Many Americans pass away in facilities such as hospitals or nursing homes while receiving care contrary to their wishes. Older persons must plan ahead and communicate their end-of-life decisions to caretakers, doctors, and family members. For instance, if an older person wishes to die at home while receiving end-of-life care for pain and other symptoms and communicates this to health care providers and family members, the likelihood that they
would die in a hospital undergoing unnecessary treatments decreases.
If the individual is no longer capable of making health care decisions for themself, a caregiver or family member may have to make those decisions on their behalf. When choosing end-of-life care, caregivers must consider numerous considerations, including the older person’s decision to seek life-extending treatments, the amount of time the older person has left to live, and the chosen setting for care.
When it comes to advanced cancer that is no longer treatable (also known as terminal or end-stage cancer), individuals have varying goals for their care. These objectives may evolve. Certain individuals wish to participate in clinical trials. Others choose palliative care or hospice care, which assist reduce the disease’s symptoms and side effects.
When cancer is terminal, treatment decisions are highly personal, and it’s normal to want to do all possible. However, you should balance these emotions with the dangers and benefits of existing treatments, as well as your attitudes toward life and death. You should ask all pertinent questions. If you opt not to undergo additional active cancer treatment, you can continue to receive supportive care to ensure your comfort.
End-of-Life Care for Advanced Cancer Patient
When should cancer treatment be discontinued?
When you have cancer and have tried numerous treatments without results, it can be difficult to determine when to discontinue treatment. Occasionally, even with the finest care, cancer spreads. It may be difficult to accept, but the best course of action at that moment may be to discontinue cancer treatment. Rather than that, you may focus on obtaining care that will keep you comfortable and pain-free.
The following section discusses determining when it is appropriate to discontinue therapy and focus exclusively on end-of-life care. You can use this information to discuss your options with your doctor and determine the best course of action for you.
Cancer reacts best to treatment when it is administered for the first time.
When a tumor is treated for the first time, there is hope that it will eradicate the cancer cells and prevent their recurrence. However, if your tumor continues to grow despite treatment, there is a slim possibility that more treatment will assist.
This is especially true for tumors of the solid tumor type, such as breast, colon, and lung cancer, as well as sarcoma. Doctors have a good understanding of how these tumors grow and decrease over time and their response to treatment. They discovered that treatment following treatment is of little or no benefit.
When is it OK to consider discontinuing cancer treatment?
If you have received three different types of treatment and your cancer has grown or spread, more treatment is unlikely to improve your symptoms or raise your chance of living longer. Rather than that, additional therapy may have major negative effects that shorten your life and diminish the quality of your remaining time.
Despite this, nearly half of people with advanced cancer continue to receive chemotherapy—even when it has little likelihood of helping. They suffer when they should not.
How do you determine whether to discontinue treatment?
It might be difficult for both the patient and the doctor to discuss the possibility of ceasing cancer therapy and focusing on end-of-life care. You may need to initiate the conversation. Your doctor should provide you with straightforward responses to any queries you may have.
You must first determine the stage of your cancer. Inquire about the stage of your cancer and the extent to which it has spread. Inquire about your prognosis or how much time you have left. Nobody knows for certain, but your doctor should be able to give you an estimate in months or years. Additionally, you need to know whether additional cancer treatment can help you survive longer. Inquire about the risks and benefits of any treatment from your doctor. Combating cancer may no longer be the best course of action for you.
Occasionally, if no other treatments are known, and you wish to continue trying, you can enroll in a clinical trial. Clinical trials enable the development of novel, experimental treatments. Consult your physician to determine your eligibility for a clinical trial.
You can seek assistance at any point during your treatment to alleviate your symptoms and improve your quality of life. This is referred to as palliative care. If you opt against more cancer treatment, it’s time to focus on a type of palliative care known as hospice care.
Hospice care significantly enhances your quality of life
Hospice care refers to care provided near the end of life. Hospice is end-of-life care for your physical, mental, and spiritual needs. It does not cure cancer, but it does assist keep you pain-free and free of other symptoms. Additionally, it assists you and your family make the most of the time you have remaining together.
Hospice care can be provided in the patient’s home, a hospice center, or a hospital. Among the services offered are the following:
- Physician and nursing care
- Management of pain
- Medical devices and medications to alleviate symptoms
- Counseling for family and friends who are grieving
- Services of a social worker
Respite care, to provide a break for your caregivers
When is the appropriate time to begin hospice care?
You may reach a point where no additional cancer treatments are effective for you. According to the American Society of Clinical Oncology, now is the time to seek hospice care (ASCO). You may have arrived at that stage if:
- Your doctor believes you will not survive more than six months.
- There are no other medicines that offer greater benefits than risks.
- You want to maximize your quality of life for the time you have remaining.