Living with Advanced and Metastatic Cancer: Support and Symptom Management
Life with advanced and metastatic cancer is different for everyone. Your physical and emotional needs and how they impact your quality of life will depend on the type and stage of your cancer. Getting the right support is especially important when living with advanced or metastatic cancer.
Challenges of living with advanced and metastatic cancer
Living with advanced and metastatic cancer can be challenging. The challenges of are different for everyone, but they can include:
- Feeling hopeless, angry, or sad that the cancer has spread or is unlikely to be cured. You might feel like no one understands what you are going through, not even family.
- Worrying that treatment will not help and the cancer will get worse.
- Dealing with tests, doctor’s appointments, and decisions.
- Talking with family and friends about your cancer.
- Needing help with daily activities if you feel exhausted or have side effects from treatment.
- Finding emotional and spiritual support.
- Managing the cost of treatment. Even if you have insurance, it might not cover everything.
Finding clarity
The challenges that come with advanced and metastatic cancer can make staying positive even more difficult. However, talking about your needs and concerns with your cancer care team can empower you to find ways to help with these challenges, allowing you to live a better life. You may want to ask questions such as:
- Based on my cancer status, what do you think I should expect at this point? What about expectations moving forward?
- 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?
- 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 treatment?
- What support options are there for me?
- How will I pay for treatment? Will my health insurance cover it?
Getting answers to your questions can help you decide what your next steps should be as you are making treatment decisions.
Making treatment decisions
Treatment choices for advanced and metastatic cancers depend on:
- The type of cancer
- Where the cancer started
- How much it has spread into the area around it
- What symptoms you are having
- Your personal preferences
These factors may impact the goal of treatment. For cancer that has spread or become advanced, the goal might change from curing the cancer to controlling the cancer and its symptoms.
What’s most important is that each person makes the best decision for themselves. You should understand your options and decide what’s best for you.
In general, cancer that has spread will need treatment that reaches all parts of the body (systemic treatment), like chemotherapy, targeted therapy, immunotherapy, or hormone therapy. Other treatments, like surgery or radiation, only treat a certain part of the body, but can help prevent or relieve certain symptoms, like pain.
Some people might want to get cancer treatment if there’s a chance it may help shrink the cancer or slow its growth. The cancer will not go away but it may become smaller or not grow as quickly, helping to reduce current symptoms and prevent others from developing. Others might decide that the potential side effects or other burdens of cancer treatment, like cost and time away from home, aren’t worth the possible benefits.
Some people may choose not to have treatment if their cancer is already advanced or metastatic when diagnosed. Others may decide to stop treatment if the cancer becomes advanced or metastatic. This may be hard for some loved ones to accept, but you have the right to make this decision. It often helps to include your loved ones in these tough choices, but you should get to make the decisions that are best for you.
Palliative care can be helpful for anyone with advanced or metastatic cancer, whether they decide to get more cancer treatment or not. Palliative care isn’t the same as hospice. Its focus is on improving quality of life by helping patients and caregivers manage the symptoms of a serious illness and side effects of treatment. It can be helpful for people of any age and at any stage in a serious illness.
You can learn more about palliative care and how it can help with symptom control in "Managing symptoms of advanced cancers," below.
Long-term treatment for advanced and metastatic cancer
For some people, advanced or metastatic cancer can be managed as a chronic illness. With this approach, cancer and its symptoms can be controlled for a long period of time with cancer treatment. Palliative care can be provided at the same time to control symptoms of the cancer and treatment side effects.
Facing family issues
An illness that goes on for months or years can put huge stress on the family. The longer the stress lasts, the more likely family members are to become exhausted in body and mind. Fatigue added to worry and fear can take a toll.
Advanced and metastatic cancer can change the way family members relate to one another. Families that can solve conflicts and support each other tend to cope better. Families that have had trouble with problem-solving in the past may find this situation especially challenging. A counselor can help families talk through how best to support each other and plan for problems that may come up.
Roles within the family often change, too. How family members take on new tasks or fill in for the person with cancer can affect how well the family adjusts to the illness and the possibility of loss.
