Understanding and Dealing with Terminal Cancer

Generally, terminal cancer shortens someone’s life expectancy. But someone’s actual life expectancy depends on several factors, including:

• the type of cancer they have
• their overall health
• whether they have any other health conditions

Doctors often rely on a mixture of clinical experience and intuition when determining someone’s life expectancy. But studies suggest that this estimate is usually incorrect and overly optimistic.

To help combat this, researchers and doctors have come up with several sets of guidelines to help oncologists and palliative care doctors give people a more realistic idea of their life expectancy. Examples of these guidelines include:

• Karnofsky performance scale. This scale helps doctors evaluate someone’s overall level of functioning, including their ability to do daily activities and care for themselves. The score is given as a percentage. The lower the score, the shorter the life expectancy.
• Palliative prognostic score. This uses someone’s score on the Karnofsky performance scale, white blood cell and lymphocyte counts, and other factors to produce a score between 0 and 17.5. The higher the score, the shorter the life expectancy.

While these estimates aren’t always accurate, they do serve an important purpose. They can help people and their doctors make decisions, establish goals, and work toward end-of-life plans.

Terminal cancer is incurable. This means no treatment will eliminate the cancer. But there are many treatments that can help make someone as comfortable as possible. This often involves minimizing the side effects of both the cancer and any medications being used.

Some doctors might still administer chemotherapy or radiation to prolong life expectancy, but this isn’t always a feasible option.

Personal choice

While doctors have some input in the treatment plan for someone with terminal cancer, it often comes down to personal preference.

Some with terminal cancer prefer to stop all treatments. This is often due to unwanted side effects. For example, some might find that the side effects of radiation or chemotherapy aren’t worth the potential increase in life expectancy.

Clinical trials

Others may choose to take part in experimental clinical trials.

The treatments used in these trials likely won’t cure terminal cancer, but they contribute to the medical community’s greater understanding of cancer treatment. They can potentially help future generations. This can be a powerful way for someone to ensure their final days have a lasting impact.

Alternative treatments

Alternative treatments can also be beneficial for those with terminal cancer. Acupuncture, massage therapy, and relaxation techniques can help alleviate pain and discomfort while also potentially decreasing stress.

Many doctors also recommend people with terminal cancer meet with a psychologist or psychiatrist to help deal with anxiety and depression. These conditions aren’t uncommon in people with terminal cancer.

Receiving a diagnosis of terminal cancer can be extremely overwhelming. This can make it hard to know what to do next. There’s no right or wrong way to proceed, but these steps may help if you’re unsure what to do next.

Acknowledge your emotions

If you receive the news that you or a loved one has terminal cancer, you’ll likely go through a range of emotions, often within a short period. This is totally normal.

For example, you might initially feel angry or sad, only to find yourself feeling a slight sense of relief, especially if the treatment process has been particularly difficult. Others might feel guilt over leaving loved ones behind. Some may feel completely numb.

Try to give yourself time to feel what you need to feel. Remember there’s no correct way to react to a diagnosis of terminal cancer.

In addition, don’t be afraid to reach out for support from friends and family. If you don’t feel comfortable doing this, talk to your doctor. They can refer you to local resources and services that can help.

Receiving a diagnosis of terminal cancer can lead to an overwhelming sense of uncertainty. Again, this is completely normal. Consider tackling this uncertainty by jotting down a list of questions, both for your doctor and yourself. This will also help you better communicate with those close to you.

Questions to ask your doctor

After receiving a terminal cancer diagnosis, your doctor might be the last person you want to talk to. But these questions can help start a dialogue about the next steps:

• What can I expect in the coming days, weeks, months, or years? This can help give you an idea of what’s to come down the road, allowing you to better prepare yourself to face these new challenges.
• What’s my life expectancy? This may sound like a daunting question, but having a timeline can help you make choices you can control, whether that’s taking a trip, catching up with friends and family, or attempting life-prolonging treatments.
• Are there any tests that can give a better idea of my life expectancy? Once a terminal cancer diagnosis is made, some doctors may want to conduct additional tests to get a better idea of the extent of the cancer. This will help you and your doctor have a better understanding of life expectancy. It can also help your doctor prepare you for proper palliative care.

Questions to ask yourself

How someone proceeds after receiving a terminal cancer diagnosis involves a good deal of personal preference. These decisions may be incredibly difficult, but going over these questions with yourself may help:

• Are treatments worth it? Some treatments may prolong your life expectancy, but they may also make you ill or uncomfortable. Palliative care may be an option you’d like to consider instead. It’s designed to make you comfortable in your final days.
• Do I need an advanced directive? This is a document that’s designed to help you fulfill your wishes if you eventually aren’t able to make decisions for yourself. It can cover everything from which life-saving measures are allowed to where you’d like to be buried.
• What do I want to do? Some people with terminal cancer decide to carry on their daily activities as if nothing has changed. Others choose to travel and see the world while they still can. Your choice should reflect what you want to experience in your final days and who you want to spend them with.

Talking to others

What you decide to share about your diagnosis is completely up to you. Here are some discussion points to consider:

• Your diagnosis. Once you’ve had time to process the news and decide on a course of action, you can decide to share with your friends and family — or to keep it mostly private.
• What’s important to you. In these remaining months and days, you can decide what your daily life looks like. Pick the places, people, and things that are most important to you in this time. Ask your family to support your plans to spend your days the way you wish.
• Your final wishes. While an advanced directive will handle much of this for you, it’s always wise to share your wishes with friends and family to ensure things are carried out the way you want them to be.

Thanks to the internet, there are a lot of resources that can help you navigate the many aspects of a terminal cancer diagnosis. To start, consider finding a support group.

Doctors’ offices, religious organizations, and hospitals often organize support groups. These groups are designed to bring together individuals, family members, and caregivers coping with a cancer diagnosis. They can provide you, as well as your spouse, children, or other family members, with compassion, guidance, and acceptance.

The Association for Death Education and Counseling also offers a list of resources for many scenarios involving death and grief, from creating an advanced directive to navigating holidays and special occasions.

CancerCare also offers a variety of resources for dealing with terminal and advanced cancer, including educational workshops, financial assistance, and expert answers to user-submitted questions.

You can also check out our reading list for coping with cancer.