Skip to main content
SpringerLink
Log in

The research palliative care unit

  • Chapter
Palliative Care and Rehabilitation of Cancer Patients

Part of the book series: Cancer Treatment and Research ((CTAR,volume 100))

Abstract

Approximately 50% of cancer patients die of their illness, and the overall incidence of cancer is increasing both in developed and in developing countries [1,2]. In addition, AIDS is a major cause of death among younger individuals [3].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. World Health Organization. 1990. Cancer pain relief and palliative care. Report of a WHO Expert Committee. Geneva: World Health Organization.

    Google Scholar 

  2. Scott J, and the Committee. 1991 Canada Cancer 2000: report by the expert panel on Palliative Care. Canadian Cancer Society.

    Google Scholar 

  3. Centers for Disease Control. 1990. Estimates of HIV prevalence and projected AIDS cases. MMWR 39:110.

    Google Scholar 

  4. Connors AF, Dawson NV, Desbiens NA, et al. 1995. A conrolled trial to improve care for seriously ill hospitalized patients. JAMA 274(20):1591–1598.

    Article  Google Scholar 

  5. Rogers EM (ed). 1983. Diffusion of Innovations, 3rd ed. New York: New York Free Press, Collier Macmillan.

    Google Scholar 

  6. Miller RD (ed). 1994. Anesthesia, 4th ed., vol. 2. New York: Churchill Livingstone.

    Google Scholar 

  7. Rippe JM, Irwin RS, Alpert JS, Fink MP (eds). 1991 Intensive Care Medicine, 2nd ed. Boston: Little, Brown.

    Google Scholar 

  8. Tintinalli JE (ed). 1992. Emergency Medicine, A Comprehensive Study Guide. American College of Emergency Physicians. New York: McGraw-Hill.

    Google Scholar 

  9. Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, et al. 1994. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med 331(22): 1528.

    Google Scholar 

  10. Twycross RG, Fairfield S. 1982. Pain in far advanced cancer. Pain 14:303.

    Article  PubMed  CAS  Google Scholar 

  11. Portenoy RK, Kanner RM. 1985. Patterns of analgesic prescription and consumption in a university-affiliated community hospital. Arch Intern Med 145:439.

    Article  PubMed  CAS  Google Scholar 

  12. Twycross RG. 1980. Hospice care — redressing the balance in medicine. J R Soc Med 73:475–481

    PubMed  CAS  Google Scholar 

  13. Liegner LM. 1975. St. Christopher’s Hospice, 1974. Care of the dying patient. JAMA 234(10):1047–1048.

    Article  PubMed  CAS  Google Scholar 

  14. Mount BM. 1976. The problem of caring for the dying in a general hospital; the palliative care unit as a possible solution. Can Med Assoc J 115(2):119–121

    PubMed  CAS  Google Scholar 

  15. MacDonald N, and the Canadian Committee on Palliative Care Education. 1991 The Canadian Palliative Care Curriculum.

    Google Scholar 

  16. Fraser J. 1995. Sharing the challenge: the integration of cancer and AIDS. J Palliat Care 11(2):23–25.

    PubMed  CAS  Google Scholar 

  17. Goldstone I. 1992. Trends in hospital utilization in AIDS care 1987-1991: implications for palliative care. J Palliat Care 8(4):22–29.

    PubMed  CAS  Google Scholar 

  18. Alberta Provincial Working Group. 1990. A Report Submitted by the Alberta Provincial Working Group to the Cancer 2000 Task Force, Edmonton, AB, November.

    Google Scholar 

  19. Bruera E. 1993. Research in symptoms other than pain. In Doyle D, Hanks G, MacDonald N (eds), Textbook of Palliative Medicine, 3rd ed., vol. 3. London: Oxford Medical Publications, 87–92.

    Google Scholar 

  20. Bruera E, Kuehn N, Emery B, Macmillan K, Hanson J. 1990. Social and demographic characteristics of patients admitted to a palliative care unit. J Palliat Care 6(4): 16–20.