For someone with cancer, these changes can trigger a deep sense of loss. For example, a person who’s too sick to get out of bed may grieve the loss of a role they once filled, like parenting or being a partner. Understanding this, and finding ways for them to still be involved in daily family life, can help everyone feel more connected and supported.
People with cancer often say that lack of communication in their families is a problem. Changes in responsibilities can lead to resentment and anxiety. Family counseling can help family members learn to talk about what’s happening and how they feel. It may be especially helpful in families where some members don’t feel comfortable sharing their emotions.
The needs of family members and caregivers are important, too. See our information for caregivers and family to learn more on how to support their needs.
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 or metastatic 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 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 are filled with happiness and meaning. Living with this type of uncertainty is not easy, but for many people, this is a 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 or metastatic cancer is hard for everyone involved. It’s common to experience anxiety, distress, and depression. But you should not have to deal with these feelings on your own.
People with life-threatening illnesses need support from others to cope with their illness and its emotional effects. Support can come from:
- Family and friends
- Members of a church, synagogue, or other place of worship
- Community members, including others with cancer
- Mental health professionals
- Support groups
Asking for support is one way you can take some control of your situation.
Support from friends and community
While some people have strong support from family and friends, others may not. If you don’t get enough support from friends and family, look for it elsewhere. There are others in your community who need your companionship as much as you need theirs.
- Faith-based communities can provide connections to others and offer support for emotional and spiritual needs.
The mutual support of others with cancer might also be a source of comfort. Check with your cancer care team for resources in your community.
While some people have strong support from family and friends, others may not. If you don’t get enough support from friends and family, look for it elsewhere. There are others in your community who need your companionship as much as you need theirs.
- Faith-based communities can provide connections to others and offer support for emotional and spiritual needs.
- The mutual support of others with cancer might also be a source of comfort. Check with your cancer care team for resources in your community.
If you have ongoing feelings that interfere with your life, or if you just want to communicate and cope the best you can, it may be very helpful to talk with an expert. Social workers, counselors, psychologists, psychiatrists, or psychiatric nurse practitioners are all licensed health professionals. These counselors can be especially helpful if you are struggling with anxiety, distress or depression.
Even one session may help you and your family focus on what matters most. Your cancer care team can work with you to find the right provider for you.
Support programs come in all forms, including one-on-one or group counseling and support groups. They can be a powerful tool for people with cancer and their families. Talking with others who are in situations like yours can help ease loneliness. You can speak without feeling judged. And you can often get useful ideas from others that might help you. The American Cancer Society can help you find many different support programs in your community.
When exploring support groups, you may notice differences in several factors:
- Formality: Some are more structured and offer educational resources, while others are causal and centered around social interaction
- Participants: Certain groups are just for people with cancer, while others are geared toward caregivers, friends, or a combination
- Cancer focus: Some groups are for a specific cancer type or stage
- Duration: Some groups run for a set number of weeks at a time, while others continue indefinitely
Some people find online support groups helpful because they like the privacy they can offer. It may be comforting to chat with other people in situations much like yours, without having to share any more than you want to. But it’s important to remember that chat rooms and message boards are not the best source of medical information, especially if they are not monitored by trained professionals or experts. Each person’s situation is unique, and what helps one person might not be right for someone else.
Support in any form allows you to discuss your feelings and develop coping skills. Studies have found that people who take part in support programs often have an improved quality of life, including better sleep and appetite.
Managing symptoms of advanced and metastatic cancers
While most advanced and metastatic cancers are unlikely to be cured, there are still ways help you feel as good as possible for as long as possible.
Palliative care (sometimes called supportive care) focuses on improving a person’s quality of life by helping to manage the symptoms caused by cancer and side effects of treatment. This can include physical side effects as well as the emotional, social, mental, and spiritual impacts of an advanced or metastatic cancer diagnosis.
While advanced and metastatic cancer doesn’t always cause symptoms, many times it does. Symptoms often depend on the size and location of the cancer. Your cancer care team can tell you the most about your cancer and what symptoms it might cause.
