What is the Purpose of Supportive Care?

What are the objectives of supportive care?

Undergoing cancer treatment presents complex challenges for patients and their families, often spanning several months. Preventing and treating treatment side effects (radiotherapy, chemotherapy, and biological medications) is crucial for improving patients' quality of life and enabling them to complete their treatment without interruption due to excessive discomfort.

Supportive care in oncology, also known as adjuvant or palliative therapy, aims to alleviate symptoms caused by serious illnesses such as cancer. Supportive care therapies in oncology can be administered at any stage of the treatment journey and encompass various aspects: personal care, psychological support, social support, patient environment, and nutrition. In short, any intervention that can reduce pain and improve the patient's quality of life, making treatment more bearable.

There's a misconception that these interventions are solely for the terminal stages of the disease, but today their application is more widespread than ever, starting from the moment of initial diagnosis.

Cancer supportive care does not replace traditional therapies and medications but helps patients cope with the pain and side effects of the disease or treatments. The most frequent side effects include nausea, fatigue, urinary problems, and erectile dysfunction. This type of adjuvant intervention supports patients and their families at all stages of the disease, particularly during critical moments: after the initial diagnosis, in case of symptom worsening, in case of relapse, and unfortunately, in the terminal phase.

Supportive palliative care can be administered in a hospital, at home, or in a hospice—facilities and hospices that care for seriously ill individuals when home care is not feasible. Supportive care can be prescribed on the instructions of the general practitioner or specialist, as part of ongoing care, or by contacting volunteer organizations. This type of therapy can be provided by the oncologist themselves or other healthcare professionals, including psychologists specializing in the treatment of oncological diseases.

What are the different types of supportive care?

Patients receive scheduled supportive care, whether it's a transfusion, pain management, etc., and in emergencies when unforeseen events occur. Among the most well-known and burdensome side effects requiring supportive care in oncology, patients experience nausea and vomiting, but also mucus and skin rashes with new targeted therapies, or cancer-related fatigue—chronic fatigue that sometimes persists long after treatment ends. This fatigue should be reported and never underestimated as it often prevents a return to active professional and social life. Then there's depression, which must also be managed as effectively as possible and never underestimated, as well as the psychological problems of family members, particularly young children.

How to Access Supportive Care?

An oncology patient can receive supportive care at home, in a care center, or in a hospital:

• Home palliative care consists of a set of multidisciplinary professional services provided directly to the home of the ill person. The goal is to provide the homebound patient with all necessary therapies to meet their health needs, even complex ones, ensuring the best possible quality of life;
• Palliative care centers or hospices are structures that are part of the care network for patients in the terminal phase, for the temporary hospitalization of patients suffering from progressive and advanced diseases, with rapid evolution and a poor prognosis, for whom any therapy aimed at curing or stabilizing the pathology is no longer possible or inappropriate. Hospices provide medical and nursing care and the presence of technical caregivers seven days a week, 24 hours a day, and have formalized protocols for pain and symptom control, sedation, nutrition, hydration, and formalized programs for patient and family information, communication, and support, counseling in case of death and bereavement, clinical audit, and psycho-emotional support for the team;
• Inpatient palliative care is characterized by palliative advice provided by a medical and nursing team with specific skills and experience, day hospital services, outpatient activities, and inpatient services. Day hospital palliative care ensures the provision of therapeutic services of particular complexity that cannot be provided in other structures of the palliative care network. Outpatient clinics provide services for independent patients who need specialized multidimensional assessment for optimal symptom control, including pain, and family support;

EXPRESS QUOTE

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Which Teams Provide Supportive Care?

The physician specializing in palliative care manages and intervenes in the control of symptoms and side effects of cancer therapy, aiming for a better quality of life for the patient and their loved ones. It is at this delicate moment in life that the need for support appears to alleviate pain, understood not only as a physical and clinical experience but as an existential process.

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