supportive

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.

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 who have run out of other treatments.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

Pegfilgrastim (Neulasta) is a long-acting form of the growth factor G-CSF, given once per chemotherapy cycle to speed white cell recovery and prevent febrile neutropenia; one dose replaces about eleven daily filgrastim injections. Biosimilars have been sold since 2018 and the Onpro on-body injector delivers it automatically the day after chemotherapy; bone pain is the main side effect.

Plerixafor (Mozobil) is an injection given with G-CSF to flush stem cells out of the bone marrow into the blood so that enough can be collected for an autologous transplant in myeloma or lymphoma.

Prednisone is the everyday steroid tablet in cancer care. It is the P in CHOP and MOPP for lymphoma, part of childhood leukaemia treatment, and taken with abiraterone in prostate cancer.

Prehabilitation is a few weeks of structured exercise, nutrition and psychological preparation between diagnosis and surgery to make patients fitter for the operation and speed recovery.

Psycho-oncology recognises and treats the anxiety, depression, fear of recurrence and existential distress that affect a third of people with cancer, using screening, psychotherapy adapted to cancer, and medication.

Rasburicase (Elitek) is an enzyme infusion that rapidly dissolves the uric acid released when large numbers of leukaemia or lymphoma cells die at the start of treatment, protecting the kidneys from tumour lysis syndrome.

Rolapitant (Varubi) is a long-lasting anti-sickness tablet taken once before chemotherapy, alongside a 5-HT3 blocker and dexamethasone, to prevent nausea and vomiting in the days after treatment.

Quadramet (samarium-153 lexidronam) is a radioactive bone-seeking injection that lodges in bone metastases and irradiates them from inside, approved in 1997 to relieve pain from prostate, breast and other cancers spread to bone. Most patients get relief within one to two weeks, but marrow suppression follows at three to five weeks, and radium-223 and PSMA radioligands have largely replaced it.

An old antidote proven in two paediatric trials to halve permanent hearing loss from cisplatin, and approved in 2022 as the first drug to prevent a chemotherapy side effect in children.

Organised follow-up for the 18 million US and 50+ million global cancer survivors: watching for recurrence and second cancers, managing long-term side effects such as heart damage, infertility, neuropathy and fatigue, and helping people return to work and life.

Sterile talc is puffed or instilled into the chest cavity after fluid is drained to make the lung stick to the chest wall, stopping cancer-related fluid (malignant pleural effusion) from building up again.

Telotristat ethyl (Xermelo) is a tablet that cuts the serotonin that neuroendocrine tumours pour out, easing the relentless diarrhoea of carcinoid syndrome when somatostatin analogue injections are not enough.

Thyrogen is an injected version of thyroid-stimulating hormone that lets people with thyroid cancer have radioiodine treatment and follow-up blood tests without stopping their thyroid hormone tablets and suffering weeks of hypothyroidism.

Tocilizumab (Actemra) is a rheumatoid arthritis antibody that has become the rescue drug for cytokine release syndrome, the fever and blood-pressure crash that CAR-T cells and bispecific antibodies can trigger. Every CAR-T centre must have it on hand.

Red cell and platelet transfusions, iron and erythropoiesis-stimulating agents keep patients safe through chemotherapy and marrow failure; restrictive thresholds and ESA caution reflect trials showing more is not better.

A conditioning chemotherapy given before donor stem-cell transplant in AML and MDS; it was long used in Europe and reached the US in 2025.

Uridine triacetate (Vistogard) is an oral antidote for fluorouracil or capecitabine overdose, or for dangerously early severe toxicity from these drugs, and must be started within four days of the chemotherapy.

Zoledronic acid (Zometa) is a fifteen-minute infusion given every few weeks or months to strengthen bone and prevent fractures, spinal cord compression and the need for radiotherapy in people with myeloma or cancer that has spread to bone; it also treats dangerously high calcium caused by cancer.