The rapidly evolving field of Palliative Care focuses on the management of phenomena that produce discomfort and that undermine the quality of life of patients with incurable medical disorders. The interdisciplinary clinical purview includes those factors - physical, psychological, social, and spiritual - that contribute to suffering, undermine the quality of life, and prevent a death with comfort and dignity. Palliative Care is a fundamental part of clinical practice, the parallel universe to therapies directed at cure or prolongation of life. All clinicians who treat patients with chronic life threatening diseases are engaged in palliative care, continually attempting to manage complex symptomatology and functional disturbances. The scientific foundation of palliative care is advancing, and similarly, methods are needed to highlight, for practitioners at the bedside, the findings of empirical research. Topics in Palliative Care Series is divided into sections that address a range of issues. Addressing aspects of sumptom control, psyshocsoical functioning, spiritual or existential concerns, ethics, and other topics, the chapters in each section review the given area and focus on a small number of salient issues for analysis. The authors present and evaluate existing data, provide a context drawn from clinical and research settings, and integrate knowledge in a manner that is both practical and readable. The specific topics covered in Volume 5 are Cultural issues in Palliative Care, Palliative Care in Geriatrics, Communication Issues in Palliative Care, Outcomes Research in Palliative Care, Opiod Tolerance; Reality of Myth?, and Pain and other symptoms: Treatment Challenges.