Comment: Embracing innovative ways of reaching out
Philip Larkin
pp 109-109
I consider myself to be one of that rare breed of academics/clinicians who have the best of both worlds. Working in a university environment, but with a dedicated clinical commitment each week, enables me to deliver contemporary and clinically-focused teaching and learning for palliative care, and to contribute regularly to the palliative nursing care agenda.
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Metastatic prostate cancer: a review of established treatments and novel agents
Anna Tran, Lyndon Ridges-Jones and Ananya Choudhury
pp 110-113
Prostate cancer is the most common cancer diagnosed in men – accounting for 22.2% of all male cancers in Europe – and the third most common cause of cancer-related death. Since the discovery that metastatic prostate cancer was responsive to androgen deprivation over 60 years ago, little progress had been made in the management
of the disease. However, in the last two decades, this has seemed set to change. This article will review the treatment options and current research in the management of metastatic prostate cancer.
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How to give haematology patients better end-of-life care
Laura Nightingale, Margaret Monsell, Wai Keong Wong and Chi-Chi Cheung
pp 114-117
Haematological malignancies, such as lymphoma, leukaemia and myeloma, form a diverse disease group, varying in symptoms, course and outcome. Each poses unique end-of-life care planning problems. There is anecdotal evidence that patients with haematological malignancies are not receiving appropriate or timely referrals to palliative care, and that there is little integration between haematology and palliative care services.
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Case study masterclass 56: Management of bleeding in a cancer patient with deep venous thrombosis
Ehab Ibrahim and Kim Steel
pp 118-119
Chris, aged 40, is married to Lilly; they have eight-year-old twins. He worked as a carpenter until 2007, when he was diagnosed with adenocarcinoma of the small bowel. Chris was initially managed with bowel resection and adjuvant chemotherapy; however, later on that year, he suffered deep venous thrombosis (DVT) in his left leg. For this, he received anticoagulation treatment for six months. Then, in 2009, he suffered a pulmonary embolism and was placed on lifelong warfarin therapy.
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Case study masterclass 55 answers: A middle-aged man with opioid-induced hyperalgesia
Nicola Loveday
pp 120-120
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Improving access to specialist palliative care through a telephone triage service
Jane Sutherland and Nicola Stananought
pp 122-125
The UK national agenda for modernising healthcare services, and for making high-quality palliative care accessible to all patients with life-limiting illness, brings with it a host of challenges for specialist palliative care providers. The need for services to be equitable, flexible and encompassing the care of patients with nonmalignant conditions is paramount. Expanding services to keep pace with increasing demand when there are limited financial resources is a real challenge, as is providing a range of services that promote patient choice.
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Illness and poetry: find a sharable narrative
Columba Quigley
pp 126-129
Medicine is fundamentally narrative. The stories circulated as a result of illness are not equal, however, and the medical narrative tends to ‘trump’ all other discourses. The ‘case’ –which is, in essence, the patient’s story transformed into a highly conventional medical narrative – tends to be ordered and toneless. The language used reflects the need to objectify the story as much as possible, with narrowly descriptive terms and an absence of metaphor. This ritualised storytelling attempts to depict a clinical picture as dispassionate and emotionally detached as possible.
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Is the experience of cancer-related pain shaped by ethnic or cultural background?
Jonathan Koffman and Cassie Goddard
pp 130-135
Albert Schweitzer is noted to have said, ‘Pain is an even worse master than death’. Indeed, there is a good reason why he would have said this. Pain is the most common and often the most distressing symptom associated with cancer, with a prevalence of over 90% in the more advanced stages of the disease. Although treatments for managing cancer pain have improved dramatically in recent years, some patients still experience severe pain because of poor management, a reluctance to take medication, or the symptom’s refractory nature.
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Contribution of occupational therapy to the palliative care team: results of a pilot project
Nancy Squire
pp 136-139
Despite the higher profile that has been afforded palliative medicine in recent years, difficulties such as failed patient discharges and delayed transfers from the acute setting, and patient/family dissatisfaction regarding decision-making, still arise. Such problems may not be directly attributable to medical decisions, yet their impact on the delivery of a successful palliative care intervention can be considerable. This invites the question, ‘What can be done to minimise these problem areas?’.
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‘Heart art’: bringing hospice art therapy to the public
Linda Miller and Elizabeth Johnston Taylor
pp 140-143
The ‘Heart art’ exhibition was a display of artworks created by hospice patients in a public gallery in New Zealand. This exhibition provided patients attending a hospice day unit with a goal to aim towards, and validated their inner experiences by allowing them to express themselves through art. It also gave the community an opportunity to commemorate life and express grief.
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Building capacity: opportunities for allied health in Australian palliative care
Natasha Atkinson, Mark Mather and Katherine Clark
pp 144-147
Allied health professionals (AHPs) are ‘highly skilled, tertiary trained autonomous professionals’ who, alongside primary clinical carers such as nursing staff, contribute to patient care. In Australia, AHPs most commonly identified as operating within palliative care services include social workers, physiotherapists, occupational therapists, pharmacists, bereavement workers, speech pathologists, dietitians and psychologists.
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European insight: DGP: a new palliative care landscape is emerging in Germany
Friedemann Nauck and Birgit Jaspers
pp 149-151
Two years have passed since the first contribution to the ‘European insight’ section of the European Journal of Palliative Care (EJPC) from the Deutsche Gesellschaft für Palliativmedizin (DGP), the German professional and scientific association for palliative medicine. In those two years, much has changed in Germany regarding both the concept and the provision of care for severely and terminally ill patients. This is reflected by the steady increase of the DGP’s membership, which by March 2011 had gone up again to approximately 3,650 members.
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