Steven M. Grunberg, MD, Professor of Medicine and Pharmacology, Division of Hematology/Oncology, University of Vermont, discusses the adoption of guidelines by clinicians as well as the biggest barrier to starting patients on supportive care therapies such as the combination of NK-1 antagonists, 5-HT3 antagonists, and dexamethasone.

Grunberg adds that the adoption of pathways is always a slow process and perhaps should not always be adopted 100%. He feels guidelines should act as a starting point that is built upon using a clinician’s clinical judgment in order to individualize the treatment. As an example, the 5-HT3 antagonist in combinations with a corticosteroid has been used for some time and is widely accepted by most treating physicians. However, the adoption of newer NK-1 antagonists has been a slower process because many physicians are not in the habit of prescribing this treatment.

There will always be some form of obstacle that makes providing the best patient care difficult. One of the challenges is the different types of vomiting that can occur. It is easy to see the results of therapy on acute vomiting; however, delayed vomiting is harder to recognize and treat because it can occur multiple days after the patient has left the clinic.

Providing the best patient care involves communication between the patients and their care team. Grunberg encourages nurses and physicians to call the patients days after the treatment to ensure that side effects have not presented themselves. If the side effects are not known, they cannot be treated.

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Steven M. Grunberg, MD, University of Vermont, on Barriers to Providing Effective Supportive Care for Patients with Cancer.

Dr. Grunberg on Barriers to Effective Supportive Care

Steven M. Grunberg, MD, Division of Hematology/Oncology, Vermont Cancer Center, Professor of Medicine and Pharmacology, University of Vermont, describes the 2012 Multinational Association of Supportive Care in Cancer (MASCC) Symposium, held in New York City, from June 28-30.

MASCC is an international organization that represents over 50 countries, Grunberg explains. The latest installment of its annual symposium hosted over 1,500 supportive care specialists from 60 countries all with an interest in symptom management, supportive care in cancer, and treating the side effects of both the cancer and its treatment.

Grunberg notes that the ultimate goal of the supportive care specialist is to help make treatments tolerable for patients. The annual MASCC symposium seeks to meet this need by offering 16 study groups, workshops, and multiple international experts specializing in cancer related nausea, vomiting, bone health, mucositis, nutrition, palliative care, and survivorship.

While a majority of the attendees are primarily doctors, approximately one third consists of nurses, psychologists and chaplains. This unique audience provides an opportunity to gain the perspective of a multidisciplinary group. Additionally, the international nature of the symposium provides an opportunity to communicate with colleagues from around the world.

To fully engage its international audience, the MASCC conference is designed to move from continent to continent each year. As a result, the 2013 meeting will be held in Europe.

View more from the 2012 MASCC International Symposium

Dr. Steven Grunberg, from the Vermont Cancer Center, Describes the 2012 Multinational Association of Supportive Care in Cancer Symposium.


Steven M. Grunberg, MD

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Dr. Grunberg on Barriers to Effective Supportive Care

Dr. Grunberg Describes the MASCC International Symposium