Advancements in Supportive Care

As researchers gain a better understanding of the toxicities associated with chemotherapy and radiation therapy, they have focused more on developing drugs and therapeutics that address the complications of cancer treatment.

One of the most important advancements in cancer treatment has been recognizing that supportive care and symptom management are key, regardless of the stage of disease or intent of treatment, says Jennifer S. Temel, MD, assistant professor of medicine at Harvard Medical School and clinical director of thoracic oncology at Massachusetts General Hospital in Boston. “More specifically, there is greater data demonstrating that the provision of supportive care, for example palliative care, can improve the experience of cancer patients.”

Another important advancement is encouraging better communication between patients and providers, says Thomas J. Smith, MD, director of palliative medicine at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore.

Patients want to know: ‘What do I have? What’s going to happen to me? What can be done about it?’ And this is nearly universal.

“Patients want to know: ‘What do I have? What’s going to happen to me? What can be done about it?’ And this is nearly universal,” he says. “In every culture—about 90 to 95 percent of people want all the available information. The data are clear that oncologists like me don’t often give this information.”

Another major advance, according to Smith, is in the integration of palliative care and hospice into usual care. This is now recommended by the American Society of Clinical Oncology for anyone with serious cancer, he says. Research indicates that care with both an oncology and a palliative care team can lead to better symptom management, improved communication, less depression and better understanding of the illness and options.

Palliative care is focused on relieving the symptoms, pain and stress of a serious illness and is appropriate at all stages of the disease.

But many patients hear the word “palliative” and immediately think of hospice, says Charles Loprinzi, MD, a breast cancer specialist at the Mayo Clinic in Rochester, Minn. “It is important to explain the difference,” he says, “as the two are very different. And it is important to incorporate palliative care early on in treatment.”

Other advancements include the increasing use of integrative therapies and the use of bonemodifying drugs in bone metastasis.