The short answer
When cancer is advanced, you may face new choices about care. These decisions are very personal. Weighing the risks and benefits, asking questions, and telling your team what matters most can help you choose the path that is right for you.
Decisions about care in advanced cancer are very personal and may change over time.
It helps to weigh the possible benefits of more treatment against its risks and downsides.
You have the right to decide how to live the rest of your life.
Telling your team your goals, and how much you want to know, guides your care.
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The full explanation.
New choices, deeply personal
At some point during cancer treatment, there may come a time when you need to make new choices for your care. When dealing with advanced cancer, people have different goals, and these goals may change over time.
Some people want to try more aggressive treatments. Others choose options such as palliative care or hospice, which help control the symptoms and side effects of the disease. There is no single right answer, and the choice is yours.
Weighing the benefits and downsides
Decisions about care when cancer is advanced are very personal, and it is natural to want to do all you can. But it helps to weigh these feelings against the risks and benefits of the available treatments, as well as your own feelings about life and death.
Ask all the questions you need to, such as:
- What is the best I can hope for by trying another treatment?
- Is this treatment meant to ease side effects or slow the spread of cancer?
- Is there a chance a new treatment will be found while we try this one?
- What are the side effects and other downsides, and how likely are they?
- Are the possible rewards bigger than the possible drawbacks?
Having answers to these questions may help you choose whether to continue or begin more treatment. Talking it over with the people closest to you may help too.
You have the right to decide how to live the rest of your life. If you choose not to go through more active cancer treatment, you can continue to receive supportive care to keep you as comfortable as possible.
Telling your team what you need
When you have an advanced cancer diagnosis, your health care team needs to know what you want. Many people have a team of providers who work together to help them, and it helps to sit down and talk things out together.
Tell your team your goals for care at this stage and how you would like to move forward. Tell them what is most important to you now. For example, is it:
- controlling symptoms and feeling comfortable?
- receiving care at home?
- being open to experimental treatments?
- setting a date to attend a special event?
- going on a special vacation?
Good communication is key. When your team understands what you need, they can help you plan for what comes next.
Deciding who decides, and what to know
A few other topics are worth discussing with your team:
- Who will make the decisions. Some people want to make all the decisions themselves; others prefer family members to make most of them. What would you prefer?
- What you want to know about the stage of your cancer. Decide what you want to know, how much, and when you have heard enough. Let your doctor and family know, and ask them to follow your wishes.
- Your pain control options. Some people assume severe pain always comes with advanced cancer, but this does not have to be the case. Pain can be managed throughout the disease, so be honest and open about it.
- What your family wants to know. Some family members may find it hard to hear how far the disease has advanced. If you feel comfortable, ask how much they want to know, then let your team know their wishes.
A word about predicting the future
It is normal to want to know how long you will have to live, and to want to prepare for what lies ahead. But no one knows the future. Predicting how long someone will live is difficult.
Your doctor may be able to give you an estimate based on the type of cancer, treatment, and other factors, but it is a guess. Some people live long past the time a doctor first predicted; others live a shorter time. The best any of us can do is to try to live fully, for today.
Words to know
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Common questions
▸How do I decide whether to keep treating advanced cancer?
These decisions are very personal. It helps to weigh your feelings about doing all you can against the risks and benefits of the available treatments, as well as your own feelings about life and death. Asking your team clear questions and talking it over with people close to you can help.
▸What questions can I ask about more treatment?
You can ask what is the best you can hope for by trying another treatment, whether it is meant to ease side effects or slow the cancer, what the side effects and downsides are and how likely, and whether the possible rewards are bigger than the possible drawbacks.
▸Do I have to make all the decisions myself?
You get to choose. Some people want to make all the decisions; others want family members to make most of them. Some want to know every detail; others prefer to know as little as possible. Let your doctor and family know your preference and ask them to follow it.
▸What if I decide to stop active cancer treatment?
If you choose not to go through more active cancer treatment, you can continue to receive supportive care to keep you as comfortable as possible, including care that manages pain and other symptoms.
▸How do I make sure my care matches what matters to me?
Tell your health care team what is most important to you now, such as controlling symptoms, receiving care at home, being open to experimental treatments, or being well enough for a special event. Good communication helps them plan care around your goals.
Questions to ask your doctor
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