Ease the Discomfort and Stress of Cancer Treatment with Supportive Care

More and more patients are being offered palliative, or supportive, care, and this is a welcomed trend.
BY DEBU TRIPATHY, M.D.
PUBLISHED May 01, 2019
More and more patients are being offered palliative, or supportive, care, and this is a welcomed trend.

This type of care, which ranges from yoga and acupuncture to physical therapy and psychological counseling, as well as medications, aims to treat the physical, emotional and psychological symptoms or side effects of therapy and develop individual plans to address and monitor these problems over time. It’s given alongside and coordinated with standard medical, surgical and radiotherapy treatments to make the process more comfortable and less stressful for patients.

That’s why the term “supportive care” is more appropriate than the older term “palliative care.” It more clearly explains the goals of these therapies and may leave patients and their physicians feeling more open to the experience.

In the supportive care clinic at our institution, The University of Texas MD Anderson Cancer Center, patients are exposed to numerous strategies that may help them ease their symptoms. They undergo a head-to-toe assessment and work out a care plan that can include pain management, surgical prehabilitation or rehabilitation, streamlining of their list of medications to help prevent drug duplication or unnecessary side effects, psychological or spiritual care, guidance from a nutritionist, integrative medicine activities such as acupuncture or yoga, and discussions about advanced care planning. Wherever they are being treated, patients with cancer should report their physical and emotional symptoms and ask for supportive care. If their institution has a supportive care clinic, patients can seek an appointment there, if this hasn’t already prescribed. Or, if their cancer centers don’t have supportive care departments, patients can ask to receive these services in other settings.

Recent studies show that real-time monitoring of symptoms may help care teams provide supportive care that is more tailored to patients’ needs and ensure that areas where help may be needed are not overlooked. This can be accomplished by asking patients to take surveys at clinic visits or by phone, text or email, with the aim of providing swift resolution of symptoms. Some study findings show that this can even improve survival. Fitbits and other wearable devices may also be used to assess patient functional status and sleep quality in real time, a strategy now being studied.

Insurance companies are increasingly covering supportive care that is based on patients’ reports of their symptoms in real time. The companies even encourage or mandate programs to systematically assess and address symptoms. This not only improves outcomes but also cuts down on emergency room visits, hospital admissions and costs in general.

Ideally, all patients who have cancer and report any physical or psychological symptoms would automatically receive supportive care. A good goal for the health care system is to make this kind of assessment and care routine at all cancer centers and take measures to get these strategies universally covered by health insurance plans. This movement is coming of age — finally.

Debu Tripathy, M.D., is editor-in-chief of CURE magazine and professor of medicine and chair of the Department of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center.
 
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