Introduction
Many patients diagnosed with cancer have far more treatment options now than they did even a decade ago. In some cases, these treatments can produce remarkable responses, completely eradicating tumours in patients whose cancer had spread throughout their bodies. Maybe treatment ended a while ago and was successful at first, but cancer has come back. Or maybe one type of cancer treatment has stopped working and cancer has kept growing. If this happens, your doctor might say your cancer has advanced or progressed. There may or may not be other treatment options. But when many different treatments have been tried and are no longer controlling cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Cancer treatments can keep cancer from spreading and even cure early-stage cancer for many people. But not all cancer can be cured. Sometimes, treatment stops working or cancer reaches a stage where it cannot be treated. This is called advanced cancer. When you have advanced cancer, you move into a different stage of life. It is a time when you start to think about the end of life. This is not easy, but it doesn’t mean you don’t have options. Some people live for years with advanced cancer. Learning about advanced cancer and knowing your options can help you make decisions that work best for you.
Some points to consider when deciding whether to continue cancer treatment:
- Trusting your cancer care team: Talking with your doctor and cancer care team, and trusting them to be honest, open, and supportive, is very important. You will have more confidence in treatment decisions if you trust the doctors making recommendations. This means communication is a key part of your care, from diagnosis throughout treatment and beyond.
2. Talking with your loved ones: Be open with your loved ones about your cancer and the news you’ve been given. Explore their thoughts, feelings, and suggestions. Talk to them about the options you have been given, along with the decisions you have made or are thinking of making. If you feel you need their input, ask. If not, be firm that you would like to make your own decision.
3. Thinking about a second opinion: When faced with deciding whether to continue cancer treatment, some patients or their loved ones may want to get a second opinion. Even when you place full trust in your doctor and cancer care team, you might wonder if another doctor could offer something else or more information. It’s normal to think about talking to someone else, and your doctor should support you if you decide to get another opinion. Remember that your cancer care team wants you to be sure about the decisions you make.
4. If another treatment is available: If you have cancer that keeps growing or comes back after one kind of treatment, it’s possible that another treatment might still help shrink cancer, or at least keep it in check enough to help you live longer and feel better. Clinical trials also might offer chances to try newer treatments that could be helpful. If you want to continue to get treatment for as long as you can, it’s important to think about the odds of further treatment having some benefit, compared to the possible risks and side effects. Your doctor can help estimate how likely it is cancer will respond to treatment you might be considering.
When a person has tried many different treatments and the cancer is still growing, even newer treatments might no longer be helpful. This is likely to be the hardest part of your cancer experience – if you have been through many treatments and nothing’s working anymore. At some point, you may need to consider that further treatment is not likely to improve your health or change your outcome or survival. Treatment in this situation is sometimes referred to as futile care. Again, it’s important to trust your cancer care team and discuss all options with your loved ones during this difficult time as you decide whether to continue treatment.
Other Treatment Choices
When standard treatments no longer work for your cancer, you still have some choices about what type of care you’d like to get. Some options include:
- Clinical trials: These are research studies that look for new ways to treat cancer. There are benefits and risks to being in a clinical trial, and each one has rules about who can participate. If you’re interested, ask your provider about clinical trials for your type of cancer.
- Palliative care: This is the treatment that helps prevent and treat symptoms and side effects from cancer. It can also help you with emotional and spiritual struggles while facing cancer. Palliative care can help improve your quality of life. You may receive this type of care at every stage of cancer treatment.
- Hospice: You may decide to choose hospice care if you are no longer seeking active treatment for your cancer. Hospice care aims to improve your symptoms and help you feel comfortable in the last months of life.
- Home care: This is treatment in your home instead of a hospital. You may be able to manage your care and get the medical equipment you need right at home. You may have to pay for some services yourself. Check with your health plan to see what they cover.
