Skip to main content

Supportive care in cancer—a MASCC perspective

Abstract

The term ‘supportive care’ arose from the medical oncology literature predominantly in the context of managing the toxicities of cancer treatment but embraces all symptom management through treatment and survivorship. Supportive care should be patient-centred with good communication which includes family and carers and applies across the cancer experience from diagnosis, treatment, survivorship to end of life care. Supportive care encompasses physical and functional, psychological, social and spiritual well-being to improve the quality of life. Supportive care must be evidence-based and thus further research is essential. Supportive care requires screening for some symptoms and tools for patients to report their outcomes. Supportive care has to accommodate new physical toxicities, emotional distress as well as financial toxicity. Supportive care is often delivered by medical oncologists but any organ-related specialist, geriatrician, palliative care clinician, pain specialist, nutritionist, psycho-oncologist, social worker, physiotherapist, nurse or allied health worker who is required to relieve a patient’s symptoms or side effects may be involved in a multidisciplinary way. The field is evolving to embrace technology such as eHealth and mHealth capabilities which will enhance integrated care.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Hui D, Mori M, Parsons HA, Kim SH, Li Z, Damani S, Bruera E (2012) The lack of standard definitions in the supportive and palliative care literature. J Pain Symptom Manag 43(3):582–592. https://doi.org/10.1016/j.jpainsymman.2011.04.016

    Article  Google Scholar 

  2. 2.

    Klastersky J (1993) Unmasking MASCC. Support Care Cancer 1:2

    Google Scholar 

  3. 3.

    Olver I (ed) (2018) The MASCC Textbook of Supportive Care and Survivorship, Second edn. Springer International Publishing, Switzerland

    Google Scholar 

  4. 4.

    Rittenberg CN, Johnson L, Kuncio GM (2010) An oral history of MASCC, its origin and development form MASCC’s beginnings to 2009. Support Care Cancer 18:775–784

    PubMed  Google Scholar 

  5. 5.

    Jordan K, Aapro M, Kaasa S, Ripamonti CI, Scotté F, Strasser F, Young A, Bruera E, Herrstedt J, Keefe D, Laird B, Walsh D, Douillard JY, Cervantes A (2018) European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol 29:36–43

    CAS  PubMed  Google Scholar 

  6. 6.

    Senn HJ (1993) Quality of life in cancer patients: whose business is it anyway? Support Care Cancer 1:115

    CAS  PubMed  Google Scholar 

  7. 7.

    Ktistaki P, Alevra N, Voulgari M (2017) Long-term survival of women with breast cancer. Overview of supportive care needs assessment instruments. Adv Exp Med Biol 989:28–284

    Google Scholar 

  8. 8.

    Klastersky J, Libert I, Michel B, Obiols M, Lossignol D (2016) Supportive/palliative care in cancer patients: quo vadis? Support Care Cancer 24:1883–1888

    PubMed  Google Scholar 

  9. 9.

    Rapoport BL, van Eden R, Sibuad V et al (2017) Supportive care for patients undergoing immunotherapy. Support Care Cancer 25:3017–3030

    PubMed  Google Scholar 

  10. 10.

    Solheim TA, Laird BJA, Balstad TR et al (2017) A randomised phase II trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer. J Cachexia Sarcopenia Muscle 8:778–788

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Middlemiss T, Lloyd-Williams M, Laird BJ et al (2015) Symptom control trials in patients with advanced cancer: a qualitative study. J Pain Symptom 85 Manage 50(5):642–649

    Google Scholar 

  12. 12.

    Zafar SY, Currow DC, Cherny N, Strasser F, Fowler R, Abernethy AP (2012) Consensus based standards for best supportive care for clinical trials in advanced cancer. Lancet Oncol 13:e77–e82

    PubMed  Google Scholar 

  13. 13.

    Hui D, De La Cruz M, Mori M et al (2013) Concepts and definitions for “supportive care”, best supportive care”, “palliative care”, and “hospice care” in the published literature, dictionaries, and textbooks. Support Care Cancer 21(3):659–685

  14. 14.

    Lee RT, Ramchandran K, Sanft T, Von Roenn J (2015) Implementation of supportive care and best supportive care interventions in clinical trials enrolling patients with cancer. Ann Oncol 26:1838–1845

    CAS  PubMed  Google Scholar 

  15. 15.

