PRINCIPLE 4: Supportive care

PRINCIPLE 4: Supportive care

Supportive care is a vital part of any cancer treatment program. Supportive care deals with issues that emerge for patients, families and carers from the effects of the cancer diagnosis and its treatment. It is made up of all the services, information and resources patients may need to meet their physical, psychological, social, information and spiritual needs from the time of diagnosis.

Supportive care may be ‘patient-defined’ and based on unmet needs. It is a core component of evidence-based clinical care and its benefits are well established. All cancer patients and their carers should be formally supported and have access to understandable, relevant information about the medical, practical and emotional aspects of the cancer and its treatment (Fitch 2008). The wishes and needs of the patient, their family and their carers should determine the level of support provided. Supportive care is a standard or routine aspect of cancer care and the treatment team should make patients aware of this.

Supportive care should begin from the time of diagnosis and continue throughout the cancer pathway.

For health professionals, supportive care involves:

  • screening and assessing patients and families for their supportive care needs
  • providing patients with access to a range of multidisciplinary support services, groups and therapies designed to assist them to live with cancer and its treatment and optimise recovery
  • optimising referral pathways to community support organisations (cancer-related non-government, not-for-profit and charities) that provide services to cancer survivors – these address many of the care-navigation, psychosocial and information needs of cancer survivors and those affected by cancer (Australian Cancer Survivorship Centre 2019)
  • being aware of and delivering culturally appropriate care.

All members of the multidisciplinary team have a role in providing supportive care along the care pathway, with special attention at transition points.

Supportive care involves routinely and systematically assessing patients to determine their needs. Health professionals can use a variety of validated screening tools for this task (see box below). Clinical review and individual assessment are still required to ensure all patient concerns are identified.

More information

Visit the WeCan website for information and resources on supportive care.

Validated screening tools

  • National Comprehensive Cancer Network
  • Distress Thermometer and Problem Checklist and Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP).

Adult & Young Adult Screening tool

  • The Adolescent & Young Adult Psycho-Oncology Screening Tool (AYA-POST) (Patterson et al. 2021) & The Psychosocial Assessment Tool (PAT) (Kazak et al. 2011)

Key review points

The treatment team should assess patients for supportive care needs at these key stages:

  • initial presentation or diagnosis (first three months)
  • the beginning of treatment or a new phase of treatment
  • change in prognosis
  • if a patient is found to have a germline genetic mutation predisposing to cancer
  • end of treatment
  • throughout survivorship
  • diagnosis of recurrence
  • change in or development of new symptoms
  • palliative care
  • end-of-life care
  • other time points based on clinical judgement.

The team also needs to decide whether the patient requires ongoing referral to supportive care services. Access to services can be through general practice–led chronic disease management plans, team care arrangements and mental health plans. Community support services also have a role to play.

See Appendices A and B, and special population groups for more information on supportive care and the specific needs of people that may arise.