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American Pain Society
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Glenview, IL 60025
John D. Loeser, MD, Department Editor
Reviewed by Dermot Fitzgibbon, MD
Roger S. Cicala (ed.), Contemporary Books, Lincolnwood, IL, 2001, 301 pages, $17.95 (soft cover), ISBN 0-7373-0423-5
For many patients, the diagnosis of cancer is a major traumatic event evoking emotional and physical concerns. Professional and public interest in pain management has increased in recent years. With the involvement of special advocate groups for improved pain management such as the Agency for Health Care Policy and Research (AHCPR) and Joint Commission on Accreditation of Health Care Organizations (JCAHO), healthcare professionals and the lay public have been exposed to a variety of publications on the management of cancer pain. In spite of many publications directed at professionals managing cancer patients, pain in the cancer patient continues to be problematic and is often inadequately treated. Perhaps a different educational focus, one in which the patient becomes a self-advocate for improved pain management by “taking control of pain” may help improve this disturbing situation.
The Cancer Pain Sourcebook is one such focus and provides a comprehensive guide for cancer patients with pain. The book has five contributing authors, all experienced in pain management. It is divided into three main parts. Part I addresses issues causing pain and explains how the body senses pain, how tumors cause pain, treatment-associated pain, and other factors that worsen pain and suffering. Part II deals with standard treatments of pain and focuses on pharmacological approaches (opioids and nonopioid analgesics), nerve blocks and nerve destruction, alternative delivery systems, alternative therapy options, and palliative treatment options. Part III provides details of advanced treatment options such as intraspinal delivery, pain treatment for special situations, hospice care, and participation in medical trials. There is also a comprehensive appendix listing common opioid medications, nonopioid medications, pain treatment resources, cancer support groups, resources on finding information on cancer studies and research trials, and resources for hospice care. Each part is essentially a text in itself, yet the editor manages to cohesively link each part such that the reader is able to progress logically through the complexities of modern day pain assessment and management.
Each chapter provides extensive information and is written in a clear, comprehensive, and patient-oriented fashion. The information presented is up-to-date and scientifically accurate. I particularly enjoyed the section on herbal and natural pain remedies. Most current scientific texts on cancer pain management do not address this area and I have noticed in my own practice that this is one where an increasing number of patients are seeking information from healthcare professionals. Dr. Cicala is to be commended on his excellent objective presentation of this material and also on his comments of the limitations of these remedies and the concept of the “wonderpill.”
In the introduction, Dr. Cicala contends that after reading this book, the reader will know more about pain and its causes than most doctors do. I agree. This is an excellent reference text for the cancer patient with pain. In addition, I suggest that many clinicians caring for cancer patients could benefit from reading this text. The book is not a quick reference text that provides information in an easy-to-read fashion. It is better reserved for the patient (or clinician) that will take the time to sit down, contemplate, and ultimately use the information presented.
Dermot Fitzgibbon is assistant professor of anesthesiology and director of pain services at the University of Washington in Seattle.
