Ask CancerCare

A. I am sorry that you have been told that there are no other options to treat your cancer.  It seems that you have been on quite a journey over the last years which likely took an incredible amount of courage and energy. It is possible that your brave demeanor allowed your family to think that the cancer would remain under control for a long time to come.

It is not uncommon for people to deny the seriousness of cancer, including people with cancer as well as their loved ones. While denial is often thought of in a negative way, it can be a useful protective mechanism that insulates from the sometimes intense emotional pain of the cancer experience. Perhaps the indifference that you see in some of your family members has a component of denial that has protected them from the pain of emotion resulting from their concern for you.

You may want to identify a strategy to communicate your concerns to your family.  A nurse or your treating physician, a social worker, or clergy member or friend may help to facilitate a discussion with your family. Family members might benefit from meeting with you and one or more of these support persons to talk about your cancer as it presents currently and what the expectations will be going forward. In this way, you can begin to discuss with them what support you need.

At the same time, you may find that it is helpful to share your experiences with others who are going through similar challenges through CancerCare's counseling and support group services. CancerCare provides free face-to-face, telephone and online support groups which are moderated by professional oncology social workers.

The National Hospice and Palliative Care Organization offers a program for those facing decisions, which includes practical information for those living with serious illness.

I hope that you have found this to be helpful, and I welcome you to talk further about your concerns with a CancerCare social worker.

A. It must be a very difficult time for your family and you are to be commended in seeking out resources and support services that are available to assist you and your family during this time.

Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice will work with the person and their family to ensure needed services can be provided. In order to receive hospice services, your father's doctor will need to make a referral to a local hospice provider. You may also contact a local hospice in your area to get guidance about what steps you should take.

The National Hospice and Palliative Care Organization (NHPCO) offers information and resources about end-of-life and hospice through its Caring Connections website. The Caregiver Resource Directory also can provide you with extensive information. We’ve created a fact sheet, "Caregiving at the End of Life", that provides some guidance as you care for your father.

It’s important that you continue to follow-up with his Medicaid application, as benefits will be retroactive to the date when he applied and can be used to pay any medical bills that may be incurred during the application period. CancerCare’s fact sheets, "Getting to Know Your Entitlements" and "Financial Help for People with Cancer" may also be helpful in outlining other resources that may be available.

If you continue to have difficulties securing hospice services for your father, please contact us to speak with an oncology social worker by calling 1-800-813-4673 (HOPE).

A. I am very sorry to hear of your grandmother’s diagnosis of lymphoma. Lymphoma is the term used to describe cancer of white blood cells, called lymphocytes, which are a crucial component of the immune system.  As with any cancer, there are important factors in determining a patient’s prognosis. These include the type of cancer, the stage of the cancer, the age of the patient and the patient’s general health. It is also important to consider whether the cancer is a new diagnosis or whether it has been treated and come back.

While it is not possible to tell you exactly what to expect in terms of your grandmother’s condition, it is important to begin to plan for her care.  Talk with her physician about her prognosis and find out more details about your grandmother’s situation. To help you better communicate with the physician and health care team, you may want to read our fact sheet, “Doctor, Can We Talk?”

You will want to develop a plan that includes all available family, social and medical supports to care for your grandmother in body, mind, and spirit.  You may also want to discuss with your grandmother what her wishes are regarding her care. It is important to have information about your grandmother’s health insurance or other coverage she may have and what medical and supportive care services they can provide during this time. 

A social worker can assist you in developing a plan that suits the needs of your grandmother and your family.  CancerCare’s professionally trained social workers have expertise in determining what resources are available to your grandmother and your family. We also offer support groups for caregivers, both online and by telephone. You can find more detailed information about advanced cancers on our website.

The Leukemia & Lymphoma Society provides specific information about lymphoma and offers support services provided through their local chapters.

A. You have made a difficult decision to change the focus of your treatment from curative to palliative. No doubt this decision was made after careful consideration and consultation with your physician and members of your support team.

Palliative care recognizes that for some people with cancer, a cure is not possible. It focuses on quality of life in order to help maintain the best possible level in regard to physical, emotional and spiritual care, as well as supporting family needs.

Most people report that they are not as fearful about dying as they are about the possibility of experiencing pain and distress. You will find that there are many ways to address physical pain and also learn some ways to describe your discomfort to your treatment team by reviewing our booklet, Controlling Cancer Pain: What You Need to Know to Get Relief.

Palliative care may be available through your local treatment center, or may be accessed through hospice. Medical professionals are available with an expertise in symptom management, as well as assistance in your home to manage daily needs, a social worker to support you and your family, and chaplaincy services to provide you with spiritual care. Getting to know your palliative care team early after you decide to pursue palliative treatment will allow them to get to know you and your preferences, as well as how you respond to pain management techniques. We offer a fact sheet, "Your Health Care Team: Your Doctor is Only the Beginning", that outlines some of the professionals who may be available to help you.

While your care at this time is palliative in nature, the importance of hope can not be dismissed. Hope is that balance between positive attitude and expectations for the future. Hope can continue to nourish you, and you can nurture hope through the way in which you continue to conduct your life. Settling old problems and practical affairs will give you peace of mind. Make plans with family and friends as you are able to continue to engage in those activities that you enjoy. Focusing on the purpose and goals of each day will set up an achievable plan and completing what you can each day will give you satisfaction that you have done your best.