Deciding About Continued Cancer Treatment

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Your Care Instructions

Everyone with cancer hopes that treatment will cure their cancer. Or they hope that their cancer can be controlled. Everyone hopes for a return to a normal life.

But sometimes the cancer continues to grow. Treatment may not help. Or the cancer spreads to other organs. Side effects may become too hard to live with.

At some point you may need to decide whether you want to keep trying to cure the cancer.

If you decide to stop trying to cure the cancer, it doesn't mean an end to treatment. You can still receive treatment, but its focus will change.

You may receive medicine and other treatment to relieve pain, let you do activities you enjoy, and prolong your life. When you focus on pain and symptom relief instead of a cure, you still see your doctor and get excellent care. And if your health changes or new treatments become available, you can change your mind and try again to cure the cancer.

You will make this decision along with your doctor. He or she can tell you if continued treatment is likely to work and what options you have. Be sure to weigh the pros and cons of any new treatment. Some treatments may make you feel worse than the disease itself. In some cases, you may be better off trying to control your symptoms and not have treatment.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Think about talking to your doctor, counsellor, family members, or friends about how you feel. A decision not to try to cure the cancer is very hard. But the decision is yours.
  • Ask your doctor about the treatment options that you still have. Are they likely to help? You will probably have fewer treatment options if your cancer spreads or continues to grow.
  • Ask your doctor if you can enter a clinical trial to test a new treatment. Some clinical trials are for people with advanced cancer. A new treatment may be effective against your cancer. You may like the idea of helping learn whether a treatment is effective or safe. You can drop out of a clinical trial for any reason.
  • Think about your treatment and the side effects. If the treatment is not helping but is making your life miserable, you may want to end the cancer treatment.
  • Try alternative therapies to help make you more comfortable if you decide to end cancer treatment.
    • Acupuncture uses thin needles placed in certain places on the body to relieve pain.
    • Massage can help relieve muscle pain, reduce stress, and help you relax.
    • Meditation uses focused thinking and repeated words or sounds to help you reduce stress and feel more peaceful.
    • Some herbal teas may help relieve nausea.

Hospice palliative care

Think about hospice palliative care if your cancer can't be cured and you have no more than 6 months to live. Hospice palliative care focuses on your symptoms. It provides medical treatment, emotional help, and spiritual support. It also helps family members care for a dying loved one.

You don't need to be confined to a bed or in a hospital to benefit from hospice palliative care. You may still be active.

Your hospice palliative care team will be available 24 hours a day, 7 days a week. You can get care in your own home or in a hospice palliative care centre. Some hospice palliative care services also go to nursing homes or hospitals.

Hospice palliative care can:

  • Keep you comfortable while you are dying. Hospice palliative caregivers want to enhance your quality of life in your last days.
  • Relieve pain and other symptoms. Your hospice palliative care team will not try to cure your cancer.
  • Help you review your life, say important things to family and friends, and explore spiritual issues.
  • Help your family and friends deal with their grief after you die.

Coping with your feelings

  • Talk to your doctor about what you can expect if you stop trying to cure your cancer. You may want to talk about:
    • Dying. Counselling may also help you work through some of the fears and feelings you are facing.
    • Pain or other symptoms. Your pain can almost always be managed. Medicines and treatments can help you stay comfortable.
    • What gives you comfort and support. Some people don't think of spiritual matters often. For others, spirituality is a part of daily life. Facing cancer may cause you to think about spiritual questions and issues. You may find peace in your religion, by exploring nature, through community involvement, or in your relationships.
    • Help for your loved ones. They will also have fears and concerns if you decide to stop trying to cure your cancer.

End-of-life planning

End-of-life planning is a way to make sure that your wishes are met. It will make it easier for your loved ones. It also may ease your mind and make your final days more meaningful.

Talk to your family about your wishes so they are not surprised. Advance care plans are papers telling people what kind of medical care you do and don't want. You don't need a lawyer to prepare these papers. Make sure your doctor has a copy of these on file, and give a copy to a family member or close friend. You can change these instructions when you want to.

End-of-life planning can include:

  • An advance care plan that explains your wishes in case you are in a coma or can't communicate. Advance care plans tell doctors to use or not use treatments that would keep you alive. You may need to have one or two witnesses or a notary present when you sign this form.
  • Appointing a substitute decision-maker. This is a person who can make decisions about your care if you are not able to. Most people ask a close friend or family member to do this.
  • Do-not-resuscitate order, or DNR. This order asks that no extra treatments be used to save your life if your heart stops or if you can't breathe on your own. Extra treatments include electrical shock to restart your heart, a machine to breathe for you, and lifesaving medicines. If you decide to have a DNR order, ask your doctor to write it. Place the order in your home where everyone can easily see it.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You want to learn more about clinical trials.
  • You want to learn more about hospice palliative care in your area.
  • You need information about advance care plans or other end-of-life planning.

Where can you learn more?

Go to http://www.healthwise.net/ed

Enter C987 in the search box to learn more about "Deciding About Continued Cancer Treatment."

Current as of: July 26, 2016