The symposium on supportive care in cancer patients, which took place in St. Gallen, Switzerland, on February 18-21, 1987, wel comed renowned experts in the field and more than 600 partici pants from 25 countries with the aim of stimulating discussion on how to improve our professional skills and personal attitudes to ward cancer patients in all stages of their disease. Why did we or ganize such a symposium on supportive care in cancer patients? Recent decades have witnessed remarkable success in cancer treat ment, and we have learned how to cure a finite number of neoplas tic diseases. Some malignant tumors that previously entailed high fatality rates, such as leukemias, lymphomas, and testicular can cers, can now be cured, even when at an advanced stage. Yet it seems to many that our struggle to improve results and to fight death from cancer has also imposed greater toxicity on patients. Conventional scientifically based oncology has only recently made adequate efforts to improve the subjective quality of life of cancer patients, for example through prophylaxis against emesis, nausea, and scalp hypothermia, pain control and the development of psy chosocial support structures. The search for less toxic and yet equally effective treatment measures has not been one of our pri mary goals in the past. Supportive care has always been part of nurses' professional aim, even though many have not known how best to offer it.

Klappentext

This volume challenges physicians, nurses and social workers to deliver optimal supportive therapy and care to cancer patients in all stages and forms of their manifold neoplastic diseases. Too often, supportive measures such as pain control and psychosocial support are regarded as aspects of "terminal care" of cancer patients or approached in a suboptimal, isolated fashion by various monodisciplinary specialists. General and holistic supportive care, however, which integrates the professional skills of many disciplines is needed right from the beginning of cancer diagnosis. Medical, nursing, social and psychological care should be adapted subsequently as required to the various stages of the illness. Only through this interdisciplinary approach will the patient feel truly supported during his crucial fight with cancer. The chapters of the volume deal with all important aspects of supportive care: pain control, control of bleeding and infection, psychosocial support, nursing support, side effects of cancer therapy, quality of life, education about cancer, as well as supportive care for children with cancer and families affected by neoplastic diseases.

Inhalt
Management of Cancer Pain.- Differential Diagnosis of Pain in Cancer Patients.- Optimal Pharmacological Control of Chronic Cancer Pain.- Epidural Opiates and Nerve Blocks.- Electrostimulation and Neurosurgical Measures in Cancer Pain.- Treatment of Pain in the Cancer Patient: The Role of the Nurse.- Management of Bleeding and Infection.- Coagulation Disorders Associated with Neoplastic Disease.- Hematological Support in Patients Undergoing Allogenetic Bone Marrow Transplantation.- Empirical Antimicrobial Therapy for Febrile Granulocytopenic Cancer Patients: Lessons from Four EORTC Trials.- Managing, Fungal and Viral Infection in the Immunocompromised Host.- Aspects of Infections in Children with Cancer.- Selective Decontamination of the Digestive Tract and Fungal Infection in Acute Leukemia Patients.- Management of Treatment Side-Effects.- Controlling Emesis in Patients Receiving Cancer Chemotherapy.- Corticosteroids as Antiemetics.- Hypnotherapy as Antiemetic Treatment in Cancer Chemotherapy.- Fighting Alopecia in Cancer Chemotherapy.- Managing Side-Effects in Radiotherapy with Regard to the Gastrointestinal Tract.- Palliative Surgery in Cancer Patients.- Principles and Potential of Palliative Surgery in Patients with Advanced Cancer.- Palliative and Supportive Surgery for Gastrointestinal Cancer.- Surgical Supportive Care in Pediatric Oncology.- Prognostic Significance of Nutritional Status in Cancer Surgery.- Surgical Management of Tumor-Related Limb Fractures.- Surgical Management of Tumor-Related Spinal Instability.- Cancer and Nutrition.- Indications for and Results of Nutritional Therapy in Cancer Patients.- Parenteral Nutrition in Tumor Patients.- Nutritional Management of the Ambulatory Patient.- Nutritional Management of the Childhood Cancer Patient.- Malnutrition and the Role of Nutritional Support for Radiation Therapy Patients.- Vitamins and Cancer.- Unproven Dietary Methods of Treatment of Oncology Patients.- Psychosocial Care in Cancer Patients.- Liaison Psychiatry on an Oncology Ward.- Psychological Issues in Patients with Hematological Malignancies.- Psychotherapy in Support of Patients Undergoing Antineoplastic Chemotherapy.- Psychotherapy in Patients Cured of Gynecological Cancers.- Music Therapy in Support of Cancer Patients.- Psychosocial Support of Cancer Patients: A Training Program for Oncology Staff.- Cancer in Children and Families.- Supportive Care in Pediatric Oncology.- Cancer: A Family Disruption.- Quality of Life/Education About Cancer.- Psychological and Social Support of Cancer Patients: Report on a Program of the Radiotherapy Department, Erlangen.- Quality of Life for Patients Receiving Chemotherapy and Hormonal Therapy.- Public Information and Professional Education About Cancer.- The Role of Traditional Chinese Medicine in Supportive Care of Cancer Patients.