Breast cancer treatment isn’t a walk in the park. It affects you mentally and physically. You might have side effects that make your day-to-day life a lot harder. Because of this and other factors, you may choose to stop treatment at some point. That can be a hard decision to make, even when it’s the right one for you.
“People feel like they’ve failed at something, or they’ve disappointed someone,” says Elizabeth Prsic, MD, director of adult palliative care at Yale Cancer Center-Smilow Cancer Hospital. “But you have to do what’s best for you. This isn’t a battle. It’s your life. No one signed up to be a warrior here.”
There are lots of things to think about if you stop your breast cancer treatment. But no matter what you choose to do, your medical team will still be there for you.
Talk to Your Cancer Care Team
Andrea Silber, MD, a breast oncologist at Yale Cancer Center-Smilow Cancer Hospital, takes a “shared decision-making” approach when it comes to cancer care. She goes over the good and bad of stopping treatment and covers all other choices. She leaves the final say up to the person with cancer. “It’s not my role to tell someone what to do,” Silber says. “It’s my role to help someone decide what’s best for them.”
Here are some points Silber considers:
- Is this advanced cancer?
- Is this cancer potentially curable?
- Are you young with aggressive cancer?
- What kind of treatment have you had before?
- Are you stopping because of side effects?
- Can we manage bad side effects better?
- Is there another illness that needs treatment?
The “why” is also important. Sometimes people want to try an unproven alternative therapy instead of conventional medicine. “It’s not my job to tell them their idea is false,” Silber says. “On the other hand, it is my job to give them the education and information that I have that is valid and evidence-based.”
Seek Palliative Care
This kind of supportive care aims to raise your quality of life for as long as possible. You can tap into it from the time of your diagnosis all the way through end-of-life care if you need it. And when you decide to stop treatment, “that just means increased support for symptoms or other elements that may be causing you distress,” Prsic says.
There are lots of different specialists on your palliative care team. This usually includes doctors, nurses, social workers, chaplains, pharmacists, and psychologists. Even people who do art therapy. “We try to focus on the care of the whole person and not just what’s going on with their tumor, tumor marker, or chemotherapy,” Prsic says.
Palliative care can help you:
- Ease pain or other symptoms
- Manage depression, anxiety, stress, or emotional issues
- Find help for financial or legal problems
- Find spiritual support
- Manage family communication
- Find a support group
- Learn diet and exercise tips
- Plan your goals for care
- Choose a health care proxy (someone who makes health care decisions for you when you can’t)
- Make decisions about hospice care
They’ll also help you with something called legacy work. That’s when you make a special gift for your loved ones to remember you by. It can be anything. You might want to gather your favorite recipes or put photos in a scrapbook. Some people write letters or make audio or video recordings. “Whatever is important to pass along,” Prsic says.
Other Ways to Maintain Your Quality of Life
Use telehealth. You should stay in touch with your doctor. But ask them if you can do that without leaving your house. Before the COVID-19 pandemic, Silber offered home visits. “Having taken care of them throughout their treatment, I want to make sure that when they’re off treatment, they have the most comfortable and meaningful life, however long it is,” Silber says.
Bring your family on board. Your loved ones might have a hard time with your decision to stop treatment. Or they may not know what’s helpful for you now, Silber says. It’s OK to ask your doctor or palliative care team to talk to them. Whether it’s about food or long-term care goals, “a little education can go a long way,” Silber says.
Get social support. Reach out to friends, family members, support groups, or anyone who’s important to you. Silber says. And don’t be afraid to reach out to loved ones you haven’t talked to in a long time. If you don’t know how to do that, Prsic says your palliative care team can help you get in touch.
Focus on What Matters
You can’t control cancer, but you can control how you spend the time you have left. Dig in your garden, make plans for special events, or do things you’ve always wanted to do. If symptoms get in the way, tell your doctor.
Your palliative care team can help you get creative if some plans seem out of reach. For example, Prsic found a way for a woman to hear the heartbeat of her unborn grandchild. “Even though she wasn’t going to be able to meet this child in 6 months, she was able to connect,” Prsic says. “And that was a really powerful thing.”
