Living with cancer
In many cases of cancer a stage is reached when a cure is no longer possible. You will then enter the phase of palliative care. This phase can last for varying periods of time from years to months; each patient's experience is different. During this period of palliative care you will receive palliative treatment to control your symptoms and in many cases therapy against the cancer, aimed at limiting its spread.
When the expectation is that you will live for less than one year, you will enter the period of end-of life care. During this period you will continue to receive palliative care and all treatment necessary to control pain as well as other troubling symptoms. During this time you will be in full control of your life and be able to make all decisions about your health and the treatments offered.
When an Advance Decision would apply
There are two different circumstances when patients with cancer lose the ability to make their own decisions about their health.
The first is due to an acute illness such as severe infection or respiratory failure. Recovery from this acute illness will depend on the patient's underlying state of health and general nutrition as well as the severity of the respiratory failure or infection and any additional complication.
The second is in the late stages of cancer when a small number of patients go into a coma. In this situation an Advance Statement of your preferences and wishes and an Advance Decision to refuse treatment are most useful.
Symptoms and feelings associated with end stage cancer
As your condition progresses and gets worse you may suffer from some, or all of the following symptoms:
- Pain, feeling drowsy (lethargy), loss of appetite, feeling sick (nausea) and a general feeling of being unwell. These are the most common symptoms.
- If you are in pain you will be treated with medicines for pain relief. These medicines may cause constipation.
- If higher doses of pain relief medicines are required as well as certain other drugs, this might affect your ability to think clearly or concentrate and you might get some clouding of the mind.
- Towards the very end of your life you might feel that 'you can't get comfortable', or that your body is 'a constant problem'.
The psychological feelings people have when they are getting close to the end of their life can be very different. Some people have a sense of 'it's time to give up'. Others become depressed - not clinically depressed but rather sad that the end of their life is approaching. These psychological changes might make the physical symptoms worse.