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If you or a loved one has advanced cancer, many new questions and concerns arise. Perhaps you have been told that the disease is no longer responding to conventional treatment or there are no more treatment options available. This news can be difficult to accept.
One of the biggest challenges during this time is uncertainty about what’s ahead. It helps to understand advanced cancer, the options available, and ways to cope.
Cancer is generally classified as advanced when it has spread from the primary (original) site to other places in the body. When the cancer has spread only to nearby tissues or lymph nodes, it is called locally advanced cancer. When the cancer has spread to other parts of the body, it is called metastatic cancer.
Even when cancer spreads to a new location, it is still named after the area of the body where it started. For example, a person with breast cancer that has spread to the bones is said to have breast cancer with bone metastases. If a cancer has spread widely throughout the body before it is discovered and it is unknown exactly where it started, it is called cancer of unknown primary origin.
Metastasis is the spread of cancer cells from the original site to new areas of the body (often by way of the lymph system or bloodstream). Cancers in an advanced stage have often metastasized to many places throughout the body, are affecting vital organs, or can't be removed. The liver, lungs, lymph nodes, and bones are common areas of spread or metastasis.
When the same cancer resurfaces in the body after a period of time following treatment and remission (in which the cancer could not be detected), it is called a recurrence, or recurrent cancer. A recurrence is a regrowth of the original disease. Cancer cells can return to the same place where the cancer first originated, or they can migrate to other parts of the body.
Advanced cancer usually occurs after you have had cancer for some time, or if your current treatments are no longer preventing the progression of the cancer. While advanced cancer poses a more significant treatment challenge, it can mean something different today than it did even 10 years ago. Thus, having advanced cancer does not mean you are without options and hope.
Advanced cancer can sometimes be controlled with treatments that attempt to slow the growth or spread of cancer. Treatment depends on the type of cancer, where it started, the size and location of the metastasis, and other factors.
Typically, cancer that has spread requires systemic therapy. Systemic therapy refers to medications given by mouth or injected into the bloodstream to reach cancer cells throughout the body, such as chemotherapy or hormone therapy. Other treatments may include biological therapy, radiation therapy, surgery, or a combination of these.
Even if the cancer has stopped responding to treatment, many therapies can ease side effects and provide you with a much better quality of life, for a longer period of time. Palliative treatments, which can be the same treatments used to treat cancer, aim to relieve symptoms and side effects. For instance, radiation therapy may help lessen pain caused by a tumor; and medications can help prevent nausea and fatigue.
Advanced cancer is not the same for everyone. For some, the cancer is already advanced when they first learn about the disease. Others may develop advanced cancer after years of treatment. Even the same type of cancer can grow at different rates and respond differently to the same treatments. Therefore, a statistic can’t tell you what’s going to happen in your situation. Also, each person faced with advanced cancer will cope differently.
Facing advanced cancer may make you wonder about your future. You may be disappointed in your health care team, or blame yourself for past treatment decisions or lifestyle choices. You may worry about losing control of your life and becoming dependent on other people. These feelings are all normal.
When dealing with advanced cancer the following questions may surface:
Everyone handles advanced cancer differently. It is normal to feel sad at times, but you don’t have to feel down all the time. There is room for happiness even with advanced cancer. It is important to remember that you are still in control of your choices and actions. You may discover that this can be a time of personal growth, renewed relationships, and second chances.
NOTE: WITH ADVANCED CANCER, IT IS NORMAL TO EXPERIENCE STRONG EMOTIONS. HOWEVER, IT IS IMPORTANT TO KEEP YOUR HEALTH CARE TEAM INFORMED ABOUT HOW YOU ARE FEELING.
NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER PRIOR TO MAKING DECISIONS ABOUT YOUR CANCER TREATMENT AND CARE.
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