    Ryn V, Phelan SM, Arora NK et al (2014) Patient-reported quality of supportive care among patients with colorectal cancer in the Veterans Affairs Health Care system. J Clin Oncol 32:809–815

    PubMed  PubMed Central  Google Scholar 

  16. 16.

    Cherny N (2011) Best supportive care: a euphemism for no care or a standard of good care? Semin Oncol 38(3):351–357

    PubMed  Google Scholar 

  17. 17.

    Cherny NI, Abernathy AP, Strasser F, Sapir R, Currow D, Zafar SY (2009) Improving the methodologic and ethical validity of best supportive care studies in oncology: lesson from a systematic review. J Clin Oncol 27:5476–5486

    PubMed  Google Scholar 

  18. 18.

    Nipp RD, Currow DC, Cherny NI, Strasser F, Abernathy AP, Zafar SY (2015) Best supportive care in clinical trials: a review of the inconsistency in control arm design. Br J Cancer 113:6–11

    CAS  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Currow DC, Foley K, Wheeler JL, Abernathy AP (2011) The need for re-evaluation of best supportive care studies reported to date. Br J Cancer 104:390–391

    CAS  PubMed  PubMed Central  Google Scholar 

  20. 20.

    World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Amended by the 59th WMA General Assembly, Seoul, October 2008

  21. 21.

    Ahmed N, Ahmedzai S, Vora V, Hillam S, Paz S (2004) Supportive care for patients with gastrointestinal cancer. Cochrane Database Syst Rev 3:CD003445

    Google Scholar 

  22. 22.

    Basch E, Dueck AC, Rogak LJ, Minasian LM, Kelly WK, O’Mara AM, Denicoff AM, Seisler D, Atherton PJ, Paskett E, Carey L, Dickler M, Heist RS, Himelstein A, Rugo HS, Sikov WM, Socinski MA, Venook AP, Weckstein DJ, Lake DE, Biggs DD, Freedman RA, Kuzma C, Kirshner JJ, Schrag D (2017) Feasibility assessment of patient reporting of symptomatic adverse events in multicenter cancer clinical trials. JAMA Oncol 3:1043–1050

    PubMed  PubMed Central  Google Scholar 

  23. 23.

    Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D (2017) Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 318:197–198

    PubMed  PubMed Central  Google Scholar 

  24. 24.

    Albaba H, Barnes TA, Veitch Z et al (2019) Acceptability of routine evaluations using patient-reported outcomes of common terminology criteria for adverse events and other patient-reported symptom outcome tools in cancer outpatients: Princess Margaret Cancer Centre Experience. Oncologist. https://doi.org/10.1634/theoncologist.2018-0830

  25. 25.

    Ripamonti CI, Pessi MA, Boldini S (2012) Supportive Care in Cancer Unit at the National Cancer Institute of Milan: a new integrated model of medicine in oncology. Curr Opin Oncol 24:391–396

    Google Scholar 

  26. 26.

    Cella DF (1994) Quality of life: concepts and definition. J Pain Symptom Manag 3:186–192

    Google Scholar 

  27. 27.

    Jansen F, van uden-Kraan F, Zwieten V, Witte BI, Verdonck-de Leeuw (2015) Cancer survivors’ perceived need for supportive care and their attitude towards self-management and eHealth. Support Care Cancer 23:1679–1688

    PubMed  Google Scholar 

  28. 28.

    Kim Y, Carver CS (2019) Unmet needs of family cancer caregivers predict quality of life in long-term cancer survivorship. J Cancer Surviv 13(Jul 24):749–758. https://doi.org/10.1007/s11764-019-00794-6

    Article  PubMed  Google Scholar 

  29. 29.

    Oliveri S, Ferrarti F, Manfrinati A, Prvettoni G (2018) A systematic review of the psychological interventions of genetic testing: a comparative analysis among cardiovascular, neurodegenerative and cancer diseases. Front Genet 9:624. https://doi.org/10.3389/fgene.2018.00624

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Mathioudakis AG, Salaakri M, Pylkkanen L et al (2019) Systematic review on women’s values and preferences concerning breast cancer screening and diagnostic services. Psychooncology 28:939–947

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    Skinner EH (2017) Intensive preoperative prehabilitation improves functional capacity and postoperative hospital length of stay in elderly patients with lung cancer [synopsis]. J Physiother 63:184

    PubMed  Google Scholar 

  32. 32.

