Quality of life and supportive care.

Quality of life and supportive care are complementary concepts in the care of cancer patients. Neither is easy to define. Both have received increasing attention in the medical literature of recent years. From the clinical perspective, supportive care is one means toward the end of improving patients' quality of life. In order to evaluate our degree of success in this endeavour, we must agree on operational definitions of those aspects of care and its outcome we wish to study, then devise, validate and apply appropriate measures. Supportive care covers a variety of topics including symptom control, anti-infective measures, nutritional supplements and psychosocial support. The aspects of quality of life studied include physical, emotional, psychological and (less commonly) spiritual wellbeing. Symptoms influenced by the disease or its treatment are often included in the assessment. Quality of life scales have been used as outcome measures in comparing treatments, and have shown independent prognostic value. This has led several groups to examine the potential of psychosocial interventions aimed at increasing duration of survival by improving quality of life. Quality of life can and should be measured as part of the assessment of the adequacy and effectiveness of supportive care.