What is advanced cancer?

Some people’s cancer may be advanced when they are first diagnosed. For others, the cancer may have spread or come back (recur) after treatment. 

Advanced cancer usually can’t be cured, but it can often be controlled. This is known as palliative treatment. Sometimes treatment can shrink the  cancer, stop or slow the spread of advanced cancer, or relieve side effects. This can help maintain quality of life for several years. In this case, the cancer may be considered a chronic (long-term) disease. Some people join clinical trials to try new treatments.

Treatment will depend on where the cancer started, how far and where it has spread, and your general health, treatment goals and preferences for care.

Common treatments include chemotherapy, radiation therapy, surgery, targeted therapy, hormone therapy, and immunotherapy. These may be used alone or in combination. These treatments are often used as part of palliative treatment. Sometimes treatment is also available through clinical trials.

Treatments can be used for different reasons, so talk to your health care team about the aim of each treatment.

Cancer and its treatment affect many aspects of a person’s life. Depending on how you feel, you may be able to continue your usual routines, such as work, for some time. Or you may need to take time off or stop work altogether.

Emotional changes – You may experience emotional changes from the cancer and its treatment, for example, some hormone treatments affect people’s emotions. Changes to your work, finances and health may also result in mood changes.

Money concerns – Treatment or other services can be expensive, and costs can add up. This may mean you worry about taking time off from work or getting financial assistance.

 Side effects – The cancer or treatment may cause a range of side effects, such as pain, nausea, fatigue or breathlessness. These may affect what you can comfortably do and your sense of independence.

Practical issues – There can be practical issues you may have to think about to make life more comfortable, such as using medical equipment, modifying your home, or getting home help. If you need to travel a long distance from your home to the hospital, you may require transport or accommodation.

Palliative care is an approach that helps people with advanced cancer to live as fully and comfortably as possible. It’s sometimes called supportive care. The main goal is to help you maintain your quality of life by identifying and dealing with your physical, emotional, cultural, social or spiritual needs. It involves a range of services offered by doctors, nurses and allied health professionals, such as physiotherapists, dietitians and psychologists, as well as volunteers and carers.

While some people delay or feel anxious about having palliative care because they believe it’s only offered to people close to death, this type of care can improve quality of life from the time of diagnosis. It may be used occasionally or continuously for a few weeks or months. The number of people receiving palliative care for several years is increasing. It can help people who are referred early on in their diagnosis; there is no need to wait until the end of life. Palliative care also offers support to families and carers.

After a diagnosis of advanced cancer, some people want to find out how long they have left to live, while others prefer not to know. It’s a very personal decision.

If you would like to know the expected outcome (prognosis) of the cancer, you will need to talk to your doctor. This is a difficult question for your   doctor to answer and you may find their response is vague. As everyone is different, a doctor can give you an estimate based on what usually happens to people in your situation, but can’t say exactly what will happen to you. The actual time could be longer or shorter.

Not all people with advanced cancer die from it – for some people, improved treatments can keep the disease under control for months or years.  Other people find that different health issues become more serious than the cancer.

Some people find the uncertainty of having advanced cancer the most challenging aspect. When faced with the possibility of dying, people often think about what they’d like to achieve in the time they have left. They may begin to live day by day, or take control of their life by completing practical tasks, such as preparing a will or advance care directive, or planning the funeral.