You have the right to say no to any treatment offered, but your medical team need to be confident that you understand the nature of the treatment proposed and the possible consequences of not having it. You can refuse each treatment separately – you do not have to accept treatment on an all-or-nothing basis.
A prognosis is the likely outcome of someone’s disease. Some people want to know whether and when they will die from cancer; others don’t wish to know. If you are referred to palliative care, it does usually mean that at some stage you may die from the cancer.
However, no-one can tell you exactly when you are going to die. Your doctors may be able to give a general indication of your life expectancy, based on an average patient, but everyone is unique and responds differently to different kinds of medical, practical, spiritual and emotional care.
Dealing with death is difficult and confronting for most people and their families, whatever their cultural background or religious beliefs. Talking over any fears, worries, guilt or other emotions you are experiencing may help you come to terms with your condition.
Consider sharing your thoughts with family and friends, or speak confidentially to a trained counsellor, social worker, psychologist or spiritual adviser. You can also call Cancer Council 13 11 20 and ask for the Emotions and Cancer and Facing End of Life booklets.
If your family and friends want more information about helping someone with a life-limiting illness and about grief and bereavement, they can visit Palliative Care Australia.
"When I asked my GP why doctors are so reluctant to suggest palliative care, he said some patients found it too difficult to deal with. Our feeling was that to know the truth about the diagnosis and what may lie ahead was essential." – Janine
People with advanced cancer usually experience major physical and psychological changes. These can have an enormous impact on how they feel sexually, but do not mean that intimacy needs to end.
We are all sexual beings, and intimacy can provide comfort and maintain connection. Even if sexual intercourse is no longer possible or desired, you may find physical closeness through cuddling, stroking or massage.
Many people receiving palliative care have said they would welcome the chance to discuss their sexual wellbeing with health professionals.
If you have concerns about sexual intimacy at any stage, talk to your GP or nurse. You can also call Cancer Council 13 11 20 or see our Sexuality and Intimacy section.
You may wonder whether there are any other therapies you could try. Complementary therapies, such as massage and relaxation, are used with conventional medical treatments and may decrease stress and anxiety. Alternative therapies, such as coffee enemas, are chosen by some people instead of conventional treatments and can be harmful. Let your doctor know about any therapies you want to use, as some may not be safe or evidence-based.
To find out more, call 13 11 20 for a free copy of Understanding Complementary Therapies.
It can be a good idea to think about your wishes for your future medical care, and to discuss these with your family, friends and health care team. This process is called advance care planning, and it can be started at any stage, whether you are healthy or ill.
You can write down your wishes in what is known as an advance care plan or advance care directive. Although this may not be legally binding, it does provide a record for doctors, family and carers to consider. Advance care planning doesn’t mean you have given up or will die soon – many people review their wishes from time to time.
You can appoint someone to make decisions for you if at some point in the future you’re not able to make them yourself. This can include decisions about your finances, property, medical care and lifestyle. A substitute decision-maker should be someone you trust and who understands your values and wishes for future care. Depending on where you live, the documents for appointing this person may be known as an enduring power of attorney, enduring power of guardianship, or appointment of an enduring guardian.
Each state or territory has different laws about advance care
planning and substitute decision-makers. For more information,
talk to a social worker, call Cancer Council 13 11 20, or visit Advance Care Planning Australia or Palliative Care Australia.
Reviewed by: Dr Michelle Gold, Director of Palliative Care, Alfred Health, VIC; Patricia Chaplin, Consumer; Dr Jan Maree Davis, Area Director, Palliative Care Service, Calvary Healthcare Sydney and St George Hospital, Kogarah, and Conjoint Lecturer, University of New South Wales, NSW; Denise Green, Consumer; Palliative Care Australia; Paula Ryan, Nurse Unit Manager, Cancer & Specialist Palliative Care Service, Rockhampton Hospital, QLD; Pippa Sangster, Telephone Support Group Facilitator, Cancer Council NSW, NSW; Robyn Tucker, Cancer Nurse, Cancer Information and Support Service, Cancer Council Victoria, VIC; Trilby Witton-Oates, Social Worker, Rockhampton Hospital, QLD.