Deciding Against Cancer Treatment

• A cancer diagnosis often brings with it a lot of decisions, especially about treatment. And sometimes those decisions can be difficult to make or understand.

  That’s especially true if you or a loved one is thinking about forgoing treatment altogether or stopping treatment because it’s no longer working.

  Patients have many different reasons for why they might decide to skip or end cancer treatment. But often, “it’s about how much longer they’re going to live, and how they want to spend their life,” said Paula H. Finestone, PhD, a clinical psychologist at Fox Chase Cancer Center. “An individual wants to have some control over what happens and what they do with the time they have.”

  Some people want to focus their time on things they enjoy rather than pursue treatment, especially if the therapy will cause serious side effects or has only a small chance of working. A person’s age and overall health can also play a role—cancer treatment tends to be tougher on older adults, particularly those already dealing with other chronic health conditions.  

  Making the best decision for you

  Any competent patient has the right to stop or forgo treatment. But before you decide that is what you want to do, talk with your healthcare team. They can help you weigh the risks and benefits of starting or continuing therapy, how likely the therapy is to be effective, how therapy would affect your quality of life, and how much time you’d likely have left without therapy.

  It’s also worth thinking about how your priorities would be affected. If you want to spend more time at home with your family, rather than be in the hospital, would skipping or stopping treatment help you achieve that goal? Keep in mind, too, that palliative care and hospice are always available to help manage symptoms so you don’t have to be uncomfortable. And you can still keep in touch with your oncologists to talk about concerns or questions as your cancer progresses or changes.

  Finally, remember—opting out of treatment isn’t giving up.

  “We’re all going to come to the end of our life,” Finestone said. “The difference between a person with a very serious cancer and everybody else is that the cancer patient has more information about what might bring them there.”

  When you disagree with a loved one’s decision

  Having a loved one refuse or end cancer treatment can be a hard decision to accept. It’s OK to ask your loved one how they came to their decision, and to make sure that they’ve explored all of their options. But even if you don’t like their choice, you ultimately have to respect it.

  Your loved one’s decision might make you feel frustrated, or sad, or even trigger anticipatory grief. All of those feelings are normal, but try to make the most of the time you have together.

  “There’s this conflict where your loved one is still here and you know you should enjoy being with them, but you know they’re not going to be here forever,” Finestone said. “And that can be very difficult and very sad. I would encourage family and friends to seek support from hospice and other bereavement services.”

  Learn more about the Bereavement Support Group offered at Fox Chase.