Article Outline

• Section A
• • Management of Chronic Cancer Pain
  • • How Painful Is Cancer in Animals?
    • General Approach to Cancer Pain Management
    • The Importance of Alleviating Pain in the Cancer Patient
    • Assessment of Cancer Pain
    • Principles of Alleviation of Cancer Pain
    • • Pharmacologic Therapy
      • Classification of Cancer Pain
    • Drugs and Strategies Used for Management of Pain in Cancer Patients
    • • Nonsteroidal Antiinflammatory Drugs
      • Acetaminophen
      • Opioids
      • N-Methyl D-Aspartate Antagonists
      • Combination Analgesics
      • Anticonvulsant Drugs
      • Tricyclic Antidepressants
      • Sodium Channel Blockade
      • Steroids
      • Bisphosphonates
    • Neuronal Ablation or Exhaustion Therapy
    • Radiation Therapy
    • Acupuncture
    • The Future: Toward a Mechanistic Understanding of Cancer Pain
  • References
• Section B
• • Nutritional Management of the Cancer Patient
  • • Metabolism of Cancer: Substrate Utilization
    • Cancer Anorexia and Cachexia
    • Epidemiology, Prevention, and Risk Factors
    • Implementing a Nutritional Plan for the Oncology Patient: Nutritional Assessment
    • Feeding the Hospitalized Oncology Patient
    • Coax Feeding and Pharmacologic Appetite Stimulation
    • Assisted Enteral Support
    • Parenteral Support
    • Nutritional Support in the Cancer-Bearing Patient
    • • Substrate
      • Amino Acids
      • Polyunsaturated Fats
      • Vitamins and Minerals
      • Antioxidants/Supplements
  • References
• Section C
• • Relationship-Centered Approach to Cancer Communication
  • • A Paradigm Shift: Paternalism to Partnership
    • Relationship-Centered Care
    • Core Communication Skills for Cancer Communication
    • • Gathering Information
      • • Identify the Client's Full Agenda
        • Elicit the Client's Perspective
      • Explaining and Planning
      • • Assess the Client's Knowledge Level
        • Give Information in Manageable Chunks and Checks
      • Building Relationships
      • • Offer Partnership
        • Ask Permission
        • Express Empathy
        • Demonstrate Appropriate Nonverbal Behavior
      • Providing Structure
      • • Summarize
    • “I Don't Have Time for This…”
    • Approaches to Cancer Conversations
    • • Delivering Bad News
      • Discussing Prognosis
      • Assessing Quality of Life
      • Transitioning to Palliative Care
      • Preparing Families for Euthanasia
      • Providing Support for Grief and Loss
      • Caring for Yourself
    • Conclusion
  • References

• CANCER CACHEXIA
• • Phases of Cachexia
  • Alterations in Carbohydrate Metabolism
  • Alterations in Protein Metabolism
  • Alterations in Lipid Metabolism
  • Changes in Energy Requirements
• DIETARY MANAGEMENT OF CANCER PATIENTS
• • Diet Characteristics
  • Calculating Energy Needs
• METHODS OF FEEDING
• CONCLUSION
• References