You may need to start the conversation.
Some doctors don't ask patients about end-of-life issues. If you want to make choices about these issues, talk with your doctors so that your wishes can be carried out. Open communication can help you and your doctors make decisions together and create a plan of care that meets your goals and wishes. If your doctor is not comfortable talking about end-of-life plans, you can talk to other specialists for help. (See the PDQ summary on Communication in Cancer Care.)
Prognosis, treatment goals, and making decisions are some of the end-of-life issues to discuss with your doctor.
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Understand your prognosis
Having a good understanding of your prognosis is important when making decisions about your care and treatment during advanced cancer. You will probably want to know how long you have to live. That's a hard question for doctors to answer. It can be different for each person and depends on the type of cancer, where it has spread, and whether you have other illnesses. Treatments can work differently for each person. Your doctor can talk about the treatment options with you and your family and explain the effects they may have on your cancer and your quality of life. Knowing the benefits and risks of available treatments can help you decide on your goals of care for the last stages of the cancer. |
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Decide on your care goals
Your care goals for advanced cancer depend in part on whether quality of life or length of life is more important to you. Your goals of care may change as your condition changes or if new treatments become available. Tell your doctor what your goals of care are, even if you aren't asked. It's important that you and your doctor are working toward the same goals. |
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Take part in making decisions
Do you want to take part in making the decisions about your care? Or would you rather have your family and your doctors make those decisions? This is a personal choice and your family and doctors need to know what you want. |
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There are ways to improve communication with your doctors.
Tell your doctor how you and your family wish to receive information and the type of information you want. Also ask how you can get information at times when you can't meet face-to-face.
Remembering what your doctor said and even remembering what you want to ask can be hard to do. Some of the following may help communication and help you remember what was said:
- Have a family member go with you when you meet with your doctor.
- Make a list of the questions you want to ask the doctor during your visit.
- Get the information in writing.
- Record the discussion with tape recorders, smart phones, or on video.
- Ask if your doctor or clinic offers any of the following:
- A cancer consultation preparation package, which includes aids such as a question idea sheet, booklets on decision making and patient rights, and information about the clinic.
- A talk with a psychologist about advance planning and end-of-life issues.
- An end-of-life preference interview, which includes a list of questions that can help you explain your wishes about the end of life.