First reactions

Will I die?

What do I do now?

Hope

You have been told, or you have come to realise, that you have advanced cancer: cancer that won't go away and is unlikely to be cured.

Most people say it is devastating to realise this, even worse than when their primary cancer was diagnosed. For people who didn't even know that they had primary cancer, a diagnosis of advanced cancer can be a double blow. Sometimes there is also relief: you may have suspected that something was wrong and now you know.

There are big decisions to make about treatment, what to tell family and friends and what to do at home and work. The news touches every aspect of your life. At first, it may be hard to accept that things will improve, but they can. In time, you are likely to find your usual resilience again. So don't rush into hasty decisions at this point.

Will I die?

Death is one of the first things people think of when they learn that their cancer is advanced.

‘It was like facing a firing squad.'

This is often mixed with other feelings, like dread at the thought of the journey ahead - perhaps pain, loss of control and loneliness.

These emotions can be overwhelming at first, but with time and some help, your feelings are likely to change. Some people begin to live ‘day to day'. Others find that preparing for death helps them to remain in control of their life.

‘There is still a life to be lived and pleasures to be found and disappointments to be had. Living with advanced cancer is a different life, not just a journey towards death.'

What do I do now?

Take some time and allow the news to sink in. For some people, treatment for the cancer can keep the disease in check for months or years, without curing it. Treatment can also help control symptoms such as pain. Treatment decisions are still very important, no matter at what stage your cancer is.

You will need to discuss your cancer and your outlook (prognosis) with your doctor - although no one will be able to tell you exactly what course your cancer will take.

Most people find they want information and support. You might find encouragement through talking with other patients or by joining a support group for people with cancer. See Services and Information.

Hope

There may be times when hope seems absent.

But everyone needs something to hope for. Sometimes, you may hope for recovery or survival. Other times, you may hope for good days with understanding company or the love of family and friends. You may find yourself hoping you will keep your dignity and be free of pain. Some people explore paths they've never tried before and find hope in this new dimension of their lives. Others find hope in small projects, such as planning a swim in the sea next summer. Some people find hope in their religious beliefs and some describe feelings of hope that are hard to explain to others.

‘It seemed to help me when I put my feelings on paper. The file was called "hope" at first. Now I call it "healing". What shall I call it next?'

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