    Driessen EJ, Peeters ME, Bongers BC, Maas HA, Bootsma GP, van Meeteren NL, Janssen-Heijnen ML (2017) Effects of prehabilitation and rehabilitation including a home-based component on physical fitness, adherence, treatment tolerance, and recovery in patients with non-small cell lung cancer: a systematic review. Crit Rev Oncol Hematol 114:63–76

    PubMed  Google Scholar 

  33. 33.

    Leensen MCJ, Gropenveld IF, Rejda T et al (2017) Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 7:e014746

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    Jacobsen PB, Nipp RD, Ganz PA (2017) Addressing the survivorship care needs of patients receiving extended cancer treatment. Am Soc Clin Oncol Educ Book 37:674–683

    PubMed  Google Scholar 

  35. 35.

    Krakowski I (2006) Supportive care for people affected by cancer: concept and management. Rev Pract 56:1989–1996

    Google Scholar 

  36. 36.

    Moore PM, Rivera S, Bravo-Soto GA, Olivares C, Lawrie (2018) Communications skills training for healthcare professionals working with people who have cancer. Cochrane Database Syst Rev 7:CD003751. https://doi.org/10.1002/14651858.CD0037561.pub4

    Article  PubMed  Google Scholar 

  37. 37.

    Multinational Association of Supportive Care in Cancer. MASCC Guidelines https://www.mascc.org/guidelines (Last accessed September 2019)

  38. 38.

    Davies A, Leach C, Caponero R, Dickman A, Fuchs D, Paice J, Emmanuel A (2019) MASCC recommendations on the management of constipation in patients with advanced cancer. Support Care Cancer 28:23–33. https://doi.org/10.1007/s00520-019-05016-4

    Article  PubMed  Google Scholar 

  39. 39.

    Lacouture ME, Anadkat MJ, Bensadoun R-J et al (2011) Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer 19:1079–1095

    PubMed  PubMed Central  Google Scholar 

  40. 40.

    Multinational Association of Supportive Care in Cancer. MASCC International Pain Management Centre. https://mascc.memberclicks.net/pain-center (Last accessed September 2019)

  41. 41.

    Australian Government Cancer Australia EdCan. Supportive Care Screening. http://edcan.org.au/edcan-learning-resources/supporting-resources/supportive-care/screening (Last accessed September 2019)

  42. 42.

    National Comprehensive Cancer Network. NCCN Distress Thermometer for Patients. 2013 November 2014; Available from: http://www.nccn.org/patients/resources/life_with_cancer/pdf/nccn_distress_thermometer.pdf (Last accessed September 2019)

  43. 43.

    Multinational Association of Supportive Care in Cancer. MASCC Assessment Tools https://mascc.memberclicks.net/tools-and-apps (Last Accessed September 2019)

  44. 44.

    Brahmer JR, Lacchetti C, Schneider BJ et al (2018) Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. https://doi.org/10.1200/JCO.2017.77.6385

  45. 45.

    PDQ® Adult Treatment Editorial Board. PDQ Financial Toxicity and Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated 01/30/2018. Available at: https://www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity-hp-pdq. (Last Accessed April 2018)

  46. 46.

    Davidoff AJ, Erten M, Shaffer T, Shoemaker JS, Zuckerman IH, Pandya N, Tai MH, Ke X, Stuart B (2013) Out-of-pocket health care expenditure burden for Medicare beneficiaries with cancer. Cancer 119:1257–1265

    PubMed  Google Scholar 

  47. 47.

    Carrera PM, Olver I (2015) The financial hazard of personalized medicine and supportive care. Support Care Cancer 23:3390–3341

    Google Scholar 

  48. 48.

    Shih YC, Smieliauskas F, Geynisman DM et al (2015) Trends in the cost and use of targeted Cancer therapies for the privately insured nonelderly: 2001 to 2011. J Clin Oncol 33:2190–6219

    PubMed  PubMed Central  Google Scholar 

  49. 49.

    Bradley CJ, Yabroff KR, Warren JL, Zeruto C, Chawla N, Lamont EB (2016) Trends in the treatment of metastatic colon and rectal cancer in elderly patients. Med Care 54:490–497

    PubMed  Google Scholar 

  50. 50.

    Herrstedt J (2018) The latest consensus on antiemetics. Curr Opin Oncol 30:233–239

    PubMed  Google Scholar 

  51. 51.

    Gordon LG, Walker SM, Mervin MC et al (2015) Financial toxicity: a potential side effect of prostate cancer treatment among Australian men. Eur J Cancer Care 2017;26(1). https://doi.org/10.1111/ecc.12392

  52. 52.