    PubMed  CAS  Google Scholar 

  21. Lichter I, Hunt E. 1990. The last 48 hours of life. J Palliat Care 6(4):7–15.

    PubMed  CAS  Google Scholar 

  22. Ventafridda V, Ripamonti C, De Conno F, Tamburini M, Cassileth BR. 1990. Symptom prevalence and control during cancer patients last days of life. J Palliat Care 6(3):7–11

    PubMed  CAS  Google Scholar 

  23. Doyle D. 1983. Symptom relief in terminal illness. Med Pract 1:694–698.

    Google Scholar 

  24. McGuire DB. 1992. Comprehensive and multidimensional assessment and measurement of pain. J Pain Symptom Manage 7(2):312–319.

    Article  PubMed  CAS  Google Scholar 

  25. Ahles TA, Blanchard EB, Ruckdeschel JC. 1983. The multidimensional nature of cancer-related pain. Pain 17:277–288.

    Article  PubMed  CAS  Google Scholar 

  26. Banning A, Stugren P, Henricksen H. 1991 Treatment outcome in a multidisciplinary cancer pain clinic. Pain 47:129–134.

    Article  PubMed  CAS  Google Scholar 

  27. Fields HL, Basbaum AI. 1994. Central nervous system mechanisms of pain modulation. In Wall PD, Melzak R (eds), Textbook of Pain, 3rd ed., vol. 12. London: Churchill Livingstone 243–257.

    Google Scholar 

  28. Bruera E. 1994. New developments in the assessment of pain in cancer patients. Support Care Cancer 2:312–318.

    Article  PubMed  CAS  Google Scholar 

  29. Coyle N, Breitbart W, Weaver S, Portenoy R. 1994. Delirium as a contributing factor to ‘crescendo’ pain: three case reports. J Pain Symptom Manage 9(l):44–47.

    Article  PubMed  CAS  Google Scholar 

  30. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. 1991 The Edmonton symptom assessment system (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7(2):6–9.

    PubMed  CAS  Google Scholar 

  31. Kaasa T, Coomis J, Gillis K, Bruerae, Hanson J. 1997. The Edmonton Functional Tool: Preliminary Development and Evaluation for Use in Palliative Care. J. Pain Sympt. Manage 13(l):10–19.

    Article  CAS  Google Scholar 

  32. Bruera E, Schoeller T, Wenk R, MacEachern T, Marcelino S, Suarez-Almazor M, Hanson J. 1995. A prospective multi-center assessment of the Edmonton Staging System for cancer pain. J Pain Symptom Manage 10(5):348–355.

    Article  PubMed  CAS  Google Scholar 

  33. Folstein MF, Folstein S, McHugh PR. 1975. ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. J Psych Res 12:189–198.

    Article  CAS  Google Scholar 

  34. Ewing JA. 1984. Detecting alcoholism. The CAGE Questionnaire. JAMA 252:1905–1907.

    Article  PubMed  CAS  Google Scholar 

  35. Bruera E, MacDonald S. 1993. Audit Methods: The Edmonton Symptom Assessment System. In Higginson I (ed), Clinical Audit in Palliative Care. Oxford: Radcliffe Medical Press 61–77.

    Google Scholar 

  36. Cella DF, Tulsky DS. 1990. Measuring quality of life today: methodological aspects. Oncology 4:29–38.

    PubMed  CAS  Google Scholar 

  37. Mor V, Laliberte L, Morris JN, et al. 1984. The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer 53:2002–2007.

    Article  PubMed  CAS  Google Scholar 

  38. Massie MJ, Holland J, Glass E. 1983. Delirium in terminally ill cancer patients. Am J Psychiat 140(8):1048–1050.

    PubMed  CAS  Google Scholar 

  39. Bruera E, Miller L, McCallion J, Macmillan K, Krefting L, Hanson J. 1992. Cognitive failure in patients with terminal cancer: a prospective study. J Pain Symptom Manage 7(4):192–195.

    Article  PubMed  CAS  Google Scholar 

  40. Pereira J, Hanson J, Bruera E. 1997. The Frequency and Clinical Course of Cognitive Impairment in Patients with Terminal Cancer. Cancer 79(4):835–842.

