Expert Insights on Palliative Care in Surgical Oncology

Edited by Dr. Bridget N. Fahy, this issue of Surgical Oncology Clinics delves into the critical topic of palliative care in surgical oncology. A distinguished panel of experts has been assembled to provide comprehensive reviews on various aspects of this complex and multifaceted field.

Current Guidelines for Integration of Palliative Care in Oncology

Dr. Fahy and her team of experts explore the current guidelines for integrating palliative care into oncology practices. This section provides healthcare professionals with the necessary knowledge to develop and implement effective palliative care strategies that enhance patient outcomes and improve quality of life.

Management of Malignant Bowel Obstruction

This section focuses on the management of malignant bowel obstruction, a common complication in patients with advanced malignancies. The authors discuss the various treatment options available, including surgical, endoscopic, and pharmacological interventions, and provide guidance on selecting the most appropriate approach for individual patients.

Management of Peritoneal Carcinomatosis & Malignant Ascites

Peritoneal carcinomatosis and malignant ascites are significant challenges in the management of patients with gastrointestinal malignancies. This chapter reviews the diagnostic and therapeutic strategies for these conditions, highlighting the importance of a multidisciplinary approach involving medical oncologists, surgical oncologists, and palliative care specialists.

Artificial Nutrition in Patients with Advanced Malignancy

The role of artificial nutrition in patients with advanced malignancies is a topic of ongoing debate. The authors examine the indications and contraindications for various forms of artificial nutrition, including parenteral and enteral nutrition, and discuss the ethical considerations that must be taken into account when making decisions about nutritional support.

Selecting Patients for Palliative Procedures in Oncology

This section addresses the complex issue of selecting patients for palliative procedures in oncology. The authors provide criteria for identifying patients who are likely to benefit from palliative interventions and discuss the importance of careful patient selection to ensure optimal outcomes and minimize potential complications.

Palliative Radiotherapy: Indications and Outcomes

Palliative radiotherapy plays a crucial role in the management of patients with advanced malignancies, providing relief from symptoms such as pain, bleeding, and obstruction. This chapter reviews the indications for palliative radiotherapy and discusses the outcomes that can be expected from this treatment approach.

Ethical Considerations for Caring for Patients with Advanced Cancer

The care of patients with advanced cancer raises a number of ethical dilemmas, including decisions about the use of life-sustaining measures, the management of pain and other symptoms, and the communication of prognosis and treatment options. This section explores these ethical considerations and provides guidance for healthcare professionals navigating these complex issues.

Evaluation and Management of Malignant Biliary Obstruction

Malignant biliary obstruction is a common complication in patients with gastrointestinal and pancreatic malignancies. The authors discuss the diagnostic and therapeutic strategies for this condition, including endoscopic, radiological, and surgical interventions, and highlight the importance of a multidisciplinary approach to management.

Systemic Anti-Cancer Treatments for Advanced Cancer Patients: What a Surgical Oncologist Needs to Know

This chapter provides an overview of systemic anti-cancer treatments, including chemotherapy, targeted therapy, and immunotherapy, which are increasingly being used in conjunction with surgical interventions for patients with advanced malignancies. The authors discuss the potential benefits and risks of these treatments and highlight the key considerations for surgical oncologists working in collaboration with medical oncologists.

Role of Palliative Medicine Training in Surgical Oncology

The integration of palliative medicine into surgical oncology training programs is essential for ensuring that surgeons have the necessary skills and knowledge to provide high-quality, patient-centered care. This section explores the role of palliative medicine training in preparing surgical oncologists for the challenges of managing patients with advanced malignancies.

Navigating Difficult Conversations: Breaking Bad News and Exploring Goals of Care in Surgical Patients

Breaking bad news and exploring goals of care are critical components of the surgeon-patient relationship, particularly in the context of advanced malignancies. The authors provide guidance on how to navigate these difficult conversations, emphasizing the importance of empathy, effective communication, and respect for patient autonomy.

Strategies for Optimizing Perioperative Pain Management for the Cancer Patient

Effective pain management is essential for optimizing patient outcomes in the perioperative period. This chapter reviews the various strategies available for managing pain in cancer patients undergoing surgery, including pharmacological, interventional, and non-pharmacological approaches, and highlights the importance of a multidisciplinary pain management team.