Choosing care and treatment for advanced cancer
Making decisions about treatment and care when you have advanced cancer isn’t easy. Only you can make the treatment and care decisions that are right for you on this last stage of your cancer journey. Some people choose to explore every option that might help them live longer, even for a week or month. Others are more concerned with their quality of life during the time they have left. Along the way, many people will offer advice, and what your family wants will be important, but you need to decide what is best for you.
Advance care planning
If you have cancer, it is important to think about your future care and treatment. This is called advance care planning. Part of the planning includes telling your family and friends what kind of health and personal care you want if you ever can’t speak for yourself.
Talk to your healthcare team about advance care planning. They can help you make decisions about your care. You may also want to review the booklet, Cancer and Advance Care Planning, developed by the Advance Care Planning in Canada initiative, the BC Cancer Agency and the BC Patient Voices Network. It includes information and samples of questions to help guide your advance care planning.
Palliative care provides physical, emotional, social and spiritual support for people with cancer and their families. Palliative treatments can include radiation therapy, chemotherapy, surgery or medicines for pain or other symptoms. The purpose of palliative care is not to cure the cancer but rather to relieve symptoms, control the cancer if possible and improve quality of life.
Palliative care doesn’t mean that doctors are giving up. It means that the focus of care changes from trying to cure the cancer to:
- making you as comfortable as possible
- helping relieve symptoms, like pain or shortness of breath
- keeping your quality of life as high as possible
- providing support during this time, which may be months or years
Palliative care specialists, including nurses, doctors, social workers, home health aides, occupational therapists and volunteers, provide this care in:
- your home
- pain or palliative care clinics
- palliative care units in hospitals
- long-term care facilities
- hospices, which offer supportive care for people at the end of life, as well as for their families
Care at home
For some people with advanced cancer and their families, staying at home for as long as possible is very important. Being cared for at home can be very comforting, but it does mean more responsibilities for loved ones who are caregivers. Discuss with members of your healthcare team what it means for you to stay at home so that everyone understands what they need to do.
Even with the right support in place, there may come a time when it’s no longer possible for you to stay at home. People with advanced cancer may need medical care and support that is too difficult for family members to provide. It’s important to recognize that moving to a hospice or palliative unit isn’t a failure on anyone’s part. Family members can still offer love and support to someone in a hospice or hospital, while having skilled care from the healthcare team.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.