Radiation Oncology in Palliative Cancer Care

Radiation Oncology in Palliative Cancer Care represents the first dedicated attempt in book form to address the glaring absence of a well-written palliative radiation therapy reference and textbook that provides a template for the end-of-life care of patients who require intervention by Radiation Oncologists as well as Hospice and Palliative Medicine Professionals working together. Palliative radiotherapy will gain increasing importance in the provision of end-of-life care for cancer patients in the coming years, and there is an immediate need for an instructive reference and textbook to guide this growth.

Even in developed countries such as the United States, the United Kingdom, and Canada, palliative care professionals believe that radiation therapy is important for their common cancer patients. Yet while they do have ready access to radiation oncology specialists and facilities, only about half of them feel sufficiently trained to identify situations where palliative radiotherapy might be most useful.   The initial five chapters of the book provide readers unfamiliar with the specifics of Radiation Oncology a framework from which they can gain the most clinical knowledge out of the ensuing treatment-oriented chapters. Meanwhile, most radiation oncologists engaged in the palliative use of radiotherapy are not fully trained and up to date in overall principles and techniques of palliation and symptom control. Five chapters in this book deal with these issues and serve to augment the radiation oncologist’s education in a way that helps to make up for any absence of the provision of this knowledge in their training programs.

The book also addresses the challenges of providing proper palliative radiotherapy care in developing countries, where the problems are different and can be even more difficult to surmount.  Economically disadvantaged countries lack the resources to provide a sufficient number radiotherapy centers to serve their populations, with technological advances placing the newest generations of treatment machines further from the reach of disadvantaged locales.  Even in countries with a reasonable number of facilities, the travel burdens placed upon patients who need to be evaluated and treated by doctors in these centers may be prohibitive. 

Contributors

Foreword

Part 1 General principles of radiation oncology

A Brief History of Palliative Radiation Oncology
Joshua Jones

The Radiobiology of Palliative Radiation Oncology 
Candice Johnstone

The Physics of Palliative Radiation Oncology 
Shaun Baggarley & Jiade Lu

Curative Intent versus Purely Palliative Intent Radiation Oncology 
Vassilios Vassiliou & Haris Charalambous

Side Effects of Palliative Radiation Oncology 
Alysa Fairchild

Part 2 General principles of palliation and symptom control

6 A History of Hospice and Palliative Medicine 
Michelle Winslow & Marcia Meldrum

7 The Current Status of Hospice  
Charles F. von Gunten, Frank D. Ferris, & A.J. Mundt

8 The Current Status of Palliative Care 
Tom Smith & Susannah Yovino

9 Pain Management  
Erin McMenamin

10 Palliative Care in Low and Middle Income Countries: A Focus on Sub-Saharan Africa
Henry Ddungu & Elizabeth Barnes

Part 3 Locally advanced or locally recurrent diseases

11 Primary Tumors of the Central Nervous System 
Caroline Chung & Eric Chang

12 Head & Neck Cancer 
Albert Tiong & June Corry

13 Breast Cancer 
Ian Kunkler

14 Lung Cancer  
George Rodrigues & Benjamin Movsas

15 Gastrointestinal and Colorectal Cancer 
Rob Glynne-Jones & Mark Harrison

16 Genitourinary Malignancies  
Gillian Duchesne

17 Gynecologic Cancer
Firuza Patel
 
18 Hematologic Malignancies 
David Howell

19 Pediatric Cancers  
Tamara Vern-Gross

Part 4 Metastatic Disease

20 Metastatic Bone Disease 
Yvette van der Linden & Dirk Rades

21 Spinal Cord Compression  
Ernesto Maranzano & Fabio Trippa

22 Brain metastases  
May Tsao

23 Liver Metastases
Sean Bydder

24 Malignant Neuropathic Pain, Adrenal, Choroidal and Skin Metastases
Daniel E Roos & Aaron H. Wolfson

Part 5 Integration of Radiation Oncology and Palliative Care

25 Design Challenges in Palliative Radiotherapy Clinical Trials 
Deb Watkins Bruner & Lawrence Berk

26 Radiation Oncology Cost Effectiveness 
Andre Konski

27 Quality measures of palliative radiotherapy  
James Hayman, Rinaa Punglia & Anushree M. Vichare

28 Technologically Advanced Palliative Radiation Oncology 
Simon Lo, Bin S. Teh, Samuel T. Chao, Arjun Sahgal, Nina A. Mayr & Eric L. Chang