Coping with Advanced and Metastatic Cancer

Living with advanced cancer can be very different for each person. It is important to understand what you can expect with your type and stage of cancer. Set up time to talk to your cancer care team to talk about your concerns and ask your questions.

You may want to ask questions such as:

• What do you think I should expect at this point?
• What are my options? Are there effective treatments available for me?
• What’s the goal of treatment right now? Control of the cancer? Comfort?
• How long do you think I can live with this cancer? What’s the range of survival times for people in my situation? Am I going to die soon?
• How often will I need treatment or need to see the doctor?
• What tests will I need to watch for changes in the cancer?
• What symptoms do I need to watch for and tell you about?
• What can be done for symptoms I have (pain, fatigue, nausea, etc.)?
• What if I decide I don’t want any more treatment?
• What support options are there for me?
• How will I pay for treatment? Will my health insurance cover it?

Making treatment decisions about advanced cancer

Getting answers to your questions can help you decide what your next steps should be. Will you pursue treatment to try and manage your cancer on an ongoing basis, or will you decide that you’d rather not undergo treatment?

Palliative care can be helpful for anyone with advanced cancer, whether they decide to get more cancer treatment or not. Palliative care is not the same as hospice. Palliative care focuses on improving quality of life by helping patients and caregivers manage the symptoms of a serious illness and side effects of treatment. Palliative care can be helpful for people of any age and at any stage in a serious illness. Palliative care should be used whenever a person has symptoms that need to be controlled.

For some people, advanced cancer can be managed as a chronic illness. With this approach, the cancer and symptoms can be controlled for a long period of time with cancer therapy. Palliative care can be provided at the same time to control symptoms of the cancer and the treatment.

For some, the best option may be to not get more treatment and instead focus on having the best quality for the rest of their lives. Palliative care can be very helpful in managing symptoms, dealing with the feelings about having cancer, and handling concerns about death. When a person nears the end of their life, a transition is often made to hospice.

What is most important is that each person makes the best decision for themselves. It is essential to understand your options and decide what is best for you.

Facing family issues

Illness that goes on for months or even years can put a huge stress on the family. The longer the stress lasts, the more at risk the family is for mental distress. Family members may become exhausted in body and mind. Fatigue added to worry and fear can take a toll.

Advanced cancer changes the way family members relate to one another. Families that can solve conflicts well and who support each other tend to do best in dealing with a loved one’s cancer. Families who found problem-solving hard in the past are likely to have more trouble dealing with this stressful situation. You might want to meet with a counselor and work together to plan how best to support each other and plan for problems that may come up.

Roles within the family may change, too. How family members take on new tasks and fill in for the person with cancer affects how they will adjust to losing that person.

For the person with cancer, the changes in family roles can trigger the grief that comes with loss. For instance, a woman who’s too sick to get out of bed may feel the loss of her role as a wife and/or mother. Understanding this and finding ways for her to still be involved in her family’s day-to-day life may help both her and her family.

People with cancer often say that lack of communication in their families is a problem. Changes in duties can cause resentment and anxiety. Family counseling might help family members learn to deal with the changes that are taking place. It can also help members learn to discuss their feelings more comfortably. Counseling is especially helpful in families where some members don’t feel comfortable openly talking about their feelings.

The needs of family members and caregivers are important, too. See our information for caregivers and family or call us to learn more.

Finding hope

Hope is an important part of everyday life. Hope gets many of us out of bed in the morning and keeps us going throughout the day.

If you have advanced cancer, you can still have hopes and dreams, even though some of these might have changed. Your hope might be to have a pain-free day, or to do something special with a family member. Just sharing and talking openly can be a hope for people with cancer and their families. There may also be real hope for relief of symptoms and slowing down the growth of the cancer.

And there’s always hope to make the most of the time you have left – for good times with family and friends, times that can be filled with happiness and meaning. Living with this type of uncertainty is not easy, but for many people, this is a good time to refocus on the most important things in life. Now is the time to do things you’ve always wanted to do and stop doing the things you no longer want to do.

Finding support

Being told you have advanced cancer can be very hard for patients, families, and caregivers. Common feelings during this life-changing experience include anxiety, distress, and depression. But you should not have to deal with these feelings on your own.