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. 2014 Jul;26(4):372-9.
doi: 10.1097/CCO.0000000000000086.

Definition of supportive care: does the semantic matter?

David Hui  1
Affiliations

Definition of supportive care: does the semantic matter?

David Hui. Curr Opin Oncol. 2014 Jul.

Abstract

Purpose of review: 'Supportive care' is a commonly used term in oncology; however, no consensus definition exists. This represents a barrier to communication in both the clinical and research settings. In this review, we propose a unifying conceptual framework for supportive care and discuss the proper use of this term in the clinical and research settings.

Recent findings: A recent systematic review revealed several themes for supportive care: a focus on symptom management and improvement of quality of life, and care for patients on treatments and those with advanced stage disease. These findings are consistent with a broad definition for supportive care: 'the provision of the necessary services for those living with or affected by cancer to meet their informational, emotional, spiritual, social, or physical needs during their diagnostic, treatment, or follow-up phases encompassing issues of health promotion and prevention, survivorship, palliation, and bereavement.' Supportive care can be classified as primary, secondary, and tertiary based on the level of specialization. For example, palliative care teams provide secondary supportive care for patients with advanced cancer.

Summary: Until a consensus definition is available for supportive care, this term should be clearly defined or cited whenever it is used.

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Figures

Figure 1.
Figure 1.. Supportive Care Issues for Cancer Patients.
From the time of diagnosis, cancer patients experience a multitude of supportive care issues, including physical, psychological and spiritual distress, as well as social and informational needs. The blue bars illustrate the relative intensity of these issues at various stages of disease. These supportive care issues are addressed by multiple disciplines, including oncology, internal medicine, palliative care, psychology and social work. Specialized interdisciplinary teams such as palliative and hospice care address the multidimensional supportive care needs of patients with advanced cancer and their families (orange cylinder). Survivorship programs focus on managing the long term treatment related side effects, and providing psychosocial support and patient education for cancer survivors.
Figure 2.
Figure 2.. A Conceptual Model for Supportive Care, Palliative Care and Hospice Care.
Supportive care includes the widest scope of services, ranging from survivorship programs for cancer survivors to bereavement care for bereaved caregivers. Palliative care provides supportive care to patients with advanced cancer and their families, and includes both palliative care programs in acute care facilities and hospice care programs in the community. Oncologists are often involved in the management of various acute and chronic treatment related adverse effects, and may involve other disciplines on a referral basis (e.g. pulmonary medicine for interstitial lung disease). Survivorship programs focus on providing care to cancer-free individuals.
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References

    1. NIH state-of-the-science conference statement on improving end-of-life care. NIH Consens State Sci Statements 2004; 21:1–26. - PubMed

    1. Hui D, Mori M, Parsons H et al.: The lack of standard definitions in the supportive and palliative oncology literature. J Pain Symptom Manage 2012; 43:582–592.

      * This study highlights the relative frequency of occurrence and the lack of definitional clarity for many key terms such in supportive and palliative oncology.

    1. Hui D, Bruera E: Supportive and palliative oncology: A new paradigm for comprehensive cancer care. Hematology & Oncology Review 2013. 9:68–74.
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