Additional Information
Book Details
Abstract
Physician Assistant Clinics aims to provide an authoritative and continuously updated clinical information resource that covers all of the relevant PA specialties. Our clinical review articles address the key points, diagnosis, prognosis, clinical management, and complications of disease and techniques, evidence, and controversies in the field. Information for quick reference, as well as in-depth coverage of a topic, is a hallmark of the Clinics’ series.This issue of Physician Assistant Clinics is devoted to Oncology and is edited by Alexandria Garino, MS, PA-C of Yale School of Medicine Physician Associate Program. Articles in this issue include: Nutrition in Cancer Care; Primary Care of the Cancer Survivor; Oncologic Emergencies; Advances in Lung Cancer; New Pharmaceutical Agents in Oncology; Ethical Considerations in Oncology; High Dose Chemotherapy and Stem Cell Rescue; Management of Graft versus Host Disease; Breast Cancer; Colon Cancer; Gynecologic Cancer; Oncology-Related Side Effects; and Improving Access to Care: The PA/MD Team.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Oncology | i | ||
| Copyright\r | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| TARGET AUDIENCE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iii | ||
| TO ENROLL | iii | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| CONSULTING EDITOR | v | ||
| EDITOR | v | ||
| AUTHORS | v | ||
| Contents | vii | ||
| Dedication: In Loving Memory of Yvonne Hsu Jee\r | vii | ||
| Foreword: Oncology\r | vii | ||
| Preface: Wanted: More Oncology Physician Assistant\r | vii | ||
| Nutrition in Cancer Care\r | vii | ||
| Oncology: Symptom Management\r | vii | ||
| Oncologic Emergencies\r | vii | ||
| An Overview of Hematopoietic Stem Cell Transplantation\r | viii | ||
| Management of Graft-Versus-Host Disease\r | viii | ||
| New Pharmaceutical Agents in Oncology\r | viii | ||
| Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma: A Review\r | viii | ||
| Ovarian Cancer: Practice Essentials\r | ix | ||
| Improving Access to Care: The Physician/Physician Assistant Team: Development of a Lymphoma-Specific Physician/Physician As \r | ix | ||
| Surgical Options for Post-Mastectomy Breast Reconstruction\r | ix | ||
| Ethical Considerations in Oncology\r | ix | ||
| PHYSICIAN ASSISTANT CLINICS\r | x | ||
| FORTHCOMING ISSUES | x | ||
| October 2016 | x | ||
| January 2017 | x | ||
| April 2017 | x | ||
| RECENT ISSUES | x | ||
| April 2016 | x | ||
| January 2016 | x | ||
| Dedication: In Loving Memory of Yvonne Hsu Jee\r | xi | ||
| Foreword:\rOncology | xiii | ||
| REFERENCES | xiv | ||
| Wanted: More Oncology Physician Assistants | xv | ||
| REFERENCES | xvi | ||
| Nutrition in Cancer Care | 363 | ||
| Key points | 363 | ||
| INTRODUCTION | 363 | ||
| Burning More and Eating Less | 363 | ||
| Intervene Early, Intervene Often, and, in Other Words, Do Not Get Behind the 8 Ball | 364 | ||
| Nutrition Pays a Price | 364 | ||
| Assess and Reassess on a Continuum | 364 | ||
| Assessment of Nutritional Requirements and Nutrition Status | 365 | ||
| Specialized Nutrition Support | 367 | ||
| Help Is on the Way: Pharmacologic Options | 367 | ||
| Combating Symptoms with Nutrition | 368 | ||
| Anorexia (Poor Appetite) | 368 | ||
| Early Satiety | 368 | ||
| Nausea and Vomiting | 369 | ||
| Diarrhea | 369 | ||
| Dysgeusia | 371 | ||
| Xerostomia | 371 | ||
| Mucositis and Pharyngitis | 371 | ||
| MAINTENANCE AND PREVENTION | 372 | ||
| SUMMARY/DISCUSSION | 372 | ||
