September 2007, Volume 34, Number 6


Knowledge Central

Gerald Bennett, PhD, APRN, FAAN - Associate Editor





Principles and Practice of Palliative Care and Supportive Oncology (3rd ed.). Ann M. Berger*, John L. Shuster, Jr., and Jamie H. Von Roenn. Philadelphia: Lippincott Williams and Wilkins, 2007, 896 pages, $199.


Principles and Practice of Palliative Care and Supportive Oncology is a comprehensive clinical textbook for oncology healthcare providers. Organized into six sections, the book covers patient care from active treatment to the end of life and provides an extensive overview of symptoms and syndromes, issues and ethical considerations in palliative care, and special interventions, populations, and research issues in supportive care and palliative care.


Section I provides an in-depth overview of pain management and constitutional symptoms, including fatigue, fever, sweats, and hot flashes. Gastrointestinal symptoms and syndromes addressed include anorexia and weight loss, dysphagia and speech problems, chemotherapy-related as well as chronic nausea and vomiting, diarrhea, malabsorption, constipation, ascites, and hiccups. Those and other gastrointestinal symptoms are reviewed along with suggested management and treatment regimens. Chapter 8, Assessment and Management of Cancer-Related Fatigue, describes fatigue as a symptom often difficult to assess, determine causative factors, and treat effectively. The chapter offers a variety of assessment tools and treatment recommendations while acknowledging that because cancer-related fatigue research is in its infancy, further focus on the problem is needed to provide a sound basis for the development of mechanism-based interventions.


Section II is a discussion of a broad range of issues in palliative care, including definitions, models, assessment, and therapies. Psychosocial issues, sexuality and reproduction, caregivers, spirituality, bereavement care, and how to start a bereavement program and manage staff stress and burnout also are discussed. Section III continues with ethical issues in palliative care such as advance directives, decision-making capacity, and the law. Section IV addresses special interventions in supportive and palliative care such as nutritional and hematologic support, rehabilitative medicine, and complementary and alternative approaches.


Special populations are addressed in section V, including long-term survivor late effects, psychosocial aspects of cancer survivorship, pediatrics, geriatrics, the intensive care setting, and palliative care in HIV/AIDS. Further review of chapter 74 on geriatric palliative care provides information on the special supportive needs of older adults based on age, physiologic function, and the challenge of assessing and managing pain. The authors acknowledge that older adults often have unrecognized and untreated symptoms, cognitive impairment, and a high prevalence of functional dependency and associated family caregiver burden. The challenges of finding funded caregiver and family supportive resources also are discussed, with a review of mixed model programs. Section VI discusses research issues in supportive care and palliative care with reviews of outcomes assessment in palliative care, measurement of quality-of-life outcomes, research ethics, and study design issues.


Principles and Practice of Palliative Care and Supportive Oncology provides needed information about patient care from supportive care and symptom management during treatment to palliative care at the end of life. The book challenges oncology nurses and other healthcare providers to research and develop the future direction of symptom management and palliative care.


Rose H. Mueller, RN, BSN, OCN®

Oncology Program Director

Chestnut Hill Hospital

Philadelphia, PA


My Healing Companion. Beverly Katherine Kirkhart. Santa Barbara, CA: Comeback Press, 2001, 216 pages, $22.90.


My Healing Companion is an enlightening guide for newly diagnosed patients with cancer facing emotional and physical stressors of the disease. The book serves as a source of learning by providing a means to identify, analyze, and document thoughts and feelings associated with the cancer journey. The book is artfully designed to provide inspiration and structure in keeping a journal of the personal experiences and feelings embedded in the adaptation to a cancer diagnosis, seeking interpersonal support, and initiating self-care. The journal is of moderate size with a merlot color and cloth-textured hard cover that feels soothing and comfortable when held. The silk red ribbon bookmark is decorative and practical. The book is written in a warm and engaging style, is easy to read, and avoids technical jargon. All of the qualities of the book taken together are so distinctive that readers may well develop a personal attachment to this portable resource.


