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John D. Loeser, MD, Department Editor
Reviewed by Dermot Fitzgibbon, MD
R. Payne, R.B. Patt, & C. Stratton Hill (Eds.), IASP Press, Seattle, 1998, 334 pages, $46.15 (members' price), $71 (hardcover), ISBN 0-931092-21-3
This book was derived from a satellite meeting of the Eighth World Congress on Pain in August 1996. Its focus is on the assessment and treatment of cancer pain. It is intended to complement rather than to duplicate other books on cancer pain and to extend the base of practical knowledge for clinicians involved in the care of the cancer patient with pain. The book is organized into 4 parts: a global perspective of cancer pain, research and clinical issues of cancer pain assessment, the impact of pain on survival, and clinical assessment and management of cancer pain.
The first part focuses on palliative care issues in Latin America, on the availability of opioids and the impact of drug distribution in Colombia, and on the Agency for Health Care Policy and Research guidelines for cancer pain relief. While each of these chapters is informative, well written, and interesting, the editors have not provided a truly global perspective on cancer pain. Only certain issues relative to North and South America are considered.
Overall, the book is informative in parts, well written, and presented in a convenient fashion. Unfortunately, much of the information is already included in standard pain management textbooks or in specialized texts on cancer pain. Superior contributions include the chapters on psychological interventions for pain, the pain-mortality link, mechanisms of bone metastasis, and nonopioid analgesics for cancer pain. Of some concern is the statement by Quaicoe, McLaughlin, and Hassenbusch that the general indication for spinal opioid therapy is that pain cannot be controlled with systemic opioids because of dose-limiting side effects. While this statement may have validity in a very small percentage of cancer patients, the authors present little if any evidence to support their contention that intrathecal opioid therapy is more efficacious than systemic opioid therapy. In a similar fashion, the chapter on neurosurgical considerations and options by Arbit fails to add any new information on current applications of neurosurgical procedures for cancer pain management. The chapter on alternative routes for administering analgesics at home really does not contribute to the overall goals of the book. Many other chapters provide standard information readily available in other books, manuals, or journal articles.
This book fails to meet its stated objectives of providing new and complementary information on assessment and management of cancer pain. It does, however, provide a concise summary of aspects of clinical care, which some readers may find useful. However, clinicians experienced in cancer pain management will probably derive little overall benefit. Symposia such as the one this book is based on often do not lend themselves to the production of a meaningful book. Individual contributions cannot be edited to produce a balanced overall approach, some topics are overrepresented and others are omitted, and much of the material appears in print or on Web sites well before publication.
Dermot Fitzgibbon is assistant professor of anesthesiology at the University of Washington in Seattle.
Reviewer content represents the opinion of the reviewer, not APS.
Please direct your suggestions for future Resource Reviews to John D. Loeser, MD, Department Editor, at jdloeser@u.washington.edu