    De Souza JA, Yap BJ, Wroblewski K et al (2017) Measuring financial toxicity as a clinically relevant patient-reported outcome: the validation of the Comprehensive Score for financial Toxicity (COST). Cancer 23:476–484

    Google Scholar 

  53. 53.

    De Souza JA, Proussaloglou E, Nicholson L, Wand Y (2017) Evaluating financial toxicity (FT) interventions. J Clin Oncol 354(15):(Suppl e21637

    Google Scholar 

  54. 54.

    Robotin M, Olver I, Girgis A (eds) (2010) When cancer crosses disciplines. A Physicians Handbook. Imperial College Press, London

    Google Scholar 

  55. 55.

    Scotté F, Bossi P, Carola E, Cudennec T, Dielenseger P, Gomes F, Knox S, Strasser F (2018) Addressing the quality of life needs of older patients with cancer: a SIOG consensus paper and practical guide. Ann Oncol 29:1718–1726

    PubMed  Google Scholar 

  56. 56.

    Floyd JD, Nguyen DT, Lobins RL, Bashir Q, Doll DC, Perry MC (2005) Cardiotoxicity of Cancer therapy. J Clin Oncol 23:7685–7696

    CAS  PubMed  Google Scholar 

  57. 57.

    Mulrooney DA, Yeazel MW, Kawashima T et al (2009) Cardiac outcomes in a group of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort. MMJ 339:b4604. https://doi.org/10.1136/bmj.b4604

    Article  Google Scholar 

  58. 58.

    Armenian SH, Lacchetti C, Barac A, Carver J, Constine LS, Denduluri N, Dent S, Douglas PS, Durand JB, Ewer M, Fabian C, Hudson M, Jessup M, Jones LW, Ky B, Mayer EL, Moslehi J, Oeffinger K, Ray K, Ruddy K, Lenihan D (2017) Prevention and monitoring of cardiac dysfunction in survivors of adult cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 35:893–911

    PubMed  Google Scholar 

  59. 59.

    Scotté F, Oudard S, AboudaggaH ER, Bonan B (2013) The practical approach to improve safety and management in chemotherapy units based on the PROCHE – prgramme for optimization of the chemotherapy network monitoring program. Eur J Cancer 49:541–544

    PubMed  Google Scholar 

  60. 60.

    Association of Community Cancer Centres. Froedeert and the Medical College of Wisconsin Clinical Cancer Centre at Froedtert Hospital Campus. https://www.accc-cancer.org/home/about/awards/accc-innovator-awards/2018-winners/froedtert-clinical-cancer-center [Last accessed October 2019]

  61. 61.

    The Christie NHS Foundation trust. Acute Oncology https://www.christie.nhs.uk/services/a-to-h/acute-oncology/ [last accessed October 2019]

  62. 62.

    Vasile E, Lucchesi M, Ginocchi L et al Dedicated supportive care team at the oncology unit: a model of simultaneous care for cancer patients. Support Care Cancer 22:867–868

  63. 63.

    Ripamoniti CI, Molani P, Desti C et al (2017) A supportive care in cancer unit reduces costs and hosptialisations for transfusions in a comprehensive cancer center. Tumori 103:449–456

    Google Scholar 

  64. 64.

    Multinational Association of Supportive Care in Cancer (2019) MASCC to Recognise Centers of Excellence in Supportive Care in Cancer. https://www.mascc.org/index.php?option=com_content&view=article&id=771:mascc-to-recognize-centers-of-excellence-in-supportive-care-in-cancer&catid=39:mascc-headlines&Itemid=323 (Last accessed September 2019)

  65. 65.

    Moynihan T, Herrstedt J (2016) Supportive Care Measures. In Dittrich C, Kosty M, Jezdic S et al. ESMO/ASCO recommendations for a global curriculum in medical oncology edition 2016. ESMO Open 1:e00097. https://doi.org/10.1136/esmoopen-2016-000097

  66. 66.

    American Society of Clinical Oncology. Supportive Oncology Care. https://elearning.asco.org/coursecollection/supportive-oncology-care (last accessed September 2019)

  67. 67.

    World Health Organisation. WHO Definition of Palliative Care. https://www.who.int/cancer/palliative/definition/en/ (Last accessed September 2019)

  68. 68.

    Haun MW, Estel S, Rücker G et al (2017) Early palliative care for adults with advanced cancer (review). Cochrane Database Syst Rev (Issue 6):Art no CD011129

  69. 69.

