supportive

Advance care planning means talking with your family and your care team about what matters to you and writing down the care you would want if you became too unwell to say. You can start at any point, and you can change it later.

In England and Wales, an adult can write down in advance which treatments they refuse if they later cannot decide. To refuse treatment that keeps you alive, it must be in writing, signed, witnessed and say it applies even if your life is at risk.

Allopurinol is a long-established tablet, also given by drip, that lowers the body's production of uric acid. When treatment breaks down a large number of cancer cells quickly, uric acid can build up and harm the kidneys; allopurinol is used to prevent and manage this.

Amifostine (Ethyol) is an infusion given just before chemotherapy or radiotherapy to shield the kidneys from cisplatin and the salivary glands from radiation, reducing dry mouth after head and neck treatment.

The drugs that stopped chemotherapy from meaning days of vomiting: 5-HT3 blockers (ondansetron, palonosetron), NK1 blockers (aprepitant), dexamethasone and olanzapine, given by the emetic risk of each regimen.

Aprepitant (Emend) was the first of a new class of anti-sickness drugs. Taken with a 5-HT3 blocker and dexamethasone, it prevents the delayed nausea and vomiting that follow strongly emetogenic chemotherapy such as cisplatin.

Belumosudil is a pill for chronic graft-versus-host disease, the long-term immune complication of donor stem-cell transplants used to cure blood cancers.

Zoledronic acid and denosumab reduce fractures, spinal cord compression and bone pain from bone metastases and myeloma, prevent treatment-induced bone loss, and in postmenopausal breast cancer modestly reduce recurrence in bone.

Crysvita is an antibody for a rare bone-softening condition in which the body leaks phosphate. Some small tumours cause it by making too much of a hormone called FGF23; when the tumour cannot be found or removed, Crysvita blocks the hormone.

Systematic treatment of cancer pain with opioids, adjuvant drugs, radiation and procedures such as nerve blocks and intrathecal pumps. Most pain can be controlled, yet under-treatment remains common, especially where opioids are unavailable.

Blood clots are the second commonest cause of death in people with cancer. Risk scores identify who should take preventive blood thinners during chemotherapy, and direct oral anticoagulants have largely replaced injections for treatment.

In the last days of life, care focuses on comfort: recognising that someone is dying, talking openly with them and their family, keeping them hydrated if that helps, and having medicines ready for pain, breathlessness, sickness, agitation and noisy breathing.

Catumaxomab (Korjuny) is an antibody infused into the abdominal cavity to control malignant ascites, the build-up of fluid caused by cancers such as ovarian and stomach cancer, in people whose other treatments have stopped working.

Darbepoetin alfa (Aranesp) is a longer-acting version of erythropoietin given every one to three weeks to treat anaemia caused by chemotherapy, reducing transfusions but with the same warnings about clots and tumour growth as epoetin.

Defibrotide (Defitelio) is the only approved treatment for hepatic veno-occlusive disease, a life-threatening liver complication of high-dose chemotherapy before stem cell transplant, in patients whose kidneys or lungs are also failing.

Denosumab is an injection under the skin that blocks the signal driving bone breakdown. As Xgeva it prevents fractures and other bone complications in people whose cancer has spread to bone or who have myeloma; as Prolia it treats osteoporosis, including bone loss caused by hormone therapy for breast and prostate cancer.

Dexamethasone is a long-acting glucocorticoid steroid that kills lymphoid cancer cells directly, which is why it sits in nearly every myeloma regimen and in childhood leukaemia and lymphoma protocols. It is also the standard drug for preventing chemotherapy sickness and for brain swelling and spinal cord compression; high blood sugar, insomnia, muscle wasting and infection follow prolonged use.

Dexrazoxane protects the heart from the cumulative damage of doxorubicin in women with metastatic breast cancer who need to keep receiving it, and, as Totect, limits tissue destruction when an anthracycline leaks out of a vein.

Dignity therapy is a short, one-to-one talking therapy for people near the end of life and their families. In a large trial it did not lower distress more than usual care, but patients said it helped them, their sense of dignity and their families.

