Surgical Palliative Care

Geoffrey P Dunn, Attending Surgeon, Department of Surgery, Hamot Medical Center and Medical Director, Great Lakes Hospice, Erie, Pennsylvania, USA, Alan Johnson, Emeritus Professor of Surgery, University of Sheffield, UK - Makes suggestions to surgeons about how to incorporate palliative care principles into surgical practice - Shows palliative care clinicians how surgery can be used for effective palliation - Describes the unique metabolic problems encountered as a result of the surgical management of palliative patients - High profile Editors with an international team of contributors This book describes the principles and practice of surgery in the context of palliative and supportive care. Surgery is often considered too invasive to be useful in palliation and clinicians instinctively turn to radiotherapy, chemotherapy and other drugs. Surgery, with increasingly minimal access techniques, may be simpler and less invasive than other treatments and produces excellent palliation. Indeed, most types of surgery are not curative and the aim of this book is to alert all concerned with palliative care to the usefulness and appropriateness of a surgical option. The book is made up of two sections. The first deals with general issues, varying from quality of life measurement to spirituality, and the second section illustrates their application in different specialties of surgery ranging from neurosurgery to urology. The book ends with a challenge to surgeons to change their perspective from curative surgery, in terms of simply cure or failure, to improvement in quality of life and relief of symptoms. Palliative medicine and pain consultants need to know more about surgery and surgeons need to know more about palliative care: this volume addresses both these needs. ABOUT THE SERIES: Supportive care is the multidisciplinary holistic care of patients and their families from the time around diagnosis, through treatments aimed at cure or prolonging life, and into the phase currently acknowledged as palliative care. It involves recognising and caring for the side-effects of active therapies as well as patients' co-morbidities, psychological, social and spiritual concerns. It also values the role of family carers and helps them in supporting the patient, as well as attending to their special needs. Unlike traditional palliative care, which grew from terminal care of cancer patients, supportive care is not restricted to dying patients and neither to cancer. Thus this series covers the support of patients with a variety of long-term conditions, who are currently largely managed by specialist medical teams in hospital and by primary care teams in community settings. Each volume therefore provides practical guidance on the supportive care of patients at all stages of the illness. Contents Part 1 1 G P Dunn: Introduction - is surgical palliative care a paradox? 2 A Easson & A Ng: Selection and preparation of patients for surgical palliation 3 P Angelos: The ethics of interventional care 4 M D Barber & K C H Fearon: The physiological response to surgical trauma 5 L Stevens: The psychological response to surgery 6 P Ravenscroft & E Ravenscroft: Spirituality & surgery 7 A Mosenthal, D Price & P Murphy: Interdisciplinary care 8 Koller, Nies & Lorenz: Quality of life issues in palliative surgery 9 K H Simpson & D J Bush: Anaesthesia and peri-operative pain management Part 2 10 S Rogers: Symptom palliation of diseases of the head and neck (including dentistry) 11 B Nelems: The surgical relief of the symptomatic chest 12 A Johnson: Surgery for the control of symptoms in the abdomen 13 A P Doherty & J M O'Sullivan: Symptom control in urological malignancy 14 T J Krizek: Wound and reconstructive problems in advanced disease 15 D L Johnson: Neurosurgical palliation 16 D Yorsten: The role of the ophthalmologist in advanced disease 17 R Aluwihare: Perspectives from the developing world and diverse societies 18 G P Dunn & A Johnson: Epilogue: a message to all surgeons