    Roila F, Molassiotis A, Herrstedt J et al (2016) 2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients. Ann Oncol 27(suppl 5):119–133

    Google Scholar 

  70. 70.

    Lo SS, Buss MK (2019) What is the difference between supportive and palliative care? ASCO News June 3

  71. 71.

    Multinational Association of Supportive Care in Cancer. https://www.mascc.org/ [Last accessed Feb 6 2020]

  72. 72.

    Prochaska JJ, Coughlin SS, Lyons EJ (2017) Social media and mobile technology for cancer prevention and treatment. Am Soc Clin Oncol Educ Book 37:128–137

    PubMed  PubMed Central  Google Scholar 

  73. 73.

    Languis-Eklöj A, Crafoord M-T, Chritiansen M, Fjell M, Sundberg K (2017) Effects of an interactive mHealth innovation for early detection of patient-reported symptom distress with focus on participatory care: protocol for a study based on prospective, randomized, controlled trials in patients with prostate and breast cancer. BMC Cancer 17:466. https://doi.org/10.1186/s12885-017-3450-y

    Article  Google Scholar 

  74. 74.

    Garcia SF, Wortman K, Cella D et al (2019) Implementing electronic health record-integrated screening of patient-reported symptoms and supportive care needs in a comprehensive cancer center. https://doi.org/10.1002/cncr.32172

  75. 75.

    Maguire R, Fox PA, McCann L, Miaskowski C, Kotronoulas G, Miller M, Furlong E, Ream E, Armes J, Patiraki E, Gaiger A, Berg GV, Flowerday A, Donnan P, McCrone P, Apostolidis K, Harris J, Katsaragakis S, Buick AR, Kearney N (2017) The eSMART study protocol: a randomized controlled trial to evaluate electronic symptom management using the advanced symptom management system (ASyMS) remote technology for patients with cancer. BMJ Open 7:e015016. https://doi.org/10.1136/bmjopen-2016-015016

    Article  PubMed  PubMed Central  Google Scholar 

  76. 76.

    Jibb LA, Stevens B, Nathan PC et al (2017) Implementation and preliminary effectiveness of a real-time pain management smartphone app for adolescents with cancer: a multicenter pilot clinical study. Pediatr Blood Cancer 64. https://doi.org/10.1002/pbc.26554

  77. 77.

    Russell L, Pascoe MC, Seymour JF, Aranda S, Butow P, Gough K, Schofield P (2019) The trials and tribulations of conducting an m-health pilot randomized controlled trial to improve oral cancer therapy adherence: recommendations for future multisite, non-drug clinical trials. BMC Res Notes 12:226. https://doi.org/10.1186/s13104-019-4264-6

    Article  PubMed  PubMed Central  Google Scholar 

  78. 78.

    Atema V, van Leeuwen M, Oldenburg HS et al (2016) Design of a randomized controlled trial of Internet-based cognitive behavioral therapy for treatment-induced menopausal symptoms in breast cancer survivors. BMC Cancer 16:920

    PubMed  PubMed Central  Google Scholar 

  79. 79.

    Smith AB, Bamgboje-Ayodele A, Butow P et al (2019) Development and usability evaluation of an online self-management intervention for fear of cancer recurrence (iConquerFear). Psychooncology 29:98–106. https://doi.org/10.1002/pon.5218

    Article  PubMed  Google Scholar 

  80. 80.

    Ananda-Rajah MR, Bergmeir C, Petitjean F, Slavin MA, Thursky KA, Webb GI (2017) Towards electronic surveillance of invasive mold diseases in hematology-oncology patients: an expert system combining natural language processing of chest computed tomography reports, microbiology, and antifungal drug data. Clin Care Inform 1:1–10

    Google Scholar 

Download references

Author information

Affiliations

Authors

Contributions

All authors contributed to the study concept and the writing of the manuscript. The first draft was completed by Olver and all authors contributed to revisions. All authors have approved the final manuscript.

Corresponding author

Correspondence to Ian Olver.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Olver, I., Keefe, D., Herrstedt, J. et al. Supportive care in cancer—a MASCC perspective. Support Care Cancer 28, 3467–3475 (2020). https://doi.org/10.1007/s00520-020-05447-4

Download citation

Keywords

  • Supportive care
  • Cancer
  • Symptoms
  • Treatment toxicity
  • Quality of life