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Cancer treatments can help stop cancer from growing or spreading. But sometimes treatment does not work well or stops working.
Maybe treatment ended a while ago and was successful at first, but cancer has come back. Or maybe one type of cancer treatment has stopped working and the cancer has kept growing. If this happens, your doctor might say your cancer has advanced or progressed. There may or may not be other treatment options. But when many different treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments.
Here are some points to consider when deciding whether to continue cancer treatment.
Talking with your doctor and cancer care team, and trusting them to be honest, open, and supportive, is very important. You will have more confidence in treatment decisions if you trust the doctors making recommendations. This means communication is a key part of your care, from diagnosis throughout treatment and beyond.
Try to avoid asking your doctor and cancer care team questions like, "What would you do?" or "If you were in my place, would you try another treatment?" Instead, try asking questions like, "Can you tell me all of my options, please?" and "What do you recommend based on your experience treating my type of cancer?"
Be open with your loved ones about your cancer and the news you've been given. Explore their thoughts, feelings, and suggestions. Talk to them about the options you have been given, along with the decisions you have made or are thinking of making. If you feel you need their input, ask. If not, be firm that you would like to make your own decision. You can read more about the importance of communication in Nearing the End of Life.
When faced with deciding whether to continue cancer treatment, some patients or their loved ones may want to get a second opinion. Even when you place full trust in your doctor and cancer care team, you might wonder if another doctor could offer something else or more information. It's normal to think about talking to someone else, and your doctor should support you if you decide to get another opinion. Remember that your cancer care team wants you to be sure about the decisions you make. You can read more in Seeking a Second Opinion.
If you have cancer that keeps growing or comes back after one kind of treatment, it’s possible that another treatment might still help shrink the cancer, or at least keep it in check enough to help you live longer and feel better. Clinical trials also might offer chances to try newer treatments that could be helpful.
If you want to continue to get treatment for as long as you can, it’s important to think about the odds of further treatment having some benefit (and what this benefit might be), compared to the possible risks and side effects. Your doctor can help estimate how likely it is the cancer will respond to treatment you might be considering. For instance, the doctor might say that more treatment might have about a 1 in 100 chance of working. It’s important to have realistic expectations if you do choose this plan. The possible benefits, risks, side effects, costs, schedule of treatments and visits, and effect on quality of life should always be considered and discussed.
When a person has tried many different treatments and the cancer is still growing, even newer treatments might no longer be helpful. This is likely to be the hardest part of your cancer experience – if you have been through many treatments and nothing’s working anymore. At some point you may need to consider that further treatment is not likely to improve your health or change your outcome or survival. Treatment in this situation is sometimes referred to as futile care. Again, it's important to trust your cancer care team and discuss all options with your loved ones during this difficult time as you decide whether to continue treatment.
Whether or not you continue treatment, there are things you can do to help maintain or improve your quality of life. It’s important that you feel as good as you can.
Be sure to ask about and get treatment for any symptoms you might have, such as nausea or pain. Palliative care can be used whether you are getting cancer treatment or not. And it can be used at any stage of your illness. Palliative care is used to help ease symptoms and side effects. You can learn more in Palliative Care.
If the decision to stop treatment is made, at some point, you might benefit from hospice care. At the end of life, hospice care focuses on your quality of life and helping you manage your symptoms. Hospice care treats the person rather than the disease; it focuses on the quality of your life rather than its length. While getting hospice care means the end of treatments such as chemo and radiation, it doesn’t mean you can’t have treatment for the problems caused by your cancer or other health conditions. In hospice the focus of your care is on living life as fully as possible and feeling as well as you can at this difficult time. You can learn more in Hospice Care.
Your hope for a life without cancer might not be as bright, but there is still hope for good times with family and friends – times that are filled with happiness and meaning. Pausing at this time in your cancer treatment gives you a chance to refocus on the most important things in your life. Now might be the time to do some things you’ve always wanted to do and to stop doing things you no longer want to do. Though the cancer might be beyond your control, there are still choices you can make.
You can learn more about the changes that occur when curative treatment stops working, and about planning ahead for yourself and your family, in Advance Directives and Nearing the End of Life.
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 journalists, editors, and translators with extensive experience in medical writing.
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Last Revised: May 13, 2019
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