CANCER IN CONTEXT : A Practical Guide to Supportive Care
James Brennan in collaboration with Clare Moynihan
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Oxford University Press 2004
424pp
ISBN 0-19-851525-1
RRP £29.95 $US52.50
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Health care professionals who work in both palliative care and medical oncology have long advocated the need for the principles of palliative care, with its multiprofessional holistic approach to all aspects of physical and psychosocial suffering, to be applied earlier in the course of the cancer illness and not reserved until the patient has advanced or terminal disease. The UK is now leading the way, introducing such care under the banner ‘Supportive Care’.
In the introduction, this book is described as ‘a guide for health care staff who support patients and their families through the many changes and challenges that cancer entails.’ ‘[It] is about the impact of cancer on people’s lives and the vital role that health care professionals play in shaping this experience and minimizing the distress involved.’
The approach used differs from traditional psycho-oncology, with its preoccupation with quantifying psychological and psychiatric morbidity, and underlines the need to understand people’s distress in the context of their personal, social and spiritual life. Various chapters describe the management of suffering in human context, in the personal context, in the context of the patient’s family and carers, in the social context, and in clinical context. The last two chapters deal with communication and with the care of the professional caregivers.
And in case you think this is all just more psychobabble, the authors note that ‘Psychosocial experts on their own have very little effect on the distress of cancer; it is the caring hands and the listening ears of doctors, nurses and radiographers that will always have the greatest impact on how people regard their illness.’ As one who works in both medical oncology and palliative care, the type of care outlined in this book is long overdue and, if it can be successfully introduced into busy oncology services, will be a quantum improvement in the care out patients receive.
Roger Woodruff,
Director of Palliative Care, Austin Health, Melbourne , Australia
March 2005
Author Information
James Brennan is Consultant Clinical Psychologist, Bristol Haematology and Oncology Centre, and Senior Lecturuer in Palliative Medicine, University of Bristol, UK
Clare Moynihan is Senior Research Fellow at the Institute of Cancer Research and the Royal Marsden Hospital Trust, London, UK
Table of Contents
Introduction
Part 1: Human context . Human nature; The catastrophe of cancer; What helps people with cancer?; Quality of life
Part 2: Personal context. Changed lives; Expectation about illness; Shock of diagnosis; Denial and avoidance; Delays to diagnosis; "Why me?" - the meaning of cancer; Coping with treatment; Relationship with healthcare team; Practical concerns; Relationship with family and friends; Impact on self; Hope; The body; Existential beliefs; Ending treatment; Living with uncertainty.
Part 3: Other people . What is social support and why is it important?; Family context; Partner relationship; Caring.
Part 4: Social context. Background and introduction; Social class; Gender; Homeless people; Defining 'homelessness'; Ethnicity; Defining 'race', 'culture', and 'ethnicity'; Ethnicity and giving support: communication, advocacy, and interpreters; An interpreter; An advocate; Refugees and asylum seekers.
Part 5: Clinical context. General practice; Diagnosis; Surgery; Radiotherapy; Chemotherapy and hormone therapy; Common treatment difficulties; Rehabilitation; Recurrence; Palliative care; Bereavement care.
Part 6: Communication. Communication and ethics; Information; Staff-patient relationship; Patient-centred communication; Eliciting concerns; Specific communication issues; Professional issues in communication.
Part 7: Professional context . Part 1; Stress and burnout in healthcare professionals; Cancer professionals; Preventing burnout and reducing stress; Part 2; User-involvement; Voluntary support; Complementary therapy and alternative medicine.
