Deciding about treatment for advanced cancer
Some people are happy to have whatever treatment their doctor recommends, but others like to know as much as possible before starting any course of treatment.
The treatment that’s appropriate for you will depend on your type of cancer and where it is in your body. You may be offered surgery, radiotherapy, chemotherapy, hormonal therapies, biological therapies or a combination of treatments. Treatment is often given to relieve symptoms and improve quality of life. This is sometimes called palliative or supportive treatment.
Talking about treatment options
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It’s usually possible to take a bit of time to think about your treatment options, and discuss them with the people closest to you and the doctors and nurses looking after you. Your cancer specialist (oncologist) is the best source of accurate medical information. In many hospitals, specialist nurses are available to talk over all the possible benefits and side effects of treatment, and whether you want to have further treatment or not.
Remember that the treatment is designed to be for your benefit. It’s important that you make the decision that feels right for you about which treatment, if any, you want to have, even if your family or doctors may recommend otherwise.
It can be difficult to remember the questions you want to ask your doctor - it may help to make a list before your next appointment. Some people find it useful to record the discussion with their doctor (with their doctor’s permission). Recordings can also be helpful for family and friends to listen to, so that you don’t have to keep repeating information. Alternatively take a friend or family member with you. As well as giving support, they may be able to take notes for you, or remind you of any questions that you want to ask.
Some questions you could ask your specialist
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What are my treatment options?
Is this treatment aimed at helping me live longer or deal with my symptoms?
How long will it be before I feel the benefit of any treatment?
Are there any side effects? Are they temporary or permanent?
Can I go on working? Should I try to work shorter hours?
Will I need extra help in the house or with the children?
Will I need to stay in hospital and, if so, for how long?
If I’m given treatment as an outpatient, how long will each one take and how many will I need?
Should somebody take me to and from the hospital, or will I be able to drive or travel by myself?
Will the illness affect my holiday/travel plans?
Will I have to change my diet?
Will the cancer or treatment affect my sex life?
Asking about life expectancy (prognosis)
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For many people, the most obvious and important question to ask is ‘How long will I live?’ This question is impossible for your medical team to give an exact answer to, because many things can affect life expectancy. For example, how well the cancer responds to treatment, the speed the cancer grows at and any changes in your general health. If the answer your doctor gives is too vague for you, perhaps because you need to make specific plans for the future - explain this to them. They may be able to give you more information, although they can only ever give you their best estimate.
Many different things can affect life expectancy, so your situation and your doctor’s predictions may change over time. Some people find that talking to their doctor about life expectancy is an ongoing discussion, rather than a one-off question.
While for some people it’s very important to have an idea of how long they might live, others prefer to focus on issues to do with their quality of life and choose never to ask the question. Your medical team and your loved ones may wait for you to bring up the topic of life expectancy, or they may ask you to talk with them about it. If you’re not comfortable discussing this, it’s fine to say so. It’s important to do whatever feels best for you.
Complementary and alternative therapies
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Some people wonder whether complementary or alternative therapies can help them when they are told that their cancer can’t be cured.
Complementary and alternative therapies are often grouped together, but there are important differences between them based on how and why they are used. Often a treatment can be complementary if used in one way and alternative if used in another.
Complementary therapies are most often used alongside conventional therapies such as chemotherapy and radiotherapy. They aren’t used to treat the cancer itself but can play an important part in reducing anxiety and controlling symptoms, alongside conventional medicines for symptom control. Some people also use complementary therapies to improve their emotional and physical health.
While complementary therapies are generally used in addition to conventional treatments, the term alternative therapy is often used to refer to treatments that are used in place of these treatments.
Some alternative therapists claim that their therapies can cure cancer even if conventional medicines haven’t been able to do so. But no alternative therapies have been proven to cure cancer or slow its growth. Unfortunately there have been cases in which false claims made about alternative therapies have led patients to turn away from conventional treatments that could have helped them.
If you’ve been told by your doctors that the cancer can’t be cured, this can be very hard to accept and you may look to an alternative therapy. However, if a cancer can’t be cured by conventional medical treatment, it’s equally true that it won’t be cured by alternative treatment. In this situation, some alternative therapies may do no harm, but some can cause serious side effects and make people feel unwell. Many alternative therapies can also be expensive.
Only you can decide whether or not to use alternative cancer therapies. If you decide to use an alternative therapy, it’s important to check it’s safe and to check the credentials of the therapist offering the treatment.
Most doctors are happy for their patients to use complementary therapies. But it’s important to tell your doctor if you’re using any complementary or alternative therapies, as some may make conventional cancer treatments less effective or increase their side effects.
Our cancer support specialists can answer any questions you might have about complementary or alternative therapies.