of PA Adherence......Page 431 Behavior Change Interventions......Page 432 Future Directions......Page 433 References......Page 434 Late effects of chemotherapy and radiation......Page 437 Pathogenesis of Late Complications of Oncologic Treatment......Page 438 Time Course and Documentation......Page 439 Liver......Page 440 Respiratory Tract......Page 441 Biology-Based Prophylactic or Therapeutic Approaches......Page 442 Modulation of Angiotensin......Page 443 References......Page 444 Bone Metabolism and Osteoporosis......Page 446 Tumor and Tumor Treatment–Induced Osteoporosis......Page 447 Anastrozole......Page 448 Letrozole......Page 449 Prophylaxis and Treatment With Bisphosphonates......Page 450 Who Should be Treated With Medication?......Page 451 Treatment of Tti Osteoporosis With Denosumab......Page 452 References......Page 454 Incidence of Cognitive Impairment......Page 456 Self-Reported Cognitive Function......Page 457 Mechanisms of Cognitive Impairment......Page 458 Imaging and Electrophysiologic Studies......Page 459 Hormone Therapy......Page 460 Interventions for Cognitive Impairment After Cancer Treatment......Page 461 References......Page 462 Incidence in Adult Survivors......Page 464 Incidence in Childhood Survivors......Page 465 Influence of Gender at Irradiation......Page 466 Cancer Syndromes......Page 467 Survivorship Clinics......Page 468 References......Page 469 Complementary therapies in supportive oncology......Page 472 Background......Page 473 Background......Page 474 Background......Page 475 Definition......Page 476 References......Page 477 Prognostication Defined......Page 479 Accuracy of CPS......Page 480 Prediction Factors......Page 481 Delirium......Page 482 Palliative Prognostic (PaP) Score......Page 483 Palliative Prognostic Index (PPI)......Page 484 Predictive Model for Outpatient Survival in a Palliative Radiotherapy Clinic......Page 485 Communicating Prognosis......Page 488 References......Page 489 Blaming The Messenger......Page 492 Dealing With Hope......Page 493 Ethics and Medical Politics of Truth Telling......Page 494 Spikes Strategy for Breaking Bad News: “Before you Tell, Ask”......Page 495 References......Page 499 Assessing decision-making capacity......Page 500 Triggers for Assessing Decision-Making Capacity......Page 501 Responsibility for Assessing Decision-Making Capacity......Page 502 Standardized Tools for Assessing Cognitive Function......Page 503 Decision Making for Patients Lacking Decision-Making Capacity......Page 504 References......Page 505 Discussion of treatment options in supportive oncology......Page 507 Steps to Reaching a Treatment Decision in Cancer Care......Page 508 Shared Decision Making......Page 509 The benefits of sharing treatment decisions......Page 510 Information preferences......Page 511 Patient factors......Page 512 Tools to monitor patient involvement......Page 513 Do Cancer Doctors Support an Sdm Approach When Discussing Treatment Options?......Page 514 Question prompt lists......Page 515 Consultation planning/coaching......Page 516 References......Page 517 Advance Directives......Page 520 Overcoming Barriers to the Completion of Advance Directives......Page 521 Code Status......Page 522 Treatment Transitions and Goals of Care......Page 523 Supporting Hope......Page 525 References......Page 526 Spirituality: Definition and Discourse......Page 528 Spiritual Assessment......Page 529 Spiritual Care Interventions......Page 530 Providing Spiritual Care: Individual, Team, and Institutional Implications......Page 531 References......Page 532 Continuum of Distress: From “Normal” to Disorder......Page 533 Panic Disorder and Specific Phobias......Page 534 Trajectory of Distress Response......Page 535 Risk and Resilience Factors......Page 537 Assessment......Page 538 Distress screening......Page 539 Psychological interventions......Page 540 Novel Antidepressants......Page 541 Generalized Anxiety Disorder......Page 542 References......Page 543 Prevalence......Page 546 Clinical Features......Page 547 Subtypes of Delirium......Page 548 Experience of Delirium for Patients, Family Members, Clinicians, and Staff......Page 549 Differential Diagnosis......Page 550 Causes and Reversibility of Delirium......Page 551 Antipsychotic medications......Page 553 Contribution of Delirium to Prognosis......Page 555 Prevention of Delirium......Page 556 References......Page 557 Patient Issues, Concerns, Diagnoses......Page 560 Supportive-expressive group therapy......Page 562 Interpersonal Psychotherapy......Page 563 Psychodynamic Psychotherapy......Page 564 Meaning-Centered Therapy......Page 565 Couples Therapy......Page 566 Collaborative Team Care Models of Support......Page 567 Calm Therapy......Page 568 Effectiveness of Counseling and