Specialist care for symptoms, decision-making and quality of life given alongside cancer treatment from diagnosis, not just at the end. Trials show it improves quality of life and mood and may lengthen survival.

Efbemalenograstim alfa (Ryzneuta) is a once-per-cycle white cell booster, an alternative to pegfilgrastim, that reduces the risk of febrile infections after chemotherapy.

Patients report symptoms weekly through an app or web form, and nurses respond to alerts. Randomised trials showed this simple system improved quality of life, cut emergency visits and, in one trial, extended survival by five months.

Lynkuet is a once-a-day capsule for moderate to severe hot flushes and night sweats. In Europe it is approved both for the menopause and for hot flushes caused by the hormone-blocking tablets taken after breast cancer treatment.

Many people can be cared for at the end of life in their own home, with visits from nurses, doctors and carers, equipment and medicines arranged by the hospice or community team. Ask early, because setting it up can take time.

Epoetin alfa is a manufactured version of the kidney hormone that tells the bone marrow to make red blood cells. In cancer it treats anaemia caused by chemotherapy and reduces the need for transfusions, but it is used cautiously because it can shorten survival and cause clots.

NeoRecormon is a man-made copy of erythropoietin, the hormone that tells the marrow to make red blood cells. In cancer care it treats anaemia that is causing symptoms in adults having chemotherapy for cancers that do not start in the marrow's myeloid cells.

Epoetin theta is a made-to-order version of erythropoietin, the hormone that tells the marrow to make red blood cells. It is used to treat the anaemia of chemotherapy in people with non-myeloid cancers, sparing some transfusions.

Using complementary approaches with real evidence, such as acupuncture for nausea and pain, yoga and mindfulness for anxiety and fatigue, alongside standard treatment, while steering patients away from unproven 'alternative' therapies that can shorten life.

These are fast-acting forms of the opioid fentanyl, taken as a tablet against the cheek or as a nasal spray, for sudden flares of pain in people whose cancer pain is otherwise controlled by a regular opioid. They are only for patients already tolerant to opioids.

Filgrastim (Neupogen and its biosimilars) is a daily injection that speeds the recovery of infection-fighting white cells after chemotherapy, lets doctors give chemotherapy on schedule and mobilises stem cells for transplant.

Cancer treatment can bankrupt patients even with insurance. Financial navigation programmes screen for money problems and connect patients to assistance, insurance optimisation and legal help, and trials show they reduce distress and debt.

Five Wishes is a plain-language US advance directive in which you name who decides for you and write down the medical care, comfort and spiritual support you want, and what you want your family to know.

Glucarpidase (Voraxaze) is a single emergency injection that chops up methotrexate in the blood when a patient's kidneys have failed to clear a high dose, preventing potentially fatal toxicity.

The Gold Standards Framework is a UK charity that trains GP practices, care homes and other services to care well for people in the last years of life, and accredits those that do. Its site lists accredited care homes and providers.

Granisetron is an anti-sickness medicine for chemotherapy given as a tablet, an injection, a week-long skin patch (Sancuso) or a slow-release injection that lasts several days (Sustol).

Grief after someone dies of cancer is normal and takes its own time. Hospices and cancer charities offer bereavement support to families, and help is available if grief stays very intense for many months.

Injections of filgrastim or its long-acting form pegfilgrastim after chemotherapy make white cells recover faster, cutting the risk of life-threatening infections and allowing chemotherapy on schedule.

Care in the last months of life focused entirely on comfort, at home or in a hospice, when cancer treatment no longer helps. Enrolling earlier than the typical two to three weeks gives patients and families more benefit.

Most hospice care is given at home, but a hospice team can arrange a short stay in an inpatient unit when symptoms need closer care, or a respite stay so that a family carer can rest.

Intravenous immunoglobulin is pooled antibody from many blood donors. People with chronic lymphocytic leukaemia or myeloma whose own antibody levels have collapsed, and who keep getting bacterial infections despite antibiotics, receive it as replacement.

