Special Topics in Medical Oncology
Special Topics in Medical Oncology groups the dimensions of cancer care that run alongside and beyond anticancer drug treatment: controlling pain and other symptoms, supporting people through and after treatment, attending to psychological and social needs, providing palliative and end-of-life care, and restoring function and quality of life. These topics share a focus on the person living with cancer rather than on the tumour alone.
Definition
An organising area within medical oncology covering the supportive, psychosocial, rehabilitative, survivorship, and palliative aspects of caring for people with cancer, complementing tumour-directed therapy.
Scope
This area orients readers to five supportive and patient-centred topics within medical oncology: cancer pain management, survivorship and late effects, palliative and end-of-life care, psychosocial oncology, and cancer rehabilitation and quality of life. It frames how these fields relate to one another and to disease-directed oncology; the detailed essentials live in the individual topic entries.
Sub-topics
Core questions
- How can the symptom burden of cancer and its treatment be assessed and relieved?
- What are the long-term and late consequences of cancer and its therapy for survivors?
- How are psychological, social, and existential needs addressed across the cancer trajectory?
- When and how should palliative care be integrated with active oncology care?
- How can function and quality of life be measured and supported during and after treatment?
Key concepts
- Patient-centred and supportive oncology care
- Symptom burden across the cancer trajectory
- Early integration of palliative care
- Survivorship and late effects
- Health-related quality of life
- Psychosocial distress and its screening
Clinical relevance
Supportive, psychosocial, palliative, and rehabilitative care shape how people experience cancer and its treatment, and randomised evidence shows that integrating palliative care early with standard oncology care can improve quality of life and mood (Temel, 2010). Professional bodies now recommend that these dimensions be part of routine oncology practice (Ferrell, 2017). This area describes the structure of these fields for orientation and is not a source of individual treatment guidance.
Epidemiology
The relevance of these topics grows with the expanding population of people living with and beyond cancer; survivorship statistics document millions of survivors who carry long-term and late effects of disease and treatment (Miller, 2019).
Evidence & guidelines
The integration of these supportive dimensions into oncology is supported by clinical trials and by clinical practice guidelines, including ASCO's guidance on integrating palliative care into standard oncology care (Ferrell, 2017).
History
Modern supportive and palliative oncology grew out of the twentieth-century hospice movement and the recognition that controlling symptoms and addressing the whole person are integral to cancer care. The publication of landmark trials of early palliative care and the formalisation of survivorship as a distinct phase of the cancer continuum consolidated these areas within medical oncology.
Related topics
Seminal works
- temel-2010
- ferrell-2017
Frequently asked questions
- How do these special topics differ from the rest of medical oncology?
- Tumour-directed oncology focuses on diagnosing and treating the cancer itself, whereas these topics focus on the consequences of cancer and its treatment for the person: symptoms, function, psychological and social wellbeing, survivorship, and care near the end of life.
- Is palliative care only for the end of life?
- No. Contemporary practice and trial evidence support introducing palliative care early alongside active treatment to address symptoms and quality of life, not solely in the final phase of illness.