PRIMARY AND METASTATIC BRAIN TUMOURS
Sara Booth and Eduardo Bruera (Eds)
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Oxford University Press, 2004
166 pp
ISBN 0-19-852807-8
RRP £29.95, $US 49.95
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This is the latest addition to Oxford’s Palliative Care Consultations series. The first two chapters provide concise descriptions of the oncological management of primary and metastatic brain
tumours; in contrast to some oncology texts, the discussion does not stop when the patient’s disease relapses. There is a useful chapter on the pitfalls of anticonvulsant therapy in patients
with intracranial malignancy.
Three chapters in the middle of the book, which deal with the non-oncological management, are particularly good. The first deals with the neuropsychological complications
of the disease and therapies, including behavioural changes. The next discusses all aspects of family care. The third describes the management of the communication and swallowing problems suffered
by these patients.
I was troubled by the discussions of how and when corticosteroids should be withdrawn from patients who become unconscious and cannot swallow. In one chapter, the
ethical issues are briefly discussed; in another it is stated that corticosteroids can be stopped without weaning the dose; and in a third, the acute withdrawal of steroids is described as ‘a
therapeutic strategy’ with an expected outcome of rapid deterioration that is, of course, undertaken only with the full understanding of the family. Is this not another opportunity for advance
care planning with the patient and family? Recent Papal edicts aside, I thought this clinical problem probably deserved its own small chapter.
This is a useful and up to date synopsis of the interface between neuro-oncology and palliative care. It will be a useful addition to the library shelf of any palliative
care service.
Roger Woodruff
Director of Palliative Care, Austin Health, Melbourne, Australia
August 2004
Author Information
Sara Booth is Macmillan Consultant in Palliative Medicine, Addenbrooke’s Palliative Care Service, Cambridge, UK
Eduardo Bruera is Professor and Chair, Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas,
USA
Table of Contents
1. Management of primary brain tumours
2. Management of patients with brain metastasis
3. The prevention and treatment of seizures in intracranial malignancy
4. The palliative management of raised intracranial pressure
5. Neuropsychological complications in patients with brain tumours
6. Family care whilst the patient is attending the oncology centre
7. Acquired communication & swallowing difficulties in patients with primary brain tumours
8. Nutritional problems in patients with primary cerebral malignancies
9. The last days of life
Index
