Teaching supportive care: what is the core curriculum?

Abstract

Purpose of reviewCancer treatment options have developed rapidly in the past years. Targeted-and immune therapy have resulted in additional supportive care needs. This review describes a teaching program in supportive care. Recent findingsSupportive care begins at the time of cancer diagnosis and continues until the patient has died or is cured and late toxicities and other survivorship issues have been properly addressed. Supportive care is divided into four phases. In the curative phase, competences regarding prevention and management of acute treatment and subacute treatment side effects are important. In the survivorship phase, competences related to late toxicity and chronic toxicity are warranted. In the palliative phase, focus will be on competences concerning cancer complications, and specific end-of-life competences are needed as well. Obviously some competences are needed in all phases, for example, communication skills. SummaryCompetences concerning symptoms and complications are summarized for each phase in table format. General competences are listed in the text body of the manuscript. Regular update and implementation is crucial. The future cancer population will consist of a higher number of older cancer patients and survivors. This should reflect curriculum updates as should the increasing possibilities for multigene sequencing enabling personal medicine (including supportive care) to a larger extent than today.

Supportive care for elderly patients with cancer

“…Denne artikel sammenfatter den seneste viden om supportive care til aeldre kraeftpatienter og deres naermeste pårørende. Artiklen er inddelt efter Herrstedt et als [9] fire faser for supportive care: den behandlende fase, den rehabiliterende fase, den palliative fase og fasen for livets afslutning.…”

“…Den behandlende fase indledes, når den aeldre patient er blevet diagnosticeret og informeret om sygdomsprognose, behandlingsmuligheder, bivirkninger og komplikationer [9].…”

“…Efter den behandlende fase kan kraeftsygdommen for nogle patienter fortsat vaere til stede. Nogle patienter vil rykke videre til den pallierende fase, mens andre vil have status som helbredt eller have lang overlevelsestid [9].…”

“…For patienter med fremskreden sygdom, hvor helbredelse ikke er mulig, vil behandlingsfokus og -formål vaere bedst mulig livskvalitet for patienten [9]. Også denne fase bør afhaenge af patientens behov og ønsker og evalueres og justeres løbende i et tvaerfagligt samarbejde sammen med patient og pårørende [9].…”

Ældre med kræft

“…Understøttende behandling, i.e. supportive care, omhandler al den hjaelp, en patient med kraeft har brug for ud over selve behandlingen [3]. Det er afgørende for et godt forløb, at det tvaerfaglige team har fokus på, hvor patienten er i sit kraeftforløb, da behovene aendres med tid.…”