Advanced Cancers

When you or your loved one has advanced cancer...

Most people who have survived cancer and completed their treatment will say that they live with the underlying fear that their cancer will return.  Although some people with advanced cancer are living longer and with better quality of life, it still remains a serious concern and at times a turning point in the course of your cancer treatment and care.

Advanced or recurrent cancer is not the same for everyone; it behaves differently depending on what your primary cancer diagnosis has been.  Likewise, each person faced with recurrent cancer will cope differently too.

Elizabeth Edwards is providing one example of how someone who has been diagnosed with a recurrence of breast cancer, that is in her words incurable, chooses to live.  She has plans to continue living life in the way that she defines for herself as meaningful and full of hope, while understanding the realities of her situation.

Incurable does not mean untreatable:

Often people confuse the term incurable with the notion that nothing can be done to help a person with their cancer. While the term incurable means different things to different people, medically it refers to a cancer situation in which physicians do not believe they have a treatment at this time  that will eradicate the cancer and render that person cancer free. There are though treatments that can control or slow down the cancer from growing or spreading to other parts of the body. In this way a cancer that cannot currently be cured can still be treated. For some their cancer becomes a chronic type of illness that receives various types of treatments that try to control and slow the cancer from growing further in the body.

If you or someone you care about has been diagnosed with a recurrence of cancer, here are a few things to think about, and ways that CancerCare can help:

Communication with your doctor.  It can sometimes be hard for both you and your doctor in this situation to talk openly about what a recurrence of your cancer means.  You and your family may be too preoccupied with the impact of the information or emotional at the time of the news to have a constructive conversation with your doctor about the meaning of the diagnosis and next steps. However when you have had a moment to focus or regroup, here are a few questions that you may want to ask:

• Are there other tests that I need to have now so we better understand what we are dealing with?
• Is there a treatment that will slow or stop the cancer from advancing, and how successful has this treatment been with others in my same situation?
• How might my quality of life be affected if I take this treatment or if I don’t?  Are there side effects, and if so, can they be helped?
• How will you help to make sure I have the best quality of life available—that I am free of pain and comfortable?

The question of prognosis (meaning how long one may have to live with advanced cancer) is one that some people want to ask and others do not.   No one can tell you with certainty how long you might live with your recurrence of cancer as these statistics are based on large populations of people with your cancer, not individuals. However it may be possible for a doctor to give you some information regarding a time frame (like months or years) that could be helpful to you in terms of decision making regarding treatment choices, planning for future care for yourself or children, financial decisions and how you want to spend your time.  A CancerCare social worker can help you decide what questions to ask. More information about talking to your doctor.

Defining hope and meaning in life. Hope may have defined only as a hope to be cured. A recurrence of cancer requires that you define hope in a more varied and complex way. When a person is first diagnosed with cancer, they often take stock of what is important in life. Recurrence is a time to revisit those decisions and more specifically think about the quality of your life and what that means to you. Most important is how can your doctor, family, and friends help you maintain what you define as quality living.

Your choices about what type of treatment to take now; or how long you want to continue taking a treatment with difficult side effects may be influenced by how you think about this. For some, it means continuing life as normal and making adaptations as physical changes occur .  For others, this might mean slowing down, make some radical life changes and spending more time with loved ones.  The most important thing is that you define this for yourself with the help of your medical team and/or close family or friends. Always keep in mind that you can make different choices and redefine what quality and hope means to you as you continue on with a recurrence.  A CancerCare social worker is skilled in helping you clarify these issues. More information about coping with cancer.

Talking to children. Conversations about advanced cancer can feel particularly complicated where children are concerned. The best thing you can do for your children during this difficult time is to talk to them about your recurrence and their feelings. Our program staff from CancerCare for Kids has expertise in how to talk to children about cancer.  Tips for talking with children about your cancer.

Caring advice for caregivers.  If you are the family member or friend of a person with a recurrent cancer, you have a different set of issues to face.  You may need to provide care while juggling multiple responsibilities.  You will have your own issues with redefining hope and managing the impact new medical decisions that either involve treatment or don’t. You may feel like you have no time to take care of yourself, or think about what this news means to you. Talking to a CancerCare social worker can help you cope.  More information about taking care of yourself as a caregiver.

Important resources.   Learning about resources like hospice and palliative care programs before you might need them help you to be prepared and understanding the wonderful types of care available to people with advanced cancer.  Most hospice programs can meet with you early before any type of crisis might occur to explain their services. These programs also are very helpful to family and caregivers. To locate a hospice program in your area, ask your oncologist for a recommendation, visit the National Hospice and Palliative Care website. Or contact CancerCare for referrals to local resources

CancerCare can help.  We welcome you to call us at 1-800-813-HOPE (4673) or email us at info@cancercare.org and one of our oncology social workers can talk with you about recurrent cancer or any other concerns you might have about your particular situation.