After you’ve been diagnosed with breast cancer, your oncologist may recommend many different treatments. Chemotherapy is among the treatment options available. For some, chemotherapy treatments may not kill the cancer cells, or the cells may return after a remission.

When cancer reaches this stage, it’s usually called advanced or terminal. Deciding what to do if this happens can be incredibly tough.

Your oncologist might suggest new treatments, such as trying different combinations of chemotherapy drugs that include experimental options. Still, you and your oncologist must consider whether more treatment will improve your health, or whether it’s best to stop treatment altogether and pursue palliative care.

Many people who face this point in their treatment have to consider if continuing chemotherapy for as long as possible will change their chances of survival.

While your oncologist may be able to tell you the odds or chances of a new therapy working, this is always just an estimate. No one can tell for sure how it will affect you.

It’s normal to feel obligated to try every possible treatment. But when the treatment isn’t working, the toll on your physical and emotional health can be exhausting for both you and your loved ones.

Cancer treatment is at its most effective the first time that it’s used.

If you’ve undergone three or more chemotherapy treatments for your cancer and the tumors continue to grow or spread, it may be time for you to consider stopping chemotherapy. Even if you decide to stop chemotherapy, you may still want to explore other treatment options, including experimental ones such as immunotherapy.

Review the recommendations of the American Society of Clinical Oncologists (ASCO) and Choosing Wisely as you grapple with this decision.

Choosing Wisely is an initiative created by the American Board of Internal Medicine (ABIM) Foundation. Its aim is to foster a conversation between healthcare providers and the public about “unnecessary medical tests and treatments.”

To help you make your decision on when to stop chemotherapy, ask your oncologist these questions:

  • Will continuing treatment make a significant difference in my cancer growth?
  • What other experimental options are out there for me to try?
  • Does it matter if I stop chemotherapy now or several months from now?
  • If I stop treatment, will my side effects, such as pain and nausea, go away?
  • Will stopping chemotherapy mean I stop seeing you and your team altogether?

Being open and honest with your oncology team is very important during this time. Be sure your treatment team knows your wishes. Also, be clear on what you need in the coming weeks and months.

Discuss any physical symptoms that you’re having as well as any emotions that are troubling you. Your oncologist might suggest you speak with a social worker or attend a support group with other people who are facing similar decisions. Remember, you are not alone in this.

The Advanced Breast Cancer Community and the Metastatic Breast Cancer Network (MBCN) are just two of the resources you may find helpful.

Accepting that you may have reached the limit in your care can cause more anger, sadness, and feelings of loss. Use this time to discuss your wishes with your family and friends. Think about how you want to spend time with them.

Some people decide that finishing lifelong goals or taking an overdue vacation is a better way to spend time than coping with more chemotherapy treatments.

If you decide to stop chemotherapy, be sure you’re still getting relief from symptoms such as pain, constipation, and nausea. This is called palliative care, and it’s meant to improve your quality of life.

Medications and other treatments, such as radiation, are part of palliative care.

You and your caregivers should talk with your oncologist about your needs in the upcoming months. You may decide to have a nurse come to your home for weekly care visits.

Stopping treatment isn’t easy. And talking about it with your healthcare team and your loved ones can be difficult.

However, there’s no right or wrong decision. The best choice is whichever one you feel comfortable with, whether that’s continuing chemotherapy, exploring experimental treatments, or stopping treatment altogether.

This conversation can put you at ease and relieve your loved ones of trying to guess your intentions. Ask your oncology social worker for help in making your plans.