Addressing Every “Slice of the Pie” in Supportive Oncology Care

Comprehensive supportive care requires oncology nurses and advanced practice providers (APPs) to look beyond the physical manifestations of disease and address the broader needs of patients, explained Heather Jackson, PhD, APRN, FNP-BC, NEA-BC, FAA-NP.

In an interview with Oncology Nursing News following Jackson’s presentation “Comprehensive Supportive Care for Oncology Patients” at the 9th Annual School of Nursing Oncology, hosted by Physicians’ Education Resource®, LLC, Jackson emphasized that a patient’s well-being cannot be reduced to a single issue, such as pain management, without considering the interplay of other domains of health.

She illustrated this through a “whole pie” analogy, where each slice represents an element of care—physical, emotional, social, and spiritual. Addressing only 1 slice, she noted, can leave patients vulnerable to exacerbated symptoms.

For example, unmanaged social or spiritual needs can intensify a patient’s perception of pain and contribute to decreased activity and social withdrawal. By integrating supportive care strategies across domains, oncology nurses and APPs can enhance symptom control, reduce the need for higher opioid doses, and optimize interventions.

Jackson, the administrative director of advanced practice at the Vanderbilt-Ingram Cancer Centers in Franklin and Nashville, Tennessee, underscored that whole-patient care ultimately strengthens both outcomes and quality of life.

Transcript

It seems like so often we focus on 1 aspect [of the patient], maybe the physical component of the patient care. The way I best describe it for patients is that I look at it like a piece of pie. If we’re giving comprehensive care, we don’t want to just treat 1 slice, right? Because if we don’t treat all aspects of the human being, then they can actually impact other symptoms.

For example, if we’re having pain, but also having a lack of support, spiritual support, and caregiver and social interactions, it will exacerbate the pain. They experience the pain more and ruminate more on pain. There’s a lot of evidence about that: how that can lead to deconditioning, not moving, not interacting in social engagements.

To give the best care possible—even if your focus is on pain—if you’re not treating the other aspects of the patient, then you’re not giving comprehensive care. It’s important to make sure you include that whole pie aspect, that whole comprehensive view, because often it helps our intervention.

If I’m prescribing an opioid for pain management, I often don’t have to have so many higher doses or so many pills per day if I’m addressing the rest of the aspects of the patient. It can help with our medication management as well just keeping that in mind.

This transcript has been edited for clarity and conciseness.