Decisions about treatment

You can talk about your treatment options with your medical team to help you decide what feels right for you. You may find it useful to make a list of any questions you’d like to ask. A friend or relative could also come with you to your appointments for support.

You may feel it would be helpful to get a second medical opinion. Ask your GP or specialist about how to do this.

Some people are asked to take part in a clinical trial. Cancer research trials can help doctors find better ways to treat cancer. If you choose to take part, but change your mind at a later stage, it’s fine for you to leave the trial.

Some people want to have some idea about how long they might live. Doctors can’t be certain about this but will usually be able to give some guidance based on the type of cancer you have and your particular situation. You may prefer not to ask the question and that’s fine. It’s important to do what feels right for you.

Deciding about your treatment for advanced cancer

Before deciding on any course of treatment, you may want to find out as much as possible about your options. Your doctors and nurses will talk to you about what treatments may be suitable for you, taking into account your preferences and how treatment may affect you. This will help you decide on the best course of treatment together.

Treatment for advanced cancer usually aims to try to control the cancer and help you live longer. It may also help improve your symptoms and quality of life. Controlling the cancer might mean shrinking the size of the tumour or stopping it from growing for a while. As well as treatment for the cancer, your doctors will prescribe any other medicines you need to manage symptoms.

You may be offered surgery, radiotherapy, chemotherapy, hormonal therapies, targeted (biological) therapies, or a combination of treatments.

The treatment that is best for you will depend on the type of cancer and where it is in your body.

You may need to have a few treatments before you and your doctor can decide whether to continue with a full course. For example, if you are having chemotherapy to control or shrink the cancer, you may have a scan after several weeks to see what effect the treatment is having. You can carry on with the course of treatment if the scan results show it is working.

However, there may come a time when the treatment has little effect on the cancer. You may start getting the side effects of the treatment without any of the benefits. Making treatment decisions in these circumstances is always difficult. You may want to talk with your cancer doctor (oncologist), specialist nurse and family before deciding what to do.

If you decide not to have treatment, you will be given supportive (palliative) care with medicines to control any symptoms. These may include drugs to manage pain or stop you feeling sick (nausea). You might also be given cancer treatments to ease symptoms. For example, radiotherapy can help with pain as well as being a cancer treatment.

I think there’s probably a fear of the unknown. But once they told me, I wasn’t scared any more. I said, “Okay, what are we going to do about it?”

Claire


Talking about treatment options

You will usually have some time to think about your treatment options. It can help to discuss these with your family and friends, as well as the doctors and nurses looking after you. Your cancer doctor will have the most information about treatments. If you have a specialist nurse, they can also talk to you about the possible benefits and side effects of treatment. Remember that treatment is for your benefit. So it is important to make the decision that feels right for you about which treatment, if any, you want to have.

You may have questions you want to ask your doctor or nurse specialist. Before your next appointment, it may help to make a list of these questions or write down your thoughts about the benefits and disadvantages of having a certain treatment.

You may find it useful to record the discussion with your doctor. If you want to do this, ask your doctor first. Recordings can also be helpful for family and friends to listen to, so you don’t have to keep repeating information. You can take a family member or friend with you to your appointment. As well as giving support, they could take notes for you, or remind you of any questions you want to ask.

Questions you could ask

  • What are my treatment options?
  • Does this treatment aim to help me live longer or control my symptoms?
  • If I have treatment, how much longer am I likely to live for?
  • What will happen if I don’t have treatment?
  • How long will it be before I feel the benefit of any treatment?
  • What are the side effects?
  • Can I carry on working?
  • Will I need to stay in hospital and, if so, for how long?

Tips for talking to your doctor

Find out how to get the most out of your appointments with a GP or doctor.

About our cancer information videos

Tips for talking to your doctor

Find out how to get the most out of your appointments with a GP or doctor.

About our cancer information videos


Asking about how long you might live

For some people, it is important to have an idea of how long they might live (prognosis). Others prefer to focus on their quality of life and choose to never ask the question.

