supportive-care-gaps-2026-11

Alteplase is a clot-dissolving medicine. In cancer care its common use is a small dose left inside a port or central line that has stopped working because of a clot, to get blood flowing through it again.

Anakinra is an anti-inflammatory injection approved for arthritis and rare inflammatory diseases. After CAR-T cell therapy it is used to calm a severe inflammatory reaction (IEC-HS) and as a third-line option when cytokine release syndrome does not settle.

Apixaban is a blood-thinning tablet. Guidelines now accept it for treating a clot in most people with cancer, and for preventing clots in some people starting chemotherapy who are at higher risk.

A CLABSI is a blood infection in someone who has a central line, such as a PICC, port or tunnelled line, counted when the line had been in for more than two days. Careful line care, clean hands and a chlorhexidine skin clean lower the risk.

Feeling or being sick after chemotherapy. Some drugs are far more likely to cause it than others, and the anti-sickness medicines given before treatment are chosen to match that risk, so most people are spared the worst of it.

Ciprofloxacin is an antibiotic. In the UK it is the fluoroquinolone licensed to prevent infection in adults whose white cell count is expected to fall very low after chemotherapy.

Cyclizine is an anti-sickness tablet or injection widely used in the UK, including for sickness caused by opioid painkillers and by radiotherapy.

Cyproterone is a hormone tablet for prostate cancer, used in the UK to block the brief testosterone surge when hormone injections start, as a treatment when other options do not suit, and to ease hot flushes caused by hormone therapy.

Dalteparin is a daily blood-thinning injection. Its US label is one of the few written for people with cancer: it treats a clot and keeps giving protection for six months so that another clot is less likely.

Doxycycline is an antibiotic tablet. People starting EGFR-blocking cancer drugs often take it for the first weeks to make the acne-like rash milder.

If someone has had an allergic-type reaction to a cancer drug they still need, the drug can sometimes be given again very slowly, starting with a tiny dose and stepping up over several hours under close watch. This builds temporary tolerance, so treatment can continue.

Duloxetine is a capsule for depression and nerve pain. It is the one medicine with good enough evidence to recommend for painful nerve damage caused by chemotherapy, though its benefit is modest.

Edoxaban is a blood-thinning tablet. For a clot in someone with cancer it is started after at least five days of heparin injections.

Enoxaparin is a blood-thinning injection given under the skin. People with cancer have it to prevent clots after surgery or to treat a clot in a leg vein or the lungs.

An ethanol lock fills an unused central line with strong alcohol for a few hours to kill germs inside it, aiming to prevent or clear a line infection. In children with cancer a randomised trial found it did not stop treatment failing and caused more blocked lines, so it is not routine.

Gabapentin is a tablet for nerve pain and epilepsy. In cancer care it is used for nerve pain caused by the cancer or its treatment, and sometimes for hot flushes.

Glycopyrronium dries up secretions. In the last days of life it is one of the medicines that can be tried for noisy breathing from secretions when this distresses the dying person.

Haloperidol is an antipsychotic medicine used in small doses in palliative care for nausea and vomiting, especially when the bowel is blocked.

Hyoscine comes in two forms. Hyoscine butylbromide eases gut cramps and is the first medicine NICE suggests for sickness from a blocked bowel in the last days of life; either form can be tried for noisy breathing from secretions.

Some cancers raise the calcium level in the blood, either by releasing a hormone-like protein or by breaking down bone. High calcium causes thirst, passing a lot of urine, constipation, sickness and confusion. It is treated with fluids through a drip and bone-protecting drugs.

IEC-HS is a rare, serious overreaction of the immune system after CAR-T cell treatment. It usually comes as the first reaction (cytokine release syndrome) is settling, and shows as very high ferritin, falling blood counts, clotting problems and liver changes. It is treated with drugs that calm the immune system.

Infliximab is an anti-inflammatory drip used for Crohn's disease and arthritis. When checkpoint immunotherapy causes colitis that steroids do not control, it is the usual next step; it is avoided for immune hepatitis.

Insomnia is trouble getting to sleep or staying asleep that leaves you distressed or struggling during the day. It is about three times as common in people with cancer as in other people, and a talking treatment called CBT-I is the first thing to try.

Ketamine is an anaesthetic used for sedation and pain relief during procedures, including in children having cancer care procedures, given by staff trained in anaesthesia.

In some leukaemias the white cell count climbs so high that the cells clog small blood vessels, mostly in the lungs and brain, causing breathlessness, confusion or headache. It is an emergency treated by bringing the count down quickly.

Levetiracetam is an anti-seizure medicine. After CAR-T cell therapy it is the recommended treatment for seizures, and some people at high risk of nerve side effects take it to prevent them.

Levofloxacin is an antibiotic. Children and adults expected to have very low white cell counts after chemotherapy may take it to prevent bacterial infection during that time.

Levomepromazine is a strong anti-sickness and calming medicine used in hospices and palliative care, often by a small pump under the skin, for nausea, restlessness and distress near the end of life.

Levothyroxine replaces thyroid hormone. After surgery and radioactive iodine for thyroid cancer it is given at a dose that also keeps TSH down, and it treats the underactive thyroid that immunotherapy can cause.

Lidocaine is the local anaesthetic used to numb the skin and tissues before needles and biopsies, such as a bone marrow biopsy.

