Facing an advanced cancer diagnosis is difficult for patients and families. Everyone has different information requirements and their own ways of coping.

Discussing End-of-Life Choices

National Comprehensive Cancer Network guidelines recommend that physicians discuss hospice and end-of-life choices for patients who have a prognosis of one year or less, although physicians vary in their comfort level and willingness to discuss these sensitive topics. However, putting end-of-life plans in place can lower stress on patients and families and gives patients a sense of control over how—and where—they spend their remaining time and what type of care they prefer.

When discussing your diagnosis, ask your healthcare team what you can expect in the future and be clear about how much information you want.

Understand Treatment Limitations

A study found that a majority of patients with advanced lung or colorectal cancer mistakenly believe chemotherapy might cure their disease. In an editorial challenging the study results, the author said the problem with the study might be the word "cure." To patients with advanced disease, he says, cure may not mean eradication of all disease, but may mean an end to pain or a hope for a better tomorrow with fewer incapacities.

In another opinion piece, H. Jack West, MD, wrote, "Someone who is agreeing to start a potentially challenging regimen of two or three agents for advanced lung cancer should know the limitations of what treatment can offer and specifically that we aren't giving it with an intent or realistic expectation that it will be curative treatment."

It's important that the patient or family member understands what treatments can and cannot do. The National Cancer Institute (NCI) offers a few questions that you can ask your physician:

  • What is the best we can hope for by trying this treatment and what are the possible side effects and downsides?
  • Will this treatment help to manage side effects, slow the cancer's growth, or both?
  • Are the possible rewards from treatment more substantial than the possible drawbacks?

The NCI says your desire to avoid future regrets should be measured against the positives and negatives of treatment. Only you can decide what is best for you.

Hospice Care

When patients have an estimated six months or less to live, and are no longer benefiting from treatment, they are eligible for hospice care. The focus here is on quality—not length—of life. According to the NCI, hospice care does not mean giving up hope, but changing what you hope for.

Patients who choose to enter hospice care earlier gain significant benefits and improved quality of life for the remainder of their lives.

LeslieBeth Wish, EdD, reviewed this article.



National Cancer Institute. "Coping With Advanced Cancer." Web. 5 January 2012.

Mulcahy, Nick. "Most Terminal Cancer Patients Believe Chemo is Curative." Medscape Medical News. Web. 23 October 2012.

Chustecka, Zosia. "Parents Consider 'Hastening Death' in Children With Terminal Cancer." Medscape Medical News. Web. 10 March 2010.

West, H. Jack, MD. "Is There an Optimal Time To Discuss Prognosis and Hospice With Terminal Cancer Patients?" Medscape Medical News. Web. 21 January 2010.