Oncology treatment extends beyond drug regimens to manage or cure cancer. While therapies are central to patient care, critical aspects such as psychosocial support, nutrition, survivorship, and sexual health must be integral to the overall treatment approach.
Experts from leading US institutions, including Memorial Sloan Kettering Cancer Center, Atrium Levine Cancer Institute, and George Washington Medical Faculty Associates, emphasize a multidisciplinary approach to cancer care. Throughout 2025, CancerNetwork and ONCOLOGY interviewed clinicians across the cancer care continuum to explore integrating these elements into everyday oncology practice.
Daniel C. McFarland, DO, director of the psycho-oncology program at Wilmot Cancer Center, notes that despite oncologists’ best intentions, delivering comprehensive psychosocial care remains challenging due to limited access to mental health services and insufficient training.
Survivorship is defined by the National Cancer Institute as the focus on the health and well-being of a person with cancer from diagnosis through the end of life. Survivorship encompasses physical, mental, emotional, and financial effects of cancer and its treatment.
Declan Walsh, MD, chair of the Department of Supportive Oncology at Atrium Health Levine Cancer Institute, stresses the importance of survivorship in multidisciplinary treatment. Atrium Health employs the “loved one” standard—considering how one would want a family member with cancer to be cared for—to guide their survivorship programs.
Walsh highlights that many cancer centers offer supportive services such as counseling, support groups, nutrition, and palliative care, but these are often fragmented and not easily accessible. He advocates for organizing these services cohesively within a formal supportive oncology department, akin to radiation or surgical oncology departments. Integrating supportive oncology into tumor boards aims to facilitate earlier recognition of patient needs and promote interdisciplinary collaboration.
Nutrition is a critical but under-addressed aspect of supportive care. Walsh points out that many patients diagnosed with cancer are overweight or obese, which affects both cancer risk and treatment outcomes. Conversely, undernutrition and severe weight loss are common complications of cancer and its treatment. Despite patients frequently asking about diet, evidence-based guidance on nutrition before, during, and after treatment remains limited.
Denise B. Reynolds, RD, from Atrium Health Levine Cancer Institute, highlights nutritional challenges faced by cancer patients, who often suffer from malnutrition or adverse effects like nausea, mucositis, and dysphagia that hinder food intake. Reynolds recommends small, frequent meals and soft, moist foods to ease swallowing difficulties. Maintaining oral hygiene and using cold foods or ice can soothe mouth sores caused by treatment.
Post-treatment nutrition focuses on achieving a healthy weight and incorporating exercise. Atrium Health aligns its recommendations with the American Institute for Cancer Research guidelines, which address weight management, secondary cancer prevention, and healthy eating.
Dermatologic adverse events (AEs) affect the skin, hair, and nails in up to half of cancer patients, leading to treatment interruptions. The Association of Cancer Care Centers provides resources for managing these AEs. Adam Friedman, MD, of The George Washington University, coauthored a study revealing gaps in patient awareness about dermatologic side effects such as hair loss, dry skin, rash, and nail changes.
Many patients report never being informed about potential hair loss or changes resulting from chemotherapy. Prevention strategies for mild skin and nail changes include using recommended skin products, preventing infections, moisturizing, and keeping nails trimmed short. Friedman recommends moisturizers indicated for eczema, which contain barrier protectants like colloidal oatmeal, and prefers ointments for cracked or irritated skin applied on damp skin to retain moisture.
Emerging advances in oncodermatology include risk prediction tools that consider patient demographics and comorbidities to anticipate dermatologic AEs. Clinical trials are underway for FDA-approved topical treatments, such as for EGFR-associated papulopustular eruption.
Psycho-oncology, integrating mental health into cancer care, remains underutilized. McFarland highlights this gap through discussions with experts on body image, sexual health, and mortality-related issues in cancer patients.
Clinical psychologist Michelle Fingeret, PhD, emphasizes that body image concerns affect nearly all cancer patients. Body image relates to patients’ perceptions and feelings about their bodies following treatment-related changes. Although clinicians acknowledge these issues, they often lack tools or training to address them effectively. Fingeret advocates for normalizing and validating body image concerns to encourage patient communication.
Christian J. Nelson, PhD, of Memorial Sloan Kettering Cancer Center, discusses men’s sexual health post-cancer treatment. Prostate, genitourinary, and gastrointestinal cancers and their treatments can impair sexual function and affect self-perception. Men often withdraw and avoid discussing these issues, unlike women who tend to seek social support. Nelson stresses the need for clinicians to initiate conversations about sexual health, including changes in libido, erections, orgasm, and urinary function during sexual activity. Sexual dysfunction affects 40% to 85% of men with cancer, impacting quality of life, and should be addressed routinely in patient care.
Emotional recovery continues after treatment, and patients often face a disconnect between external perceptions of recovery and their own lived experience with ongoing side effects.
Addressing mortality and end-of-life care is a difficult but essential aspect of oncology. William S. Breitbart, MD, of Memorial Sloan Kettering Cancer Center, explains the complex emotions patients face regarding death, including fear of the dying process and existential concerns about ceasing to exist.
Research indicates that end-of-life discussions improve patients’ understanding of their prognosis. However, many patients do not engage in these conversations with their oncologists. Both McFarland and Breitbart advocate for frank, compassionate communication about prognosis and outcomes. Forgiveness—for patients and providers—is vital in coping with limitations in cancer care.
In summary, comprehensive cancer care requires enhanced resources and greater integration of multidisciplinary services. Increasing visibility and collaboration among medical treatment, nutrition, psycho-oncology, and supportive care will promote a more patient-centered approach.
Additional resources include the Atrium Health Wake Forest Baptist Cancer Survivorship Clinic, American Institute for Cancer Research Mediterranean Diet guidelines, oncologic dermatology references, and psycho-oncology training programs at Memorial Sloan Kettering Cancer Center.
