Prognosis in Advanced Cancer

Predicting survival and other outcomes is increasingly being recognized as an important skill for palliative care doctors and nurses, oncologists, and other healthcare professionals who treat patients with advanced cancer. Accurate prognosis is essential if we are to offer quality of care and 'a good death', as well as to aid decision-making. There is much prognostic information available that is scattered throughout the palliative care and oncological literature but this is the first time it has been gathered systematically in one place.

Glare and Christakis, leaders in the field of prognosis, bring together a team of international contributors from across the fields of palliative care and oncology. This comprehensive but practical guide begins with the principles of prognostication, including formulating the prediction and then communicating it. Topics such as statistical issues, evidence-based medicine, and the ethics of prognostication are also covered. The second section addresses prognostication in 15 specific cancer sites once they have reached the advanced stage, following a standard template for consistency and easy access to the key information. The third section deals with prognostication in patients with a variety of common clinical conditions at the end of life, such as bowel obstruction, hypercalcaemia, and brain metastases. In addition, survival curves are provided within each chapter, palliative care conditions are examined for the first time, and a summary table of long and short term prognosis ensures this book remains practical.

Predicting survival and other outcomes is increasingly being recognized as an important skill for palliative care doctors and nurses, oncologists, and other healthcare professionals who treat patients with advanced cancer. Accurate prognosis is essential if we are to offer quality of care and 'a good death', as well as to aid decision-making. There is much prognostic information available that is scattered throughout the palliative care and oncological literature but this is the first time it has been gathered systematically in one place.

Glare and Christakis, leaders in the field of prognosis, bring together a team of international contributors from across the fields of palliative care and oncology. This comprehensive but practical guide begins with the principles of prognostication, including formulating the prediction and then communicating it. Topics such as statistical issues, evidence-based medicine, and the ethics of prognostication are also covered. The second section addresses prognostication in 15 specific cancer sites once they have reached the advanced stage, following a standard template for consistency and easy access to the key information. The third section deals with prognostication in patients with a variety of common clinical conditions at the end of life, such as bowel obstruction, hypercalcaemia, and brain metastases. In addition, survival curves are provided within each chapter, palliative care conditions are examined for the first time, and a summary table of long and short term prognosis ensures this book remains practical.

Doody Review Services

Reviewer:Marlene S. Foreman, BSN, MN(Hospice of Acadiana, Inc.)
Description:This is a very informative and necessary book for physicians working with patients at all stages of cancer. It begins with historical information and continues with chapters on specific cancers.
Purpose:The aim of the book is to improve physician skills in prognostication near the end of life in patients with advanced cancer. Accurate prognosis would assist patients and families in making legal, ethical, and medical decisions.
Audience:The book is primarily for practicing physicians in a variety of specialties including palliative care and hospice. Oncologists, internists, and family physicians also would be able to use this book. In addition, advanced practice nurses, researchers, and other medical personnel may find value. This edited book is written by a large group of qualified authors, which provides a broad perspective.
Features:Part I covers the early history of medical prognosis and moves to the present in a very interesting manner. It includes legal and ethical challenges to accurate prognosis and the effects on the patient and family. Chapters in part II are devoted to specific common cancers and prognoses based on the literature and evidence-based medicine. Part III focuses on prognostication in palliative care, describing metastatic difficulties, and pain and symptomatology suffered by patients that impact prognosis. It is very difficult to find one specific "best" in this book. As a clinical nurse specialist, I was fascinated and read the entire book cover to cover. A number of very obvious typographical errors should have been resolved before publication, but it was not difficult to determine what the word should have been.
Assessment:Overall, the quality of this book is outstanding. It is an informative and very necessary book for physicians and other medical personnel.

Dr. Paul Glare has been a Fellow of the Royal Australian College of Physicians since 1990, a Fellow of the Chapter of Palliative Medicine since it was created in 2000 and is a Fellow of the Faculty of Pain Medicine. As well as maintaining a full clinical load, he is an active teacher and researcher. His principal research interests are prognostication and the anorexia cachexia syndrome. He was the inaugural Research Fellow in the Palliative Care Program at the Cleveland Clinic Foundation, Ohio USA, from 1989 until 1991. For more than 15 years he has taken a leadership role in the development of the specialty of palliative medicine, both locally and internationally, and is currently managing major initiatives in palliative care education and service delivery for the New South Wales Department of Health. Nicholas Christakis is an internist and social scientist who conducts research on social factors that affect health, health care, and longevity. His clinical work is in the field of palliative medicine. Dr. Christakis's past research has examined the accuracy and role of prognosis in medicine, ways of improving end of life care, and the determinants and outcomes of hospice use. He is currently concerned with health and social networks, and specifically with how ill health disability, health behavior, health care, and death in one person can influence the same phenomena in others in a person's social network, including issues related to caregiver burden. Dr. Christakis was the recipient of the Distinguished Researcher Award, National National Hospice and Palliative Care Organization, awarded for an "outstanding body of work contributing to the enhancement of hospice and palliative care" in 2006.