The supportive oncology landscape: current status.

Abstract

Purpose: Cancer care has changed dramatically in the past decade, with novel treatments and longer life expectancy. Despite these advancements, many people with cancer experience significant disease and treatment-related morbidity and mortality. The term "supportive oncology" has been proposed to define various services (nutrition counseling, palliative medicine, psychology, etc.) to support individuals throughout the cancer-care continuum. Though these services are vital, their availability, implementation, and organization are inconsistent and ill-defined.

Methods: We did a Google™ search to identify the availability of sixteen empirically determined supportive oncology services. Four distinct searches were performed sequentially with the terms, 1.) "supportive oncology programs", 2.) "supportive oncology departments", 3.) "cancer care support", and 4.) "cancer support programs." Results were filtered through ten further criteria. Descriptive language regarding service organization and leadership structure was reviewed.

Results: All four searches in combination yielded 88 cancer care entities (CCE). Then, 32 (36%) were designated by the National Cancer Institute as a Comprehensive Cancer Center (NCI-CCC). Of all CCE, the most frequent service provided was support groups (76/88, 86%), and least often geriatric oncology (18/88, 21%). NCI-CCC offered a greater scope and scale of services than non-designated centers. Then, 45 (51%) CCE referred to these offerings as "services" but only 8 (9%) were organized as a formal department.

Conclusions: Heterogeneity exists in the types of supportive services provided by CCE. The predominant informal organization of supportive oncology services is notable and unsatisfactory. To improve comprehensive cancer care, there is a compelling need for organizations like the NCI, American Society of Clinical Oncology, and the Commission on Cancer to develop formal standards for supportive oncology services.