| REFERENCES | 373 | ||
| Oncology | 375 | ||
| Key points | 375 | ||
| INTRODUCTION | 375 | ||
| PALLIATIVE CARE | 376 | ||
| Interdisciplinary Approach | 376 | ||
| Palliative Care in Oncology | 376 | ||
| Benefits of Early Palliative Care | 377 | ||
| When a Palliative-Care Team Is Not Available | 377 | ||
| SYMPTOM MANAGEMENT: COMMON APPROACH | 377 | ||
| Interview | 378 | ||
| Symptom-Rating Instruments | 378 | ||
| Assessment | 379 | ||
| Treatment | 379 | ||
| PHYSICAL SYMPTOMS | 379 | ||
| Pain | 379 | ||
| Optimize analgesics and adjuvant medications | 380 | ||
| Nonpharmacologic interventions | 381 | ||
| Invasive interventions | 383 | ||
| Dyspnea | 383 | ||
| Common causes | 383 | ||
| Opioid dosing | 384 | ||
| Benzodiazepine dosing | 384 | ||
| Nausea and Vomiting | 384 | ||
| Common causes | 384 | ||
| Nonpharmacologic interventions | 384 | ||
| Constipation | 384 | ||
| Common causes | 385 | ||
| Nonpharmacologic interventions | 386 | ||
| Diarrhea | 386 | ||
| Common causes | 387 | ||
| Nonpharmacologic interventions | 388 | ||
| Cancer-Related Fatigue | 388 | ||
| Common causes | 388 | ||
| Pharmacologic interventions | 388 | ||
| Oncologic Emergencies | 397 | ||
| Key points | 397 | ||
| INTRODUCTION | 397 | ||
| FEBRILE NEUTROPENIA | 397 | ||
| NEUTROPENIA | 398 | ||
| FEVER | 398 | ||
| DIAGNOSIS | 398 | ||
| MANAGEMENT | 399 | ||
| INDWELLING CATHETERS | 399 | ||
| HYPERCALCEMIA OF MALIGNANCY | 400 | ||
| PATHOPHYSIOLOGY | 400 | ||
| DIAGNOSIS | 400 | ||
| MANAGEMENT | 400 | ||
| TUMOR LYSIS SYNDROME | 401 | ||
| PATHOPHYSIOLOGY | 401 | ||
| CLINICAL PRESENTATION AND DIAGNOSIS | 403 | ||
| MANAGEMENT | 403 | ||
| SUMMARY/DISCUSSION | 406 | ||
| REFERENCES | 406 | ||
| An Overview of Hematopoietic Stem Cell Transplantation | 409 | ||
| Key points | 409 | ||
| INTRODUCTION | 409 | ||
| INDICATION FOR TRANSPLANT | 410 | ||
| TYPES OF HEMATOPOIETIC STEM CELL TRANSPLANTATION | 410 | ||
| STEM CELL COLLECTION | 410 | ||
| CONDITIONING REGIMEN | 411 | ||
| STEM CELL INFUSION | 411 | ||
| NEUTROPENIC PERIOD AND SUBSEQUENT IMMUNE RECOVERY (ENGRAFTMENT) | 412 | ||
| POSTENGRAFTMENT | 413 | ||
| COMPLICATIONS OF TRANSPLANT | 413 | ||
| Infection | 413 | ||
| Engraftment Syndrome | 414 | ||
| Graft-Versus-Host Disease | 414 | ||
| Sinusoidal Obstruction Syndrome | 415 | ||
| Graft Rejection and Graft Failure | 415 | ||
| AREAS OF RESEARCH | 416 | ||
| HOW TO BECOME A STEM CELL DONOR | 416 | ||
| SUMMARY | 417 | ||
| REFERENCES | 417 | ||
| Management of Graft-Versus-Host Disease | 419 | ||
| Key points | 419 | ||
| INTRODUCTION | 419 | ||
| CLINICAL FEATURES OF ACUTE GRAFT-VERSUS-HOST DISEASE | 420 | ||
| CLINICAL FEATURES OF CHRONIC GRAFT-VERSUS-HOST DISEASE | 421 | ||
| MANAGEMENT OF GRAFT-VERSUS-HOST DISEASE | 424 | ||
| Management of Acute Graft-Versus-Host Disease | 424 | ||
| Management of Chronic Graft-Versus-Host Disease | 426 | ||
| Toxicities Related to Immunosuppressive Agents | 428 | ||
| COMPLICATIONS OF GRAFT-VERSUS-HOST DISEASE MANAGEMENT | 428 | ||
| Infection Caused by Immune Dysregulation | 428 | ||
| Endocrinopathies | 429 | ||
| Avascular Necrosis | 430 | ||
| Secondary Malignancy | 430 | ||
| SUMMARY | 430 | ||
| REFERENCES | 430 | ||
| New Pharmaceutical Agents in Oncology | 435 | ||
| Key points | 435 | ||
| MONOCLONAL ANTIBODIES | 435 | ||
| ANTI-CD30 | 436 | ||
| ANTI-CD38 | 437 | ||
| ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR | 442 | ||
| ANTI–EPIDERMAL GROWTH FACTOR RECEPTOR | 442 | ||
| IMMUNOMODULATORY AGENTS | 445 | ||
| IMMUNOTHERAPY | 446 | ||
