Supportive and Palliative Care

Abstract

The definition of palliative and supportive care is often overwhelming and may be confused in common clinical practice. Supportive care is the multiprofessional attention to the individual’s overall physical, psychosocial, spiritual, and cultural needs and should be available at all stages of the illness. Palliative care shares the same objectives of supportive care, and some authors consider it in the advanced stages of disease. Actually it is important to carry out all these interventions from the earlier phases of disease to improve patient quality of life, to prevent therapy discontinuation for side effects, and hence to an optimization of outcomes. Quality of life is a heterogeneous concept characterized by multidimensionality and subjectivity. Standardized questionnaires are the best method to measure and compare quality of life of different patients in different countries. Evaluation of pain and its medical therapy are outstanding elements in the supportive and palliative care of cancer patients. The correct use of WHO analgesic ladder permits a symptom control in more than 90% of subjects: the first step is the use of Fans and paracetamol; the second is the use of so-called “weak” opioids such as tramadol, codein, and dextroprepoxifene; the third involves so- called “strong” opioids such as morphine, oxycodone, buprenorphine, fentanyl, hydrocodone, methadone, tapentadol, and formulations of oxycodone/naloxone.