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Managing Cancer Care

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.

    Support from friends and community

    People with life-threatening illnesses have a strong need for other people in their lives. They need others to help them deal with their illness and its emotional effects. Support can come from family and friends; members of a church, synagogue, or other place of worship; mental health professionals; support groups; or community members. Asking for support is one way you can take some control of your situation.

    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. 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.

    Support from a counselor

    If you have ongoing feelings that interfere with your life, or if you just want to communicate and cope the best you can, consider talking with a mental health professional. It can often be very helpful to talk with an expert. Social workers, psychologists, psychiatrists and psychiatric nurse practitioners are all licensed mental health professionals. These counselors can be especially helpful if you are struggling with anxiety, distress or depression.

    You can find one by asking your cancer care team or through the nearest large hospital in your area. Even one session with a licensed mental health provider 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

    Support programs come in all kinds of forms and include one-on-one or group counseling and support groups. A support group can be a powerful tool for patients and 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.

    Some groups are formal and focus on learning about cancer or dealing with feelings. Others are informal and social. Some groups include only people with cancer or only caregivers, while others include spouses, family members, or friends. Some groups focus on specific types of cancer or stages of disease. The length of time groups meet can range from a certain number of weeks to an ongoing program. Some programs have closed membership and others are open to new, drop-in members. For those who cannot attend meetings or appointments, phone counseling is offered by some organizations.

    Online groups are another option. Some people find online support groups helpful because they like the privacy it 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.

    The American Cancer Society medical and editorial content team

    Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

    National Cancer Institute. Coping with advanced cancer. Updated June 2020. Accessed August 14, 2020.

     Swami M. Effective palliative care: What is involved. Oncology. 2018; 32(4): 108-4.  

    Last Revised: September 10, 2020

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