Recurring or advanced cancer

fruit or vegetable

For some people, cancer is a one-time illness, but for others, it's an illness that comes back and needs to be managed.

If you have recurring or advanced cancer, you may feel shocked, angry, sad, or scared, but you're still in charge of your life and have many choices. Some people find that having to manage their cancer gives them a chance to see their lives in a new way and start making the most of every day. Your doctor and care team will help you make the choices that are best for you.

Why does cancer come back?

Doctor examines a womanMost of the time, cancer comes back because some cells from your original cancer survived the treatment. It's not that your treatment was wrong, or you did something wrong, just that the cancer may not have responded to treatment or was too small to find with tests.

When cancer comes back, it doesn't always come back in the same place as the original one. If you had bone cancer, the cancer could come back in your stomach or somewhere else.

Treatment options

The options for treating recurring and advanced cancer depend on the type of cancer, where it's located, the treatment you've already had, and what your treatment goals are. You and your care team should talk about:

  • what your treatment options are now
  • whether further treatment is available
  • how successful you can expect the treatment to be
  • clinical trials you might be eligible for
  • what to expect if the treatment doesn't work

Bald womanDepending on your situation, your treatment goal may be to remove a new tumor or to improve your quality of life, even if the cancer can't be stopped.

Your care team may suggest palliative radiation, chemotherapy, or surgery to help relieve pain, remove or shrink tumors, slow the cancer's spread, or to extend your life while maintaining your quality of life. Many people choose more than one option for managing cancer. Try to base your decisions the pros and cons of the recommended treatments and how successful they're likely to be. Discuss your wishes with your care team and your family.

Coping with new challenges

It may be hard to accept a new cancer diagnosis or news that your cancer has spread, so you may have good days and bad ones as your treatment makes demands on your body and mind.

Men talkingReach out for help, either to a support group or a mental health professional.

If you had cancer before, try to remember what you did to cope — what you want to do differently — to renew your strength.

Find ways to enjoy yourself. Set little, flexible goals that help take your mind off things. Consider trying relaxation techniques and complementary care to help you feel better.

Deciding to continue treatment

At some point, you may need to make a decision to continue trying to cure the cancer or to focus only on comfort and quality of life. Even if you decide to stop cancer treatment, there's a lot that can be done to treat your symptoms.

Palliative care

Palliative care includes treatments and services to make you more comfortable, to treat or prevent side effects, or to help you with emotional and spiritual issues. It's given throughout your treatment to improve quality of life and care for the whole you.

Advance directives

In advance care planning, you choose a health care agent to manage your care if you're not able to speak for yourself and the type of care you prefer to receive, so that you get care that reflects your values at all stages of your treatment.

It's important to record your wishes in an advance directive, a form that spells out what you want—and don't want. Make sure you give copies of your advance directives to family members and your health care team. Some family members find it comforting to know your wishes, so they can support you.

End-of-life care

If you're faced with limited life expectancy, consider hospice care.

Holding handsHospice care allows you to stay in your home or in another personal, comfortable setting, such as a relative's home or Board and Care facility, during the last months of life. Specially trained doctors, nurses, spiritual leaders, social workers, and volunteers help you live comfortably and reduce your symptoms.

Admission to the Hospice Program requires written certification from the attending physician and a medical director of hospice.

If you're a caregiver, hospice can help you and your family with bereavement counseling and other services. 

Reviewed by: Michael Russin, MD, February 2016
Additional Kaiser Permanente reviewers

© 2016 Kaiser Permanente

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