Applied Psychotherapies in Supportive Care......Page 569 References......Page 570 Prevalence......Page 572 Physical Dependence......Page 573 Aberrant drug-related behaviors in medically ill populations......Page 574 Cancer Pain Patients......Page 575 Assessment......Page 576 Psychotherapeutic Approach......Page 577 References......Page 578 Occupational Stress Among Oncology Health Care Professionals......Page 580 Control......Page 581 Values......Page 582 Moral Distress......Page 583 Compassion Satisfaction......Page 584 Vitality, the Transformative Power of Positive Emotion, and Resilience......Page 585 Religion and Spirituality......Page 587 Interventions to Support Physical, Psychosocial, and Emotional Well-Being in the Professional Caregiver......Page 588 Self-Awareness as a Mechanism for Enhancing Self-Care......Page 589 Conclusion......Page 590 References......Page 591 Sexuality and intimacy after cancer......Page 595 Conceptual Framework for Understanding Sexuality and Intimacy After Cancer......Page 596 Prevalence and Predictors of Sexual Difficulties After Cancer......Page 603 How to Take a Sexual History From Patients and Their Partners......Page 604 Laboratory and Other Testing......Page 606 Interventions to Optimize Emotional and Physical Intimacy......Page 607 Education, Counseling, and Lifestyle Change Interventions......Page 608 Female Cancer Survivors......Page 611 Male Cancer Survivors......Page 612 Male Cancer Survivors......Page 613 Prostaglandin E1 Agonists......Page 614 Investigational medications that show additional promise......Page 615 Genital Surgeries to Improve Sexual Function......Page 616 References......Page 617 For Referral to a Certified Sex Therapist......Page 621 Scope of the Problem......Page 622 Attitudes of Cancer Health Care Providers......Page 623 Chemotherapies......Page 624 Sperm cryopreservation......Page 625 Embryo cryopreservation......Page 626 References......Page 627 Bereavement care......Page 629 Theories of Grief and Bereavement......Page 630 Grief Around the Time of Death......Page 631 Acute Grief Following the Death......Page 632 Prolonged Grief Disorder......Page 633 Sudden Death......Page 634 Supportive counseling......Page 635 Cognitive-behavioral therapy......Page 636 Conclusions......Page 637 References......Page 638 A......Page 640 B......Page 641 C......Page 642 E......Page 646 F......Page 647 H......Page 648 I......Page 649 L......Page 650 M......Page 651 N......Page 652 P......Page 653 R......Page 655 S......Page 656 U......Page 658 X......Page 659 Z......Page 660 Supportive Oncology, by Drs. Davis, Feyer, Ortner, and Zimmermann, is your practical guide to improving your patients quality of life and overall outcomes by integrating palliative care principles into the scope of clinical oncologic practice at all points along their illness trajectories. A multidisciplinary editorial team, representing the dual perspectives of palliative medicine and oncology, offers expert guidance on how to effectively communicate diagnoses and prognoses with cancer patients and their families, set treatment goals, and manage symptoms through pharmacological therapies, as well as non-pharmacological therapies and counselling when appropriate. The complete contents are available on (http://www.expertconsult.com) www.expertconsult.com . Annotation The first reference of its kind, Supportive Oncology, by Drs. Davis, Feyer, Ortner, and Zimmermann, is your practical guide to improving your patients' quality of life and overall outcomes by integrating palliative care principles into the scope of clinical oncologic practice at all points along their illness trajectories. A multidisciplinary editorial team, representing the dual perspectives of palliative medicine and supportive oncology, offers expert guidance on how to effectively communicate diagnoses and prognoses with cancer patients and their families, set treatment goals, and manage symptoms through pharmacological therapies, as well as non-pharmacological therapies and counselling when appropriate. The complete contents are available Supportive Oncology, by Drs. Davis, Feyer, Ortner, and Zimmermann, is your practical guide to improving your patients1 quality of life and overall outcomes by integrating palliative care principles into the scope of clinical oncologic practice at all points along their illness trajectories. A multidisciplinary editorial team, representing the dual perspectives of palliative medicine and oncology, offers expert guidance on how to effectively communicate diagnoses and prognoses with cancer patients and their families, set treatment goals, and manage symptoms through pharmacological therapies, as well as non-pharmacological therapies and counselling when appropriate