The author draws from her personal experience battling breast cancer, sharing various thoughts and feelings. She provides readers with an intimate view of her life immediately before the devastating diagnosis and the trials and tribulations associated with the journey, from treatment to survivorship. At the time of receiving her cancer diagnosis, the author also experienced other major life stressors, including divorce and bankruptcy. She describes her ordeal openly, sharing in realistic detail the challenges she faced and the process of overcoming what initially seemed to be an overwhelming situation.


The book’s journaling format includes 14 chapters that focus on relevant issues concerning acceptance and active steps in the battle to defeat the emotional burdens of cancer. Chapter topics include “Why Me?”, “I’m Overwhelmed by Anger,” “Whom Can I Talk To?,” and “My Hero Within.” Most chapters include a narrative, tasks to list or name feelings and experiences related to a particular topic, and blank pages for private thoughts. The author explains that she uses the format because she found journaling to be a very effective method in dealing with the many emotionally laden burdens she has faced as a cancer survivor. In each of the chapters, she focuses on one issue, sharing the feelings she experienced and how she dealt with them.


Examples of the book’s approach include sharing poignant moments such as hearing for the first time the diagnosis of cancer from her physician and the resulting reflection on the inevitable question of “Why me?” The author then faces the overpowering feeling of anger and addresses the issue of whom to share those emotions and feelings with, wanting someone who would listen and understand. She provides insight into the impact of the social supports she garnered to help her through the cancer journey, specifically a breast cancer support group. The author goes on to state that she needed to truly communicate with her physicians regarding her feelings related to cancer and its treatments.


The author emphasized sharing experiences that helped her to find strength within herself through the words and actions of others. She shares the reality of the negative feelings but goes a step further to identify the positives that can be derived from those experiences and how she was able to navigate through the transitions. One of the more moving chapters in the book focuses on the author’s courage and imagination to confront and overcome concerns with body image. The last two chapters of the book are the most notable. The author examines the impact of cancer on her life. In essence, the author was faced with difficult choices but was able to find meaning in her cancer experience and a more joyful approach to life.


The book encourages readers to participate in serious exploration through structured activities. The activities are simple, but many require deep reflection and introspection. Some activities require readers to identify their strengths and look to build on what they may not have known was there. The author provides directions and examples on how to carry out the activities and use the findings to move through difficult times. Throughout the book are encouraging thoughts as well as adages that give strength and courage.


The author’s enthusiasm and belief in the power of journaling are communicated effectively throughout the book. She gives specific examples of how patients can take their journals to doctor visits and treatments, jot down brief journal entries during busy times, and include more detailed thoughts during quiet times. She encourages the journal method as a safe means of chronicling thoughts, feelings, and concerns during the experience with cancer. Nurses may want to recommend the book to newly diagnosed patients as well as patients with recurring cancer. It is suitable for experienced journalists as well as those who are new to journaling. Although the focus and appearance of the book are most likely to have appeal to female patients with cancer, it is general enough to be of interest and useful for men.


Rosalind Jones, DNP, APRN-BC

Assistant Professor

School of Nursing

Medical College of Georgia

Augusta, GA


Tobacco Information for Teens: Health Tips About the Hazards of Using Cigarettes, Smokeless Tobacco, and Other Nicotine Products. Karen Bellenir. Detroit, MI: Omnigraphics, 2007, 440 pages, $65.


One of the resources designed for middle and high school students in the Teen Health Series, a specially developed volume of reference books targeting numerous health concerns, this comprehensive resource focuses on tobacco. The book is organized into seven sections: Facts About Tobacco and Tobacco Use Prevention, Tobacco Products and Nicotine Delivery Systems, Health Effects of Tobacco Use, What You Need to Know About Tobacco and Cancer, How to Quit Using Tobacco, Tobacco Use Statistics, and If You Need More Information.