    Article  PubMed  CAS  Google Scholar 

  41. Francis J, Martin D, Kapor WN. 1990. A prospective study of delirium in hospitalized elderly. JAMA 263(8):1097–1101

    Article  PubMed  CAS  Google Scholar 

  42. Folstein M, Fetting J, Labo A, et al. 1984. Cognitive assessment of cancer patients. Cancer 53(Suppl 10):2250–2257.

    PubMed  CAS  Google Scholar 

  43. Smith M, Breitbart W, Platt M. 1995. A critique of instruments and methods to detect, diagnose, and rate delirium. J Pain Symptom Manage 10(1):35–77.

    Article  PubMed  CAS  Google Scholar 

  44. Moore R, Bone L, Geller G, et al. 1989. Prevalence, detection and treatment of alcoholism in hospitalized patients. JAMA 261:403–407.

    Article  PubMed  CAS  Google Scholar 

  45. Stimmel B. 1985. Pain, analgesia, and addiction: an approach to the pharmacologic management of pain. Clin J Pain 1:14–22.

    Article  Google Scholar 

  46. Portenoy RK. 1987. Constipation in the cancer patient: causes and management. Med Clin North Am 71:303–311

    PubMed  CAS  Google Scholar 

  47. Sykes NP. 1993. Constipation and diarrhoea. In Doyle D, Hanks GWC, MacDonald N (eds), Oxford Textbook of Palliative Medicine, 4th ed., vol. 3. Oxford: Oxford University Press, 299–310.

    Google Scholar 

  48. Glare P, Lickiss N. 1992. Unrecognized constipation in patients with advanced cancer. A recipe for therapeutic diaster. J Pain Symptom Manage 7:369–371

    Article  PubMed  CAS  Google Scholar 

  49. Bruera E, Suarez-Almazor M, Velasco A, Bertolino M, MacDonald SM, Hanson J. 1994. The assessment of constipation in terminal cancer patients admitted to a palliative care unit: a retrospective review. J Pain Symptom Manage 9(8):515–519.

    Article  PubMed  CAS  Google Scholar 

  50. Beehrs OH et al. (eds). 1992. Manual for Staging of Cancer, 4th ed. Philadelphia: JP Lippincott.

    Google Scholar 

  51. Valagussa P, Bonadonna G, Veronesi V. 1978. Patterns of relapse and survival following radical mastectomy. Cancer 41:1170–1178.

    Article  PubMed  CAS  Google Scholar 

  52. Rowland J. 1989. Intrapersonal resources: coping. In Holland J, Rowland J (eds), Handbook of Psycho Oncology: Psychological Care of the Patient. New York: Oxford University Press.

    Google Scholar 

  53. Emery B, Bruera E. 1990. Patterns of patient-family/staff conflict in a palliative care unit: a two year analysis. 8th International Congress on Care of the Terminally 111, Montreal, Oct. 1 J Palliat Care 6(3):53.

    Google Scholar 

  54. Fainsinger RL, MacEachern T, Miller MJ, Bruera E, Spachynski K, Kuehn N, Hanson J. 1994. The use of hypodermoclysis (HDC) for rehydration in terminally ill cancer patients. J Pain Symptom Manage 9(5):298–302.

    Article  PubMed  CAS  Google Scholar 

  55. Bruera E, Schoeller T, Pruvost M. 1994. Letters to the Editor: Proctoclysis for hydration of terminal cancer patients. Lancet 344:1699.

    Article  PubMed  CAS  Google Scholar 

  56. Bruera E, Watanabe S, Fainsinger RL, Spachynski K, Suarez-Almazor M, Inturrisi C. 1995. Custom-made capsules and suppositories of methadone for patients on high dose opioids for cancer pain. Pain 62:141–146.

    Article  PubMed  CAS  Google Scholar 

  57. Fainsinger R, Bruera E. 1992. Palliative Care Round: Treatment of delirium in a terminally ill patient. J Pain Symptom Manage 7(l):54–56.