| TYROSINE KINASE INHIBITORS | 449 | ||
| EPIDERMAL GROWTH FACTOR RECEPTOR INHIBITORS | 449 | ||
| Gefitinib | 449 | ||
| Osimertinib | 451 | ||
| MITOGEN/EXTRACELLULAR SIGNAL REGULATED KINASE INHIBITORS | 454 | ||
| Cobimetinib | 454 | ||
| Miscellaneous Targeted Therapy | 455 | ||
| CYCLIN-DEPENDENT KINASE INHIBITOR | 455 | ||
| Palbociclib | 455 | ||
| HISTONE DEACETYLASE INHIBITORS | 457 | ||
| Panobinostat | 457 | ||
| HEDGEHOG PATHWAY INHIBITOR | 458 | ||
| Sonidegib | 458 | ||
| SUMMARY | 459 | ||
| SUPPLEMENTARY DATA | 459 | ||
| REFERENCES | 459 | ||
| Human Papillomavirus–Associated Oropharyngeal Squamous Cell Carcinoma: A Review | 465 | ||
| Key points | 465 | ||
| INTRODUCTION | 465 | ||
| DIAGNOSIS | 469 | ||
| STAGING AND DIAGNOSIS | 471 | ||
| MULTIDISCIPLINARY TREATMENT TEAM | 472 | ||
| TREATMENT | 472 | ||
| Early-Stage Treatment | 473 | ||
| Advanced Stage Treatment | 473 | ||
| PROGNOSIS | 474 | ||
| SURVEILLANCE | 475 | ||
| PREVENTION | 475 | ||
| DISCUSSION | 475 | ||
| ACKNOWLEDGMENTS | 476 | ||
| REFERENCES | 476 | ||
| Ovarian Cancer: Practice Essentials | 479 | ||
| Key points | 479 | ||
| INTRODUCTION | 479 | ||
| DISCUSSION | 479 | ||
| Diagnosis | 481 | ||
| Molecular Pathogenesis | 482 | ||
| TREATMENT | 482 | ||
| Surgery | 482 | ||
| Chemotherapy | 482 | ||
| Future Treatments | 483 | ||
| Poly adenosine diphosphate-ribose polymerase inhibitors | 483 | ||
| Immunotherapy for ovarian cancer | 484 | ||
| Monoclonal antibodies | 484 | ||
| Checkpoint inhibitors and immune modulators | 484 | ||
| Therapeutic vaccines | 485 | ||
| Adoptive T-cell transfer | 485 | ||
| SUMMARY | 485 | ||
| REFERENCES | 486 | ||
| Improving Access to Care: The Physician/Physician Assistant Team | 489 | ||
| Key points | 489 | ||
| INTRODUCTION | 489 | ||
| SUPPLY AND DEMAND FOR CANCER CARE SERVICES | 490 | ||
| BRIDGING THE GAP | 491 | ||
| THE ROLE OF PHYSICIAN ASSISTANTS IN ONCOLOGY | 491 | ||
| TEAM-BASED CARE IN ONCOLOGY | 491 | ||
| IMPLEMENTING A NEW CARE DELIVERY MODEL | 492 | ||
| PRACTICE MODELS | 493 | ||
| Shared Clinic | 493 | ||
| Independent Clinic | 493 | ||
| Lymphoma procedure clinic | 493 | ||
| Survivorship clinic | 494 | ||
| Walk-in clinic | 494 | ||
| SUMMARY/DISCUSSION | 495 | ||
| REFERENCES | 496 | ||
| SUGGESTED READINGS | 497 | ||
| Surgical Options for Post-Mastectomy Breast Reconstruction | 499 | ||
| Key points | 499 | ||
| BREAST CANCER OVERVIEW | 500 | ||
| STAGING SYSTEM | 500 | ||
| BREAST RECONSTRUCTION AFTER MASTECTOMY | 501 | ||
| Skin-Sparing and Nipple-Sparing Mastectomy | 501 | ||
| Radiation | 501 | ||
| Expander-Implant-Based Reconstruction | 501 | ||
| Autologous-Based Reconstruction | 504 | ||
| Transverse Rectus Abdominus Myocutaneous Flap/Deep Inferior Epigastric Perforator | 504 | ||
| Pedicled Latissimus Dorsi Myocutaneous Flap | 506 | ||
| Nipple Reconstruction | 507 | ||
| SUMMARY | 507 | ||
| REFERENCES | 507 | ||
| Ethical Considerations in Oncology | 511 | ||
| Key points | 511 | ||
| INTRODUCTION | 511 | ||
| PATIENT CASE 1 | 512 | ||
| Ethical Case Analysis | 513 | ||
| Treatment Refusal | 513 | ||
| Moral Distress | 515 | ||
| PATIENT CASE 2 | 515 | ||
| The Physician Assistant and Bioethics | 516 | ||
| Principle-Based Ethics | 517 | ||
| Surrogate Decision Making | 517 | ||
| PATIENT CASE 3 | 518 | ||
| Pediatric Medical Care and Research in Children | 518 | ||
| Parental Permission/Assent | 519 | ||
| Nonbeneficial Therapy | 519 | ||
| Bioethics Mediation | 520 | ||
| SUMMARY/DISCUSSION | 521 | ||
| REFERENCES | 521 |