Comprehensive Guide to Supportive and Palliative Care for Patients with Cancer

629 Pages·2022·8.221 MB·English

by  Janet L. Abrahm (editor), Bethany-Rose Daubman (editor), Molly Collins (editor)

Comprehensive Guide to Supportive and
Palliative Care for Patients with Cancer
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Comprehensive Guide
to Supportive and
Palliative Care for
Patients with Cancer
4th Edition
Janet L. Abrahm, MD
With Molly E. Collins, MD, and Bethany-Rose Daubman, MD
For Stacie
Drug dosage: The author and publisher have made reasonable efforts to determine that the selec­
tion and dosage of drugs discussed in this text conform to the practices of the general medical
community. The medications described do not necessarily have specific approval by the US Food
and Drug Administration for use in the diseases and dosages for which they are recommended. In
view of ongoing research, changes in governmental regulations, and the constant flow of informa­
tion relating to drug therapy and drug reactions, the reader is urged to check the package insert
of each drug for any change in indications and dosage and for warnings and precautions. This is
particularly important when the recommended agent is a new and/or infrequently used drug.
© 2000, 2005, 2014, 2022 Johns Hopkins University Press
All rights reserved. Published 2022
Printed in the United States of America on acid­free paper
9 8 7 6 5 4 3 2 1
Previous editions of this work were published as A Physician’s Guide to Pain
and Symptom Management in Cancer Patients, by Janet L. Abrahm, MD.
Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryland 21218­4363
www.press.jhu.edu
Library of Congress Cataloging­in­Publication Data
Names: Abrahm, J. (Janet), author. | Collins, Molly, 1980– author. | Daubman, Bethany­Rose,
1985– author.
Title: Comprehensive guide to supportive and palliative care for patients with cancer /
Janet L. Abrahm, MD ; with Molly E. Collins, MD, Bethany­Rose Daubman, MD.
Other titles: Physician’s guide to pain and symptom management in cancer patients
Description: Fourth edition. | Baltimore : Johns Hopkins University Press,
2022. | A physician’s guide to pain and symptom management in cancer patients /
Janet L. Abrahm ; with Amanda Moment and Arden O’Donnell. | Includes bibliographical
references and index.
Identifiers: LCCN 2021036802 | ISBN 9781421443980 (hardcover) | ISBN 9781421443904 (ebook)
Subjects: LCSH: Cancer—Palliative treatment. | Pain—Treatment.
Classification: LCC RC271.P33 A27 2022 | DDC 616.99/406—dc23
LC record available at https://lccn.loc.gov/2021036802
A catalog record for this book is available from the British Library.
The enhancements and full bibliography can be found at www.press.jhu.edu.
Special discounts are available for bulk purchases of this book. For more information, please contact
Special Sales at [email protected].
Contents
List of Figures and Tables vii
List of Contributors ix
Acknowledgments xi
Introduction 1
PART I. A TEAM APPROACH
CHAPTER 1. Early Days
with Molly E. Collins, MD 17
CHAPTER 2. Working with Patients’ Families
with Arden O’Donnell, MPH, MSW, LICSW, APHSW-C 76
CHAPTER 3. Spiritual Care in Palliative Care
with Rev. Katie Pakos Rimer, MDiv, EdD, BCC 109
CHAPTER 4. Sexuality, Intimacy, and Cancer
with Amanda Moment, MSW, LICSW 131
CHAPTER 5. Advancing Disease
with Molly E. Collins, MD 166
PART II. PAIN CONTROL, SYMPTOM MANAGEMENT,
AND PSYCHOLOGICAL CONSIDERATIONS
CHAPTER 6. Assessing the Patient in Pain 201
CHAPTER 7. Pharmacologic Management of Cancer Pain 230
CHAPTER 8. Nonpharmacologic Strategies in Palliative Care 366
CHAPTER 9. Psychological Considerations
with Hermioni L. Amonoo, MD, MPP 397
CHAPTER 10. Managing Other Distressing Problems 434
PART III. END OF LIFE AND BEREAVEMENT