    Article  PubMed  CAS  Google Scholar 

  58. Bruera E, Brenneis C, MacDonald RN, Michaud M. 1987. Continuous sc infusion of meto-clopramide for treatment of narcotic bowel syndrome. Cancer Treat Rep 71(11):1121–1122.

    PubMed  CAS  Google Scholar 

  59. Bruera E, Macmillan K, Pither J, MacDonald RN. 1990. The effects of morphine on the dyspnea of terminal cancer patients. J Pain Symptom Manage 5(6):341–344.

    Article  PubMed  CAS  Google Scholar 

  60. de Stoutz ND, Bruera E, Suarez-Almazor M. 1995. Opioid rotation (OR) for toxicity reduction in terminal cancer patients. J Pain Symptom Manage 10(5):378–384.

    Article  PubMed  Google Scholar 

  61. Bruera E. 1992. WHO News. Palliative care programmes in Latin America. Palliat Med 6:182–184.

    Article  Google Scholar 

  62. Stjernsward J, Bruera E, Joranson D, et al. 1995. Opioid availability in Latin America: the Declaration of Florianopolis. J Pain Symptom Manage 10(3):233–236.

    Article  PubMed  CAS  Google Scholar 

  63. Coyle N, Adelhardt J, Foley K, Portenoy R. 1990. Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last 4 weeks of life. J Pain Symptom Manage 5:83–93.

    Article  PubMed  CAS  Google Scholar 

  64. Ventafridda V, Ripamonti C, De Conno F, Tamburini M, Cassileth BR. 1990. Symptom prevalence and control during cancer patients’ last days of life. J Palliat Care 6(3):7–11

    PubMed  CAS  Google Scholar 

  65. Ferrell BR, Ferrell BA, Rhines M, Grant M. 1991 Family factors influencing cancer pain management. Postgrad J Med 67(Suppl 2):564–569.

    Google Scholar 

  66. Bruera E, Macmillan K, Hanson J, Kuehn N, MacDonald RN. 1990. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advanced cancer. Cancer 66:1279–1282.

    Article  PubMed  CAS  Google Scholar 

  67. Bruera E, Fainsinger R, Spachynski K, Babul N, Harsanyi Z, Darke AC. 1995. Clinical efficacy and safety of a novel controlled release morphine suppository and subcutaneous morphine in cancer pain: a randomized evaluation. J Clin Oncol 13(6):1520–1527.

    PubMed  CAS  Google Scholar 

  68. Anonymous. 1964. Human experimentation: code of ethics of the World Medical Association. Br Med J 2:177.

    Article  Google Scholar 

  69. Royal College of Physicians. 1990. Royal College of Physicians guidelines on the practice of ethics committees in medical research involving human subjects, 2nd ed. London: Royal College of Physicians.

    Google Scholar 

  70. Bruera E, Spachynski K, MacEachern T, Hanson J. 1993. Letter to the Editor: Cognitive failure in cancer patients who agree to participate in clinical trials. Lancet 341:247.

    Article  PubMed  CAS  Google Scholar 

  71. Bruera E. 1994. Ethical issues in palliative care research. J Palliat Care 10(3):7–9.

    PubMed  CAS  Google Scholar 

  72. Bruera E, Miller MJ, Kuehn N, MacEachern T, Hanson J. 1992. Estimation of survival of patients admitted to a palliative care unit: a prospective study. J Pain Symptom Manage 7(2):82–86.

    Article  PubMed  CAS  Google Scholar 

  73. den Daas N. 1995. Estimating length of survival in end-stage cancer: a review of the literature. J Pain Symptom Manage 10(7):548–555.

    Article  Google Scholar 

Download references

Authors
  1. Eduardo Bruera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jose Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Center for Palliative Studies, San Diego Hospice, San Diego, California, USA

    Charles F. von Gunten M.D., Ph.D, FACP

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Bruera, E., Pereira, J. (1999). The research palliative care unit. In: von Gunten, C.F. (eds) Palliative Care and Rehabilitation of Cancer Patients. Cancer Treatment and Research, vol 100. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5003-7_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-5003-7_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7272-1

  • Online ISBN: 978-1-4615-5003-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation