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Decision
Best supportive care
A plan with its own targets, symptom control, function, and time at home.
What it is
Best supportive care means treating everything that can be treated, without treatment aimed at the cancer itself. It is a plan, with goals, reviews and someone responsible, not a withdrawal of care.
It is chosen when anti-cancer treatment would cost more in side effects, hospital time and quality of life than it could realistically return. Sometimes it is chosen alongside treatment; sometimes instead of it; and it is always the patient's decision to make.
When it is used
- Where the burden of treatment plausibly outweighs its benefit given fitness, organ function or disease extent
- Where a patient, properly informed, chooses it
- Alongside active treatment, at any stage, which is the more common use
How the decision is made
- What matters most to you, asked properly and written down. Time at home, alertness, being able to eat, being at a wedding in four months, these are legitimate treatment goals.
- Which symptoms are treatable and how aggressively to treat them.
- What the plan is if things change, because a decision made now is not a decision made forever.
Consultation and planning here. Home-care coordination through partners where needed.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Pain and symptom control with a written plan
- Nutrition support and practical feeding advice
- Psycho-oncology for the patient and the family
- Advance care planning, documented so every institution can act on it
- Caregiver burden assessment and training
- Re-review whenever anything changes
Performed and billed elsewhere
- Home nursing
- Inpatient hospice or admission
- Drug dispensing
- Choosing best supportive care does not mean nobody will see you urgently. Severe pain, breathlessness, bleeding or a sudden change still need assessment, and there is a plan for that.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- What can still be treated, even if the cancer is not being treated?
- What would change your recommendation?
- What will happen to my pain, and who manages it?
- Can I change my mind later?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Lung & thoracic cancer
Non-small cell and small cell lung cancer, mesothelioma, thymic tumours
Brain & CNS tumours
Glioma, meningioma, and other central nervous system tumours
Cancer of unknown primary
CUP, cancer found without an identified site of origin
Liver cancer
Hepatocellular carcinoma, HCC
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.