Palliative treatments can help control or relieve common symptoms such as:
- Pain
- Shortness of breath
- Depression and anxiety
- Fatigue and weakness
- Loss of appetite
- Weight changes
- Nausea and vomiting
- Constipation
Some symptoms of advanced and metastatic cancer are more serious or even life threatening and may require treatment right away. For example, a buildup of fluid (effusion) in the lung, heart, or abdomen (belly) and blockages of the bowel or kidneys. Talk to your care team about what to watch for.
Some types of cancer may cause a buildup of fluid as it grows and spreads.
Lung and breast cancers, mesothelioma, and lymphoma can cause fluid to build up in the lungs (pleural effusion) or heart (pericardial effusion). These effusions can lead to pain, cough, and shortness of breath.
If the fluid continues to build up, it can prevent the lungs or heart from working normally. A pericardial effusion that is large or comes on quickly can be life-threatening.
Tumors in or around the belly, like liver, pancreatic, ovarian, bladder, or colon cancers, can cause fluid to build up in the belly (ascites). This can lead to swelling, nausea, and shortness of breath. While usually not life-threatening, ascites can be uncomfortable or even painful.
Fluid buildup can be managed in several ways depending on where and how severe it is:
- Needle or tube drainage: A needle is inserted through the skin and used to remove the fluid. Because the fluid often returns over time, a thin, hollow tube (drain) or catheter may be put in place to let the fluid be drained continuously. This may also be done if there is a large amount of fluid to be drained.
- Pericardial window: For pericardial effusions, surgery might be done to make a small opening in the lining of the heart to allow fluid to drain.
- Pleurodesis: For pleural effusions, a procedure can be done that causes the lining of the lung to stick together, sealing the space between them and preventing fluid from building up.
- Shunt: A bypass tube (shunt) is placed surgically to move extra fluid from one place to another.
- Medications: Diuretics may be given to help remove extra fluid.
Cancer in the abdomen (belly) sometimes blocks the bowels. The blockage (obstruction) keeps food and stool from moving through. This leads to severe cramping, belly pain, and vomiting.
A bowel blockage is very serious and must be treated right away. It can cause pressure to build up and create a hole (perforation) in the intestine, allowing digesting food and bacteria into the abdomen. This can lead to a severe infection, causing even worse pain, nausea, and vomiting.
Surgery to fix a blockage is not always possible if the person is very sick. Other times, the cancer might be very large and surgery may not help for long. The risks of surgery should be compared to the chances of returning to a comfortable life. However, there may be other ways to treat or prevent blockages. The best approach will depend on the size and location of the cancer:
- Stent: A small, stiff tube used to help keep the bowel open without requiring surgery.
- Ostomy (colostomy or ileostomy): Surgically bypasses the blockage by cutting the bowel above the block and connecting it to an opening (stoma) on the skin of the abdomen (belly). Stool then comes out into a bag that’s put around the opening.
- Nasogastric (NG) tube: A tube placed through the nose, down the throat, and into the stomach. It uses gentle suction to remove stomach contents and relieve nausea and vomiting. Usually used short term.
- Gastric (G) tube: A tube placed into the stomach through the skin on the belly. Offers more long-term relief than a NG tube.
- Medications: Shots or patches can be used to treat the pain and nausea that’s caused by the blockage. Other medicines can be used to decrease the amount of liquid made by the stomach and improve symptoms.
Cancer in the abdomen (belly) can sometimes block the thin tubes (ureters) that carry urine from the kidneys to the bladder. If this happens, you might stop urinating. Urine backs up in the kidneys, and they stop working. This can make you feel very tired and sick to your stomach.
In many cases, a small, stiff tube called a stent can be threaded up from the bladder and through the ureters to keep them open and let urine flow again. Another option is to put a tube through the skin and right into the kidney to allow the urine to drain into a bag outside the body. This is called a nephrostomy.
Managing symptoms by area of metastasis
Some symptoms depend on where the cancer has spread. Choose a location below to learn about common issues and ways to manage them.
Being your own advocate
The goal of any cancer care is to give you the best possible quality of life. You want to feel as good as you can for as long as you can. Talk to your cancer care team about what’s important to you. Tell them what you want to be able to keep doing. You have the right to be the decision-maker in planning your treatment.
Learn more: Advanced Cancer Care Resources - A Guide for People Living with Cancer and Their Caregivers
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: July 21, 2025
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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