Living with Advanced Cancer
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Living with Advanced Cancer
What is advanced cancer?
Cancer is a disease of the cells, which are the body’s basic building blocks. It occurs when abnormal cells divide and multiply in an uncontrolled way. There are many types of cancer and each type develops differently. Some grow slowly, some move rapidly, and others behave unpredictably. While some types of cancer respond well to treatment, other types are more difficult to treat.
The cancer that first develops in an organ or tissue is called the primary cancer. It is considered locally advanced if the tumour is very large or the cancer has spread to nearby tissues.
If cancer cells from the primary site break away and travel through the bloodstream or lymph vessels to other parts of the body, they can grow and form another tumour at a new site. This is called a secondary cancer or metastasis. A cancer may spread to any area including the lungs, brain, liver and bones. This metastasis keeps the name of the original cancer. For example, bowel cancer that has spread to the liver is still called metastatic bowel cancer, even though the main symptoms may be coming from the liver. A secondary cancer or metastasis is an advanced cancer.
Although medical treatments usually can’t cure advanced cancer, they may slow its growth or spread, sometimes for months or years. Palliative care can help manage cancer symptoms such as pain, and reduce side effects from cancer treatments. Other palliative care services can improve quality of life at any stage of advanced cancer.
Answers to some other key questions about advanced cancer are below.
What will advanced cancer mean for me?
Although advanced cancer usually can’t be cured, it can often be effectively controlled. It’s important to realise that incurable doesn’t mean untreatable – sometimes treatment can be very effective. Treatment may be able to shrink, stop or slow the spread of advanced cancer. In other cases, it can help to relieve symptoms.
Treatment can often keep the cancer under control and maintain quality of life, sometimes for several years. When this happens, the cancer is considered to be a chronic (long-term) disease.
What treatments are available?
Your treatment options will depend on where the cancer started, how far and where it has spread to, and whether it is hormone dependent or has certain genetic changes. Your doctor will also consider your symptoms and general health when recommending treatment.
Common treatments to control the cancer and relieve side effects include chemotherapy, radiation therapy, surgery, targeted therapy, hormone therapy and immunotherapy. These may be used alone or in combination.
Some people join clinical trials to try new treatments.
Treatments can be used for different reasons, so talk to your health care team about the aim of each treatment.
How will advanced cancer affect my day-to-day life?
Some people with advanced cancer can stay reasonably well and continue usual activities – working, playing sport and socialising – for a long time. Other people may need to focus on their health. It will depend on how you feel, and how cancer or treatment changes various aspects of your life.
Emotional changes – Being told you have cancer, or that it’s come back, can have a huge emotional impact. The actual cancer and any treatment you have can also change how you feel – for example, some hormone treatments directly affect people’s moods. It can be difficult to cope with the feeling of uncertainty and the stress of changes to your work, finances and relationships.
Side effects – The cancer, or its treatment, may cause a range of side effects, such as pain, nausea, fatigue or breathlessness. These can affect what you can comfortably do and your sense of independence.
Money concerns – You or a partner may need time off work, or you may have treatment or other costs that add up. This can lead to worry about money, or a need for financial assistance.
Practical issues – There may be ways to make life more comfortable, such as using medical equipment, modifying your home, or getting home help. If you travel a long way from home to the hospital, you may need assistance with transport or somewhere to stay. Call Cancer Council on 13 11 20 to find out about options open to you.
Do I need to think about palliative care?
Some people feel anxious about having palliative care, or avoid it altogether, because they think it’s only for people who are at the end of their life. But that’s not the case at all. In fact, studies show that starting palliative care early can help you to feel better for longer.
The goal is to help you maintain your quality of life at any stage of the illness. By offering a range of services and treatment, palliative care can help you live as fully and as comfortably as possible. It does this by looking after your physical, emotional, cultural, social and/or spiritual needs. For example, palliative care can include strategies to help you to manage pain, move around, eat well, and cope with your feelings.
Palliative care, which is sometimes called supportive care, might be something you choose to use now and then, or it may be ongoing. It’s now very common for people to use palliative care for several years.
There’s a range of health professionals involved in providing palliative care, from doctors and nurses to physiotherapists, dietitians and psychologists – even volunteers and carers.
Thinking about what is most important to you can guide palliative care services. For some people that may be help going travelling; for others it’s about spending more time with family. Where possible, help can be provided to focus on what is important to you.
Support for families and carers is also offered through palliative care services.
What can I expect in the future?
Not all people with cancer – even advanced cancer – will die from it. For some people, improved treatments can keep advanced cancer under control for months or years. Sometimes other health issues (such as heart disease) become more serious than the cancer.
When told they have advanced cancer, many people will want an idea of how long they may have left to live. Others may prefer not to know, or even talk about it. It’s a very personal decision. If you want to know the expected outcome (prognosis) of the cancer, talk to your doctor. It is a difficult question to answer because everyone is different. Your doctor can only give you an estimate based on what usually happens to people in your situation. The actual time that you have could be longer or shorter – it’s not possible to know for sure.
This not knowing, or feeling of uncertainty, can be one of the most challenging aspects of living with advanced cancer.
When faced with the thought of dying, people often think about what they want to do in the time they have left. They may begin to live day by day, plan a big trip or do practical tasks, such as preparing a will.
The prognosis is based on statistics, and it’s entirely possible that you will be on the good side of those statistics, and make it way beyond whatever your oncologist tells you.” JOHN
This information is reviewed by
This information was last reviewed December 2022 by the following expert content reviewers: Dr Lucy Gately, Medical Oncologist, Alfred Health and Walter and Eliza Institute for Medical Research, VIC; Dr Katherine Allsopp, Supportive and Palliative Care Specialist, Westmead Hospital, NSW; A/Prof Megan Best, The University of Notre Dame Australia and The University of Sydney, NSW; Dr Keiron Bradley, Palliative Care Consultant, Medical Director Palliative Care Program, Bethesda Health Care, WA; Craig Brewer, Consumer; Emeritus Professor Phyllis Butow, Psychologist, The University of Sydney and Chris O’Brien Lifehouse, NSW; Louise Durham, Palliative Care Nurse Practitioner Outpatients, Princess Alexandra Hospital, Metro South Palliative Care, QLD; Dr Roya Merie, Radiation Oncologist, ICON Cancer Centre, Concord, NSW; Penny Neller, Project Coordinator, National Palliative Care Projects, Australian Centre for Health Law Research, Queensland University of Technology, QLD; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Xanthe Sansome, Program Director, Advance Care Planning Australia, VIC; Sparke Helmore Lawyers; Peter Spolc, Consumer.