Ibandronic acid (Bondronat) is a bisphosphonate available in Europe as a monthly infusion or daily tablet to prevent fractures and other bone complications in women with breast cancer that has spread to bone, and to treat cancer-related high calcium.

A health and welfare lasting power of attorney lets you choose someone you trust to make decisions about your care, including life-sustaining treatment, if you become unable to decide. It has to be registered before it can be used, which takes weeks, so it is worth doing early.

Lipegfilgrastim (Lonquex) is a once-per-chemotherapy-cycle white cell booster used in Europe, similar to pegfilgrastim, for adults and children from two years old.

CALM is a brief talking therapy for people with advanced cancer, designed to treat and prevent depression and distress about the end of life. In a trial of 305 people it eased depression symptoms and helped people feel more prepared.

In the US, Medicare pays for hospice care with nothing to pay for covered services when a doctor certifies a life expectancy of six months or less and the person chooses comfort care instead of treatment aimed at cure. Care can continue beyond six months if the doctor recertifies.

In the US, Medicare can pay for a trained navigator to help people with serious illnesses including cancer coordinate care, find support services and speak up for themselves. Your doctor has to set it up at a visit, with your consent, and cost sharing may apply.

Megestrol acetate is a hormone tablet used to ease advanced breast and womb cancer, and as a liquid to improve appetite and weight in people with cancer or AIDS-related wasting.

Mesna is given with the chemotherapy ifosfamide (and high-dose cyclophosphamide) to stop its breakdown products from burning the bladder lining and causing bleeding.

Methylnaltrexone (Relistor) is an injection or tablet that relieves the severe constipation caused by strong painkillers in people with advanced cancer, without blocking the pain relief itself.

Akynzeo combines two anti-sickness drugs in one capsule or infusion taken once before chemotherapy, so a single dose plus dexamethasone protects against both immediate and delayed vomiting.

In England, adults with complex long-term health needs can have their care at home or in a care home arranged and paid for entirely by the NHS. A team of health professionals assesses whether you qualify; ask the hospital or community team to start an assessment.

Screening for malnutrition, dietitian-led counselling, supplements and tube or intravenous feeding where indicated, plus treatment of cancer cachexia, the muscle-wasting syndrome that affects up to 80% of advanced patients.

Protecting the ability to have children before cancer treatment that damages eggs, sperm or the womb: sperm and egg or embryo freezing, ovarian tissue freezing, ovarian shielding and, for some breast cancers, temporary ovarian suppression.

Specialist nurses deliver most cancer treatment and much of its safety, education and support; nurse-led clinics, navigation and symptom management improve outcomes and are the backbone of care in low-resource settings.

Ondansetron (Zofran) was the drug that made cisplatin-type chemotherapy bearable. It blocks the serotonin signal that triggers vomiting and is now a cheap generic tablet, dissolving wafer or injection used across cancer care.

Palifermin (Kepivance) is a growth factor injected for three days before and after high-dose chemotherapy and stem cell rescue to reduce the severe mouth ulcers (mucositis) that this treatment causes in people with blood cancers.

Short courses of radiation, often a single treatment, to relieve pain from bone metastases, stop bleeding, open blocked airways or protect the spinal cord. Among the most cost-effective treatments in cancer.

Palliative sedation means giving medicines that make a dying person sleep when severe suffering cannot be relieved any other way. It is ordinary medical care in the last days of life, and it is not euthanasia.

Palonosetron (Aloxi) is a long-acting anti-sickness injection given once before chemotherapy; a single dose covers both the first day and the delayed nausea that follows.

Pamidronate (Aredia) is a bisphosphonate infusion approved in 1991 for dangerously high blood calcium in cancer and later for bone damage from myeloma and breast cancer, where it roughly halved skeletal complications. Its two-hour infusion, against fifteen minutes for zoledronic acid, pushed most centres to switch, though it is cheaper and may cause less jaw osteonecrosis.