Advanced cancer treatment

What is advanced cancer?

Advanced cancer means your cancer has spread or returned (recur) after treatment and is unlikely to be cured. Sometimes people’s cancer may be advanced when they are first diagnosed.

Although advanced cancer usually can’t be cured it can be controlled. This is called palliative care and aims to help maintain quality of life. Treatment may shrink the cancer, slow or stop the spread of cancer or relieve side effects.

What treatments are available for advanced cancer?

Treatment will depend on where the cancer started, where and how far it has spread as well as your general health and personal preferences. Common treatments, which can be used alone or in combinations, for advanced cancer include:

• chemotherapy
• radiation therapy
• surgery
• hormone therapy
• targeted therapy
• immunotherapy
• palliative care
• end-of-life care

Treatment may also be available through clinical trials.

You should talk to your health care team about the aim of each treatment and which might be most suitable for you.

How do I make treatment decisions?

Being diagnosed with advanced cancer or finding out your cancer has recurred or spread, can be overwhelming and you may feel a range of emotions. Everyone’s response will be different so you should give yourself time to take in what is happening and do what is comfortable for you.

It can be difficult to decide whether or not to have treatment for advanced cancer. Some people may choose treatment even if it offers only a small benefit for a short period of time. Some people may decide to treat symptoms such as pain or discomfort rather than having active treatment for the cancer. You may want to spend as much time as possible with family and friends without the disruption of treatment or you may choose chemotherapy if it meant having two good weeks each month.

Here are some things you may like to consider:

Know your options – understanding the disease, available treatments and potential side effects can help you consider the options and make a decision you feel most comfortable with.

Record the details – finding out you have advanced cancer can be a shock and you may not remember everything you are told. It can help to take notes or to have a family member or friend with you at appointments.

Ask questions – if you want to check anything or feel confused, ask your specialist questions. You may want to prepare a list before your appointments.

Consider a second opinion – you can ask to get a second opinion from another specialist to clarify or confirm your doctor’s recommendations.

Talk about treatment decisions – discussing your options with your family and friends or with your doctor can help you make decisions about what care you want now or in the future. Palliative Care Australia has developed a discussion starter that may help you consider your preferences and how to talk about them with your family.

Do I have to have treatment?

While it may seem worthwhile dealing with treatment side effects for a primary cancer, when a cure is unlikely, you may not want to have treatments that leave you feeling exhausted or sick.

Before you start or stop treatment, think about the benefits and downsides. Ask yourself if you are feeling unwell from side effects of treatment, the advancing disease or from emotional overload? Some or all of these may be able to be treated.

Talking with others, especially your doctor and loved ones may help you to clarify your thoughts. You may also like to speak to professionals such as a social worker or counsellor, who can help you decide what is important to you.

Refusing medical treatment

Anyone has the right to accept or refuse any treatment offered. For your refusal to be accepted, you must understand the nature of the treatment being proposed and the consequences of not having it. You can also refuse each treatment separately.

In some states and territories you will need to complete a refusal of treatment certificate.

Where can I get more information and support?

Talking to your health care team is a good start. You can also visit Palliative Care Australia for information and resources or you can call Cancer Council 13 11 20.