The book transitions from simple to complex information, which is usually helpful and appealing to younger and novice readers. For example, the chapter on Smoking and the Respiratory System begins with information on what the respiratory system does, why it is important, and what happens with impaired lung function; it then progresses to specific disorders and diseases of the particular system. Additional valuable information is provided on relevant topics, such as anesthesia complications, as they relate to the respiratory system. The last two chapters are especially valuable as they provide extensive resources for obtaining more information about tobacco, tobacco prevention, and tobacco cessation.


Current research is included as well as citations from the Centers for Disease Control and Prevention and the National Institutes of Health. Although presented in black and white, the book has shaded areas in unique shapes with catchy phrases such as “It’s A Fact,” “Remember,” “Quick Tip,” and “What It Means” that have appeal and draw readers to important summaries. The book is an excellent resource for younger readers but also has significant and practical value to numerous populations who are interested in learning more about tobacco and its use. Specifically, Tobacco Information for Teens is an excellent text for students in health science disciplines, practicing healthcare providers, and researchers. Placing the book in healthcare settings, such as having it in an office location where adolescents as well as adults are seen for medical care, also would be valuable. Its ease in reading and understanding as well as its comprehensiveness make it a vital component of tobacco literature.


Martha S. Tingen, PhD, RN 

Associate Professor

Medical College of Georgia

School of Medicine

Department of Pediatrics

Georgia Prevention Institute

Interim Program Leader

Cancer Prevention and Control

Medical College of Georgia Cancer Center

Augusta, GA


Butterfly Kisses and Wishes on Wings. Ellen McVicker and Nanci Hersh, 2006, $16.95. Available at


Butterfly Kisses and Wishes on Wings is a powerful navigation tool for children with a friend or family member who has been diagnosed with cancer. The book is easy to recommend, with its rich, intuitive writing and reflective illustrations. The life experiences of the author, Ellen McVicker, and the illustrator, Nanci Hersh, are revealed in this touching story that lends understanding to the child’s experience when a loved one is diagnosed with cancer. McVicker has a diversified background, including kindergarten teaching, special education, and as director of education in a hospital setting. Hersh is a breast cancer survivor and an award-winning artist with work displayed worldwide. Both author and illustrator have children of their own.


The book is a first-person narrative from a child’s experience of being told by his mother that she has cancer. The child gives his account of his mother’s explanations for the disease and the treatments she is likely to receive. The descriptions include information about anticipated side effects of treatment such as hair loss and feeling tired. The child explores many of his questions including, “Did I do anything to make her get cancer?” and “If I hug and kiss my mom, will I get cancer, too?” Accounts are given of the mother’s reassuring responses. Although the child is not able to make the “cancer go away,” a number of helpful things that the child can do are highlighted, such as helping a younger brother or sister and bringing mom a glass of water or a tissue. The story is richly illustrated throughout with giclée prints, a beautiful art form produced by high-resolution digital scanning.


Butterfly Kisses and Wishes on Wings facilitates a child’s understanding, offers hope, and encourages communication through the cancer journey. The author successfully achieves her goal of giving voice to children and parents who may not have all the words that need to be said about cancer and its treatment. Preschool and school-aged children in particular would benefit from the book. However, its use for young adolescents should not be disregarded.


Having walked through the cancer journey with her own children, the illustrator clearly and touchingly conveys experiences of children through her artwork. Likewise, the author’s words are insightfully written and poignant. For example, emotions of fear and anger are addressed when the child exclaims “I HATE that my mom has cancer! It SCARES me.” Likewise, the book models an honest response from the parent when the child explains that “Mom says it scares her, too.” Children reading this book can be reassured that their feelings are normal.


Butterfly Kisses and Wishes on Wings is an excellent resource to support children grasping to understand what it means when someone they love has cancer. Additional resources and ordering information are available online at Pages for coloring and journaling can be downloaded, and active links to other cancer sites provide resources for helping adults talk with children about cancer.


Wanda Gomez, BSN, RN

Doctoral Student

School of Nursing

Medical College of Georgia

Augusta, GA


Digital Object Identifier: 10.1188/07.ONF.1225-1227