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This is especially true for solid-tumor cancers, like breast, colon, and lung cancer, and sarcoma. Doctors know a lot about how these cancers grow or shrink over time and how they respond to treatment. They have found that treatment after treatment offers little or no benefit. If you have had three different treatments and your cancer has grown or spread, more treatment usually will not help you feel better or increase your chance of living longer.

Instead, more treatment could cause serious side effects that shorten your life and reduce the quality of the time you have left.

Still, almost half of people with advanced cancer keep getting chemotherapy—even when it has almost no chance of helping them. They end up suffering when they should not have to.

For Professionals

It can be hard for both the patient and the doctor to talk about stopping treatment for the cancer and focus on end-of-life care. You may need to start the discussion. Your doctor should give you clear answers to any questions you ask.

Breast Cancer Treatment Plan

You need to understand how advanced your cancer is. Ask your doctor about the stage of your cancer and how much it has spread.

You are here

Ask about your prognosis, or how long you have to live. No one can know exactly, but your doctor should be able to tell you a range of months or years. And you need to know if more treatment for cancer will help you live longer. Ask your doctor to explain the risks and benefits of any treatment. Fighting the cancer may no longer be the best thing for you. Sometimes, if there are no more known treatments and you want to continue trying, you can join a clinical trial. Clinical trials offer new, experimental treatments. Ask your doctor if you are eligible for a clinical trial.

When chemotherapy is given to people with stage 4 cancer the intent is usually palliative. Making the decision to stop active cancer treatment can be very painful emotionally. What are some things to consider as you make this heart-wrenching decision? You may need to gently remind your family members that you are aware that the decision you are making is not the one they would make—and that's okay.

If you are true to yourself, your loved ones will likely support you in time. Reviewing options and thinking about risks vs benefits see below may provide "evidence" that will not only make you more comfortable in your decision but also help your loved ones understand the thoughts behind your decision.

Making a Cancer Treatment Decision That Is Right For You

Far too often people with advanced cancer—and sometimes their family members—view discontinuing treatment as "giving up. People are praised for "fighting a courageous battle with cancer. Rather, it is an active choice to live your last days in the way you wish to live them. Deciding to stop active treatments for your cancer does not mean you will need to stop all treatments. In fact, switching the focus of treatment towards managing symptoms places a higher priority on making you as comfortable as possible.

Just as we have opinions regarding our favorite colors or sports teams, everyone will have a different opinion on when it is time to stop active treatments. If your loved one is uncomfortable, let her know that you respect her ideas. It may help to have her take a moment and try to step into your shoes.

Yet this can be difficult. We often change our opinions on what we would do in a situation when we are actually the one experiencing it.

Changing Course

Taking the time to review all possible options for care may help you feel more comfortable in making your decision about further treatment. Even if you feel strongly that stopping treatment is the right choice for you, understanding options may help you explain your choice to loved ones who differ in their opinion. You may start by asking your oncologist to list all possible options for your care, including those that may only be offered at another cancer center or in a different state. An often neglected, but critically important step is to weigh the benefits you may receive from treatment against the side effects.

It's important that you have your oncologist carefully spell out what she believes the benefits of treatment would be for you, both in terms of lengthening survival and in controlling your symptoms. These benefits can then be weighed against the possible side effects of the particular treatment. As noted earlier, the majority of people with stage 4 lung and colon cancer were unaware that chemotherapy wasn't at all likely to cure their cancer.

Choosing a treatment

Interestingly, the physicians that patients said were the best at communicating were also the one who had not explained as well that chemotherapy was not being given in an attempt to cure the disease. It may help to sit down with your loved ones and your healthcare team and write out a list of pros and cons. It can be helpful to look at your spiritual beliefs as you make this decision. In contrast, if you are struggling with what happens after the body dies it may be helpful to talk to your pastor, your priest, your rabbi, or other spiritual leaders.

Many people are afraid that stopping treatment is equivalent to giving up hope. Stopping treatment does not mean you are letting go of hope. Stopping treatment is not the same thing as hospice, but hospice care is underutilized in the last days and months of life.

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When discussing stopping treatment with your oncologist it is also a good time to have a discussion about advance directives , palliative care, and hospice care. You may be wondering what is ahead, and hesitate to ask. Since there are now many more treatment options for cancer than in the past, people living with cancer and their loved ones are often called upon to make the decision as to when to stop treatment.

Unfortunately, physicians are often hesitant to broach this subject as well.