This book provides a practical guide to the management of secondary symptoms commonly seen in patients suffering from advanced cancer, AIDS, and other terminal diseases. Drawing on a vast body of knowledge about the causes of specific symptoms and what works best to relieve them, the book issues expert advice on the steps to follow when evaluating patients and finding ways to improve their comfort and quality of life. Emphasis is placed on the need for individual treatment plans that take into account psychological, social, and spiritual aspects as well as physical problems. While many of the approaches described are drug-based, non-drug measures, which are often simple to implement and can provide substantial relief, are also covered in detail.
The book has 15 concise chapters. General principles of patient evaluation and management are outlined in the first, which lists routine questions to be asked when evaluating the nature and severity of a symptom and explains the principles of treatment for both non-drug measures and drug therapies. The remaining chapters, which form the core of the guide, focus on 14 common symptoms, moving from anorexia, anxiety, and asthenia, through constipation, nausea, and vomiting, to skin problems and urinary symptoms. Complaints such as cough and hiccup, which can give rise to considerable discomfort in the terminally ill patient, are also considered. Each symptom is covered according to a common approach, which outlines possible causes, describes the steps to follow during evaluation, and explains how to select and implement the best treatment option. Details range from a five-step plan for the management of uncomplicated constipation, through alerts to cases where inappropriate treatments may be harmful or dangerous, to advice on the types of food that are particularly likely to precipitate nausea. For drug therapies, information includes recommended drugs, doses, and modes of administration, together with advice on special side effects and other problems that may arise in the terminally ill patient.
The book complements information contained in the standard WHO guide Cancer Pain Relief: with a Guide to Opioid Availability which is now in its second edition. Pain management is therefore not covered in the present work.
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