Your doctors can’t be certain what will happen to an individual person or when. So they may not be able to answer your questions fully. But they can usually give you some idea based on the type of cancer and your situation. Remember that cancer affects people differently and in an unpredictable way. Some people may have periods of stable disease where it is not causing too many problems. Some will live with their advanced cancer for a long time – sometimes years. But for others, the cancer develops more quickly and they will have less time.

Different things will affect how long you might live. For example, this may depend on how the cancer responds to treatment and how quickly the cancer grows. This means your doctor’s view may change over time. Talking to your doctor about this may be an ongoing discussion, rather than a one-off question.

Your medical team and your family and friends may wait for you to talk about how long you might live, or they may talk about it straight away. If you are not comfortable discussing it, it’s fine to say so. It is important to do whatever feels best for you.

It may be that your family and friends want more information than you do. If you are happy for them to talk about things in more detail, tell your doctor or nurse. They need to know:

  • who you are happy for them to talk to about your situation
  • that you agree to them talking to your family or friends without you being there.

It may be difficult to think of everything you would like to say or ask during your hospital appointments. You may think of lots of questions between appointments. If you do, you may have a specialist nurse who you can contact when you are not at the hospital.

Our cancer support specialists can give you information and emotional support. People with cancer and their relatives sometimes find it helpful to talk to someone they don’t know and who isn’t emotionally involved in their situation.


Second opinion

Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information. If you do go for a second opinion, it may be a good idea to take a relative or friend with you. You may also find it helpful to have a list of questions ready so that you can make sure your concerns are covered during the discussion.

Getting a second opinion

GP David Plume explains getting a second opinion about your diagnosis or treatment.

About our cancer information videos

Getting a second opinion

GP David Plume explains getting a second opinion about your diagnosis or treatment.

About our cancer information videos


Clinical trials

Current standard treatments can be helpful for many people with advanced cancer. But cancer doctors are always looking for better ways of treating cancer and managing its symptoms. One of the ways to do this is through cancer research trials, often called clinical trials. Trials help to improve knowledge about cancer and develop new treatments. Any new drug that is developed will go through trials to check it is safe and effective.

Taking part in a trial

You may be invited to take part in a clinical trial, and there can be many benefits to doing this. If you decide to take part, you will be carefully monitored during and after the study. It’s important to bear in mind that some treatments that look promising at first are often later found to be less effective than existing treatments. They may also have side effects that outweigh the benefits.

If you start taking part in a trial and then change your mind, you can leave the trial at any time. You will then be offered the current standard treatment for your situation.

If you decide not to take part in a trial, your decision will be respected and you won’t have to give a reason. There will be no change in the way you’re treated by the hospital staff, and you’ll be offered the current standard treatment for your situation.

We have more information about clinical trials.


Complementary and alternative therapies

Complementary therapies are most often used alongside or in addition to conventional medical treatment such as chemotherapy and radiotherapy. They aren’t used to treat cancer, but they can play an important part in reducing anxiety. They often include relaxation techniques, for example mindfulness.

The term alternative therapy is often used to refer to treatments that are used instead of conventional medical treatments. Some alternative therapists claim that their therapies can treat or cure cancer even if conventional medicines haven’t been able to. But no alternative therapies have been proven to cure cancer or slow its growth. Unfortunately there have been cases where false claims made about alternative therapies have led people to refuse conventional treatments that could have helped them.

Some alternative therapies although natural, can have serious side effects and could make people feel unwell. Many alternative therapies can also be expensive. 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.

It’s important to tell your specialist doctor or nurse if you’re using any complementary or alternative therapies. This is because some therapies may make conventional cancer treatments less effective or increase their side effects.

Back to Coping with advanced cancer

Who can help?

You can get care and support at home, in a hospital or in a hospice. This depends on your needs and preferences.

What is CPR?

Cardiopulmonary resuscitation (CPR) can be used to try to restart the heart and breathing if they have stopped.

Making CPR decisions

You may be asked to make a decision with your family and healthcare team about whether you want cardiopulmonary resuscitation (CPR) to be attempted.