Loperamide is an anti-diarrhoea capsule. People on some cancer drugs, such as irinotecan and neratinib, are told to keep it at home and start it at the first loose stool.

Metoclopramide is an anti-sickness medicine that also helps the stomach empty. It is the usual first choice for ongoing nausea in advanced cancer, but it is avoided when the bowel is completely blocked.

Midazolam is a fast, short-acting sedative. In cancer care it is used to keep people comfortable during procedures such as bronchoscopy, and in palliative care as the first medicine for sedation when suffering cannot be relieved any other way.

A midline is a thin tube put into a vein near the inside of the elbow or the upper arm. It is longer than an ordinary drip but stops short of the large veins near the heart, so it suits treatments that last more than a few days but are not too harsh for a smaller vein.

Minocycline is an antibiotic tablet used, like doxycycline, to make the acne-like rash from EGFR-blocking cancer drugs milder.

Mometasone is a steroid cream. MASCC experts recommend it to help prevent the skin reaction that radiotherapy can cause.

Morphine is the standard strong painkiller for cancer pain. NICE advises starting with regular morphine by mouth, with extra quick-acting doses for pain that breaks through.

Mycophenolate is a medicine that damps down the immune system, approved to stop transplanted organs being rejected. In cancer care it is used when immunotherapy side effects such as hepatitis or pneumonitis do not respond to steroids.

Naloxone reverses an opioid overdose. For people on strong painkillers for cancer, it is given in small repeated doses so that breathing recovers without bringing all the pain back.

An inflammation and infection of the bowel wall, often near the start of the large bowel, in people whose white cell count is very low after chemotherapy. It causes fever, tummy pain and diarrhoea, and is treated in hospital with antibiotics, fluids and rest for the gut.

A rare side effect of bone-strengthening drugs such as zoledronic acid and denosumab, given for cancer in the bones, in which a patch of jawbone is exposed in the mouth and does not heal. A dental check before starting and avoiding tooth extractions during treatment lower the risk.

Bone in the jaw that was in the path of radiotherapy for a head and neck cancer can lose its blood supply and break down, sometimes years later and often after a tooth is taken out. Dental treatment before radiotherapy and careful dental care afterwards lower the risk.

Oxycodone is a strong painkiller used for cancer pain, often when morphine does not suit, for example with kidney problems or when the medicine has to be given under the skin.

Tamponade is when fluid builds up in the sac around the heart and squeezes it, so it cannot fill and pump properly. In cancer the fluid usually comes from cancer cells in the sac. Breathlessness is the main symptom, and the fluid is drained with a needle or a small operation.

Piperacillin with tazobactam is a broad-spectrum antibiotic drip. NICE recommends it as the first antibiotic for suspected neutropenic sepsis, a fever when white cells are low after chemotherapy.

Posaconazole is an antifungal medicine. Its label includes preventing mould and yeast infections in people with blood cancers whose white cells stay low for a long time after chemotherapy.

Propofol is an anaesthetic given into a vein for operations and deep sedation. Children with cancer may have it for lumbar punctures and other procedures, and in palliative care it is a last-step option for sedation, given under an anaesthetist.

Raised pressure inside the skull happens when a tumour in or spreading to the brain, or a bleed around it, takes up space. The typical sign is a headache that builds over time and is worse in the morning, often with being sick. It needs urgent assessment and often a brain scan.

Rivaroxaban is a blood-thinning tablet used to treat a clot in many people with cancer, and to prevent clots in some people starting chemotherapy who are at higher risk.

SIADH is when the body makes too much of the hormone that holds on to water, so the blood becomes too dilute and its sodium falls. It is most often seen with small-cell lung cancer and with some cancer medicines, and can cause nausea, headache and confusion.

Tenofovir is an antiviral tablet for hepatitis B and HIV. Someone with current or past hepatitis B who needs certain cancer treatments takes it to stop the virus flaring up.

Tinzaparin is a once-daily blood-thinning injection used in the UK and Europe to treat and prevent clots, including long-term treatment of a clot in people with active cancer.

A tunnelled line is a soft tube that runs under the skin of the chest for a few centimetres before entering a large vein in the neck or under the collarbone, with its end outside the body. A small cuff under the skin anchors it and helps keep germs out, so it can stay in for months of chemotherapy, blood tests and transfusions.

Urea cream softens thick, dry skin. Rubbed on the hands and feet from the first day of sorafenib, a 10 per cent cream made the painful hand-foot skin reaction less common in a large trial.

Urokinase is a clot-dissolving medicine. Its US label is for large clots in the lungs; in cancer care it has also been used to unblock central lines, with low-quality evidence that it works.

Valaciclovir is an antiviral tablet against herpes viruses. People having some cancer treatments take it, or aciclovir, to prevent cold sores, mouth ulcers and shingles coming back.

Vedolizumab is a gut-targeted anti-inflammatory drip for ulcerative colitis and Crohn's disease, used when colitis caused by checkpoint immunotherapy does not settle with steroids and infliximab.

Venlafaxine is an antidepressant tablet that is also used, at the doctor's discretion, to reduce hot flushes caused by breast or prostate cancer hormone treatment.

Warfarin is an older blood-thinning tablet that needs regular blood tests. For a clot in someone with cancer, guidelines now prefer heparin injections or the newer tablets, but warfarin still has a place, for example with severe kidney failure.