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 questions 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. These can help doctors find better ways to treat cancer. If you choose to take part, but change your mind at a later stage, it is fine for you to leave the trial.

Some people want to have some idea about how long they might live. Doctors cannot 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 is okay. It is important to do what feels right for you.

Decisions about treatment

You may want to find out as much as possible about your treatment options before making any decisions. Your doctors and nurses will talk to you about what treatments may be suitable for you. These will depend on the type of cancer you have and where it is in your body. Your doctors will consider what is important to you and how treatment may affect you. This will help you both decide on the best course of treatment.

Treatment for advanced cancer usually aims to control the cancer and help you live longer. It may also aim to help improve your symptoms and quality of life. Treatment can shrink the size of the tumour or stop it from growing for a while.

You may also need other medicines to help manage symptoms.

You may be offered:

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. This is to assess the effect the treatment is having. If the scan results show that the treatment is working, you are likely to benefit from continuing with the treatment.

However, the treatment may no longer have an effect on the cancer after some time. You may start getting the side effects of the treatment without any of the benefits. In this case, you may want to think about whether to continue with treatment. Making treatment decisions in these circumstances is always difficult. It may help to talk with your cancer doctor, specialist nurse, family and friends before deciding what to do.

If you decide not to have treatment, you will be offered supportive (palliative) care to help control symptoms. This may include:

  • medicines to manage pain or stop you feeling sick (nausea)
  • radiotherapy, which is a cancer treatment that can also help reduce pain.

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 up-to-date information about treatments. If you have a specialist nurse, they can also explain the possible benefits and side effects of treatment. It is important to make the treatment decision that feels right for you.

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

You may find it useful to record the discussion with your cancer doctor, so you can remember what has been said. If you want to do this, ask them first. Recordings can also be helpful for family and friends to listen to, so you do not have to keep repeating information. You may find it helpful to take a family member or friend with you to your appointment. They can write down 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 do not 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?
  • Am I entitled to any financial benefits?

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 this question.

Your doctors cannot be certain about what will happen to an individual person or how long you might live. So they may not be able to answer your questions fully. But they can usually give you an idea based on the type of cancer and your situation. Cancer affects people differently and it can be hard to say how quickly it might progress.

Some people may have times when the cancer is stable and is not causing too many problems. Some will live with their advanced cancer for many months and 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, it may depend on how the cancer responds to treatment and how quickly it grows. You may need to talk with your cancer doctor again about what the best treatment might be and if it needs to be changed.

Your healthcare 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 is okay 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 learn about your situation in more detail, tell your cancer doctor or nurse.

Your doctor or nurse needs 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.


Who you can talk to

It may be difficult to think of everything you would like to say or ask during your hospital appointments. You may think of questions between appointments. If you do, you may have a key worker or specialist nurse who you can contact. It can help to write down any questions so you do not forget them.

Our cancer support specialists can also give you information and emotional support. Call them on 0808 808 00 00. You may find it helpful to talk to someone you do not know and who is not emotionally involved in your situation. Your family or friends may find this helpful, too.


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 to treat cancer and manage its symptoms. One of the ways to do this is through cancer research trials (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. 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 is important to remember 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 will not have to give a reason. There will be no change in the way you are treated by the hospital staff., You will 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 with or in addition to conventional medical treatments such as chemotherapy and radiotherapy. They are not used to treat cancer, but they may improve well-being. For example, they may help to reduce anxiety, improve sleeping, and cope with other symptoms. Complementary therapies often include relaxation techniques (such as mindfulness) and breathing exercises.

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 have not been able to. There is currently no evidence to show that alternative therapies are effective in curing cancer or slowing its growth.

Unfortunately, there have been cases where people have refused conventional treatments because of false claims made about alternative therapies. Some alternative therapies, although natural, can have serious side effects and can make people unwell. Many alternative therapies can also be expensive. If you decide to use an alternative therapy, it is important to check it is safe. It is also important to check the credentials of the therapist offering the treatment.

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

We have more information about cancer and complementary therapies.

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.