Estimates suggest that there are almost 3.5 million people living with or beyond cancer in the United Kingdom. This growing demographic has shifted the focus of oncology care from survival alone to helping people thrive during and after treatment. The National Health Service (NHS) Long Term Plan and initiatives such as Personalised Care and Support Planning (PCSP) have laid important foundations to improve supportive cancer care for patients in England by embedding Holistic Needs Assessments and care planning into routine practice. However, gaps still remain and we must ensure that no patient misses out on timely assessment, psychosocial support, or faces socio-economic hardship or regional disparities in supportive cancer care.

Last month, the Multinational Association of Supportive Cancer Care (MASCC/ISOO) brought together clinicians, researchers, and patient advocates from around the world to share evidence and explore the theme: ‘Informed Decisions in Supportive Cancer Care’. The conference underscored the importance of shared decision-making, chronic toxicity management, and innovative approaches to survivorship. For oncology nurses in the United Kingdom (UK), the conference spotlighted two urgent challenges: mitigating financial toxicity and delivering truly holistic, culturally sensitive care.

Financial toxicity is defined as the economic burden and subsequent distress brought about by cancer treatment and is increasingly recognised as a major determinant of outcomes. Despite the NHS offering publicly funded healthcare, many patients still face mounting indirect costs for essential items such as wigs or private therapies, which can be compounded by a loss of income due to time off work or job loss. Nurses are uniquely positioned to identify and address financial distress earlier by conducting Holistic Needs Assessments that include financial concerns, educating and advocating for patients by informing them about benefits, and financial support schemes, and connecting patients with allied healthcare professionals such as social works or charities such as Macmillan. Earlier intervention not only alleviates these anxieties but leads to increased treatment compliance and improved quality of life. 

Cancer doesn’t affect all patients in the same way, not just biologically, but emotionally, socially, and spiritually. Cultural beliefs shape how patients, and their loved ones, perceive illness, make decisions, and engage with healthcare systems. In some communities, discussing prognosis or aspects of holistic care such as sexual health may be considered taboo while for others, these are key considerations that must be discussed and planned for from the outset of treatment. MASCC sessions urged clinicians to move beyond checklists in order to deliver truly effective, personalised care, and cultivating practice that acknowledges power imbalances and personal bias. In many societies, cancer remains heavily stigmatised which can inhibit early medical advice leading to later-stage presentation and poorer outcomes. Overcoming these barriers demands culturally competent care including education around misinformation regarding cancer aetiology, signs, and symptoms, as well as access to professional interpreters from the first consultation, inclusive clinical trial recruitment, and developing patient education materials in multiple languages.  

The guiding principle ‘Nothing about us without us’ was one of the key takeaways of MASCC 2025, championing shared decision-making as the cornerstone of supportive care. Treatment decisions centred on robust evidence can only succeed when they resonate with the individual’s values, priorities, and life circumstances. This collaborative approach to care helps patients to understand risks, benefits, and consequences to allow them to make informed choices that feel right for them, achieved through the use of decision aids and peer-led workshops which can demystify options, reduce decisional regret, and foster confidence. While modern cancer treatments can add days to life, oncology nurses can add life to days when supportive care is elevated to stand alongside curative treatment and patients are empowered to live well with and beyond cancer.