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Patients with advanced cancer may develop a number of clinical complications related to tumor progression or a variety of aggressive treatments. The majority of these patients are elderly, often with multiple co-morbidities that require appropriate assessment and management. In the palliative stage of their disease, patients undergo a progressive transition from active acute care to community-based hospice care. This transition requires modification in the diagnostic tests, monitoring procedures and pharmacological treatments to adjust them to the palliative and short-term nature of the care. Internal Medicine Issues in Palliative Cancer Care looks at internal medicine through a prognosis-based framework and provides a practical approach to maximizing comfort and quality of life while minimizing aggressive investigations and therapies for patients with life-limiting disease. Forty-six common internal medicine conditions are organized into nine clinical categories: pulmonary, cardiovascular, nephrologic and metabolic, gastrointestinal, hematologic, infectious, endocrine, rheumatologic, and neuro-psychiatric. This evidence-based resource is ideal for educating clinicians delivering palliative care to cancer patients in acute care facilities about complex internal medicine problems, decision-making regarding diagnostics and therapeutics which require a good understanding of state-of-the-art internal medicine and palliative care principles.
List of contents
- 1. Introduction
- 1.1. Principles of Internal Medicine in Palliative Care
- 1.2. Principles of Prognostication
- 1.3. Principles of advance care planning
- 2. Pulmonary
- 2.1. Chronic Obstructive Pulmonary Disease
- 2.2. Pleural Effusion
- 2.3. Pulmonary Embolism
- 2.4. Non-invasive ventilation
- 3. Cardiovascular
- 3.1. Heart Failure
- 3.2. Acute Coronary Syndrome
- 3.3. Pericardial Effusion and Tamponade
- 3.4. Arrhythmias
- 3.5. Arterial Hypertension
- 3.6. Dyslipidemia
- 4. Nephrology and Metabolic Abnormalities
- 4.1. Chronic Kidney Disease and Acute Kidney Injury
- 4.2. Urinary Incontinence
- 4.3. Urinary Retention
- 4.4. Hematuria
- 4.5. Metabolic acidosis
- 4.6. Electrolyte abnormalities (Na, K, Mg)
- 4.7. Hypercalcemia
- 5. Gastrointestinal
- 5.1. Upper and Lower Gastrointestinal Bleeding
- 5.2. Acute and Chronic Diarrhea
- 5.3. Bowel Obstruction
- 5.4. Liver Failure and Hepatitis
- 5.5. Biliary Obstruction
- 5.6. Pancreatitis
- 6. Hematological Disorders
- 6.1. Anemia
- 6.2. Neutropenia
- 6.3. Thrombocytopenia
- 6.4. Bleeding Disorders
- 6.5. Deep Vein Thrombosis
- 7. Infections
- 7.1. Sepsis
- 7.2. Pneumonia
- 7.3. Urinary Tract Infections
- 7.4. Osteomyelitis
- 7.5. Skin Infections
- 7.6. Herpes Infections
- 7.7. Fungal Infections
- 8. Endocrine
- 8.1. Diabetes
- 8.2. Hyperthyroidism
- 8.3. Hypothyroidism
- 9. Rheumatology
- 9.1. Arthritis
- 10. Neuro-psychiatric
- 10.1. Acute Stroke Syndrome
- 10.2. Seizures
- 10.3. Syncope
- 10.4. Migraines
- 10.5. Dementia
- 10.6. Vitamin B12 deficiency
- 10.7. Parkinson's Disease
About the author
DH: Assistant Professor, Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center; EB: Professor of Medicine, Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center
Summary
Patients with advanced cancer may develop a number of clinical complications related to tumor progression or a variety of aggressive treatments. The majority of these patients are elderly, often with multiple co-morbidities that require appropriate assessment and management. In the palliative stage of their disease, patients undergo a progressive transition from active acute care to community-based hospice care. This transition requires modification in the diagnostic tests, monitoring procedures and pharmacological treatments to adjust them to the palliative and short-term nature of the care. Internal Medicine Issues in Palliative Cancer Care looks at internal medicine through a prognosis-based framework and provides a practical approach to maximizing comfort and quality of life while minimizing aggressive investigations and therapies for patients with life-limiting disease. Forty-six common internal medicine conditions are organized into nine clinical categories: pulmonary, cardiovascular, nephrologic and metabolic, gastrointestinal, hematologic, infectious, endocrine, rheumatologic, and neuro-psychiatric. This evidence-based resource is ideal for educating clinicians delivering palliative care to cancer patients in acute care facilities about complex internal medicine problems, decision-making regarding diagnostics and therapeutics which require a good understanding of state-of-the-art internal medicine and palliative care principles.
Additional text
This is a useful new reference book for the complex, and increasingly common area of managing medical complications and co-morbidities in palliative cancer care