CHAPTER 11. Approaching the End: Concerns of Patients and
Their Families at the End of Life 495
CHAPTER 12. The Last Days 531
CHAPTER 13. Bereavement
with Bethany-Rose Daubman, MD 562
Appendix. Wisconsin Brief Pain Inventory 587
List of Enhancements 589
Index 591
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Figures and Tables
FIGURES
1.1 Serious Illness Conversation Guide 43
1.2 Sample POLST Form 59
2.1 Sample Genogram 83
2.2 Cohesion 88
2.3 Flexibility 90
3.1 Belief in God by Race/Ethnicity 112
3.2 Importance of Religion in One’s Life 112
5.1 Trajectories of Functional Decline to Death 179
6.1 Memorial Sloan­Kettering Vital Sign Sheet Incorporating
a Pain Documentation Form 210
6.2 Pain Assessment in Advanced Dementia (PAINAD) Scale 212
6.3 From the Wisconsin Brief Pain Inventory 213
6.4 Pain Diary 215
6.5 Miss Alexander’s Pain Pattern 216
6.6 Effects of Pain on Dimensions of the Quality of Life 226
7.1 The Opioid Risk Tool 240
7.2 Analgesic Ladder 252
7.3 Duragesic Patch 255
11.1 Serious Illness Conversation Guide 504
11.2 Elements of a Comprehensive Palliative Care Program 516
11.3 Concomitant Disease­Modifying Treatment and Palliative Care 517
11.4 Functions of Palliative Care versus Hospice Programs 517
12.1 Patient Evaluation and Management Preceding Consideration
of Palliative Sedation 555
13.1 What to Expect—for the Bereaved 568
13.2 Letters to the Bereaved 572
13.3 Bereavement Risk Assessment Tool 575
TABLES
4.1 Changes That Affect Sexuality and Intimacy 160
4.2 PLISSIT Model for Addressing Sexuality and Intimacy with Patients 161
vii
viii FIGURES AND TABLES
4.3 BETTER Model for Discussing Sexuality and Intimacy with Patients 162
4.4 Sexuality Assessment Tools and Surveys 162
4.5 Suggestions to Address Sexual Concerns 163
7.1 Nonsteroidal Anti­inflammatory Drugs (NSAIDs) 356
7.2 Commonly Used Step 2 Opioids: Preparations Available 357
7.3 Commonly Used Step 3 Opioids: Preparations Available 358
7.4 Commonly Used Opioids: Equianalgesic Doses 359
7.5 Laxatives to Prevent and Treat Opioid­Induced Constipation 360
7.6 Antiemetics 361
7.7 Psychostimulants 361
7.8 Adjuvants for Neuropathic Pain 362
7.9 Adjuvants for Bone Pain 363
7.10 Topical and Oral Anesthetics 364
7.11 Pain Behaviors in Elderly Patients Who Are Cognitively Impaired 364
7.12 Agents to Be Used with Caution / Avoided in Renal Failure 365
7.13 Agents to Be Used with Caution / Avoided in Hepatic Failure 365
9.1 Pharmacologic Treatment of Anxiety and Depression 413
9.2 Treatment of Delirium 431
10.1 Oral Care 488
10.2 Pharmacologic Treatment of Nausea and Vomiting 489
10.3 Pharmacologic Treatment of Dyspnea, Cough, and Hiccups 490
10.4 Immunotherapy Toxicities 491
10.5 Pharmacologic Treatment of Insomnia 491
10.6 Treatment of Weakness and Fatigue 492
11.1 Tasks of the Dying 498
11.2 Levels of Clinical Care Provided by Hospice Programs 507
12.1 Treatment of Common Problems in the Final Days 545
Contributors
Janet L. Abrahm, MD
Professor of Medicine, Harvard Medical School
Hermioni L. Amonoo, MD, MPP
Assistant Professor, Psychiatry, Harvard Medical School
Molly E. Collins, MD
Associate Professor, Fox Chase Cancer Center / Lewis Katz School of Medicine
at Temple University
Bethany-Rose Daubman, MD
Assistant Professor of Medicine, Harvard Medical School
Amanda Moment, MSW, LICSW
Clinical Social Worker, Intensive Palliative Care Unit, Brigham and Women’s
Hospital
Arden O’Donnell, MPH, MSW, LICSW, APHSW-C
Adjunct Assistant Professor, Smith College School for Social Work
Rev. Kathleen (Katie) Pakos Rimer, MDiv, EdD, BCC
Palliative Care Chaplain, Boston; and Former Director, Spiritual Care and
Education, Beth Israel Deaconess Medical Center of Harvard Medical School
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