[Supportive care in oncology: definition, organization, limits]. / Soins de support oncologiques : définition, organisation, limites.

Supportive care in oncology: Definition, organization, limits. Supportive care have been introduced in France at the start of the 21st century, in the context of first French cancer act. They represent a coordination of health caregivers upon multidisciplinarity. Their organization follows cross disciplinary meetings and specific devoted programs like inpatients bed units or home care. The patient reported outcomes programs are in the next future of the quality of care involvement.

Soins de support oncologiques : Définition, organisation, limites. Les soins oncologiques de support ont été introduits en France au début des années 2000 dans le cadre du 1er Plan cancer. Ils correspondent à une coordination des soins et s'appuient sur la multidisciplinarité. Leur organisation repose sur les réunions de concertation pluridisciplinaire ainsi que sur des programmes d'unités dédiées à l'hôpital comme en ville et incluent des projets de liaison ville-hôpital en passant par le numérique.

[Nausea and vomiting induced by chemotherapy]. / Nausées et vomissements induits par la chimiothérapie.

Nausea and vomiting induced by chemotherapy. Nausea and vomiting induced by chemotherapy impact heavily anticancer treatment safety. It is necessary to define correctly, assess frequently and treat perfectly, following national or international guidelines. New treatment are currently developed in the field of emesis protection. Old drugs may help patients. Physicians as well as nurses and caregivers have to be involved in emesis protection. It is one of the key topic in cancer care management.

Nausées et vomissements induits par la chimiothérapie. Les nausées et vomissements chimio-induits peuvent être prévenus par des règles hygiéno-diététiques mais également par de nombreuses thérapeutiques, anciennes ou récentes. Il existe un réel effort de recherche dans ce domaine, tant pour élargir les indications que pour mieux comprendre l'administration des thérapeutiques modernes et développer de nouvelles molécules. Des recommandations nationales et internationales existent, souvent méconnues ou mal suivies, afin de protéger au maximum le patient de cet effet indésirable évitable.

Supportive Care Organization in France: a national in-depth survey among patients and oncologists.

PURPOSE: Medical doctors' (MDs), but not patients', perception of supportive care in cancer (SCC) in France has been previously assessed in a national survey. This study evaluated MDs and patients' perceptions of the SCC organization and implementation in France. METHODS: The French SCC Association conducted two observational studies: study 1 (S1), containing a 30-point questionnaire sent to 2263 MDs, and study 2 (S2), containing a 40-point questionnaire sent to 2000 patients. RESULTS: Overall, 711 MDs completed S1 and 1562 patients completed S2. In S1, 81% of MDs reported relying on a SCC organization and 76% attended SCC multidisciplinary discussions. MDs considered palliative (98%), psychological (98%), and social care (98%) as the top 3 SCC areas of importance for patients. In contrast, patients' priorities were psychology (61%), nutrition (55%) and organization of intake consultations (55%). The concept of SCC was familiar to 34% of patients; according to MDs, this concept was introduced mainly by MDs (78%) and admission nurses (41%). Outpatients identified as professional resources for SCC information general practitioners (84%), nurses (58%), and pharmacists (52%). Patients reported supportive treatment being prescribed in 63% of cases, with 64% receiving information on the negative side-effects. Among MDs, 87% reported proposing palliative and 41% adjuvant SCC treatment. Furthermore, 72% of MDs recommended SCC treatment at the metastatic stage, and 36% immediately following diagnosis. DISCUSSION: Oncologists play a vital role in enhancing SCC efficacy. This can be increased by implementing a multidisciplinary integrated approach or by assuring the availability of patient information.

Treatment and Prevention of Cancer-Associated Thrombosis in Frail Patients: Tailored Management.

Advanced age is one of the major determinants of frailty in patients with cancer-associated thrombosis. However, multiple other factors contribute to frailty in these patients. The identification of frailty in patients with cancer-associated thrombosis is critical as it influences the complexity of the anticoagulant treatment in this population at high risk of venous thromboembolism and bleeding. Factors that contribute to frailty in patients with cancer-associated thrombosis include age, type of cancer, comorbidities such as chronic kidney disease, poly-pharmacotherapy, treatment compliance, cognitive impairment, anemia, thrombocytopenia, mobility, nutritional status, Eastern Cooperative Oncology Group grade, risk of falls, and reduced life expectancy. In the absence of specific clinical studies current anticoagulant treatment guidelines for the management are not fully applicable to frail patients with cancer. The anticoagulant treatment should therefore benefit from a tailored approach based on an algorithm that takes into account the specificities of the malignant disease.