Cancer is a disease of the cells, which are the body’s basic building blocks. It occurs when abnormal cells divide and multiply in an uncontrolled way. Advanced cancer means the cancer has spread from the original (primary) site or has come back (recurred).
Health professionals use several different terms to describe cancer that has moved beyond early stages, including secondary, metastatic, stage 4 and advanced. Sometimes health professionals don’t use a particular name. Regardless of the words used, it’s frightening to hear that the cancer has spread or come back.
The cancer that first develops in an organ or tissue is known as the primary cancer. It is considered locally advanced if the tumour is very large or the cancer has spread to nearby tissues.
If cancer cells from the primary site break away and travel through the bloodstream or lymph vessels to other parts of the body, they can grow and form another tumour at a new site. This is called a secondary cancer or metastasis.
Palliative treatment and care
Advanced cancer usually can’t be cured, but it can often be controlled. This is known as palliative treatment, and it can shrink, stop or slow the spread of advanced cancer, or relieve side effects, sometimes for several years. In this case, the cancer may be considered a chronic (long-term) disease.
Palliative care is an approach that helps people with advanced cancer to live as fully and comfortably as possible. It’s sometimes called supportive care.
While some people delay or feel anxious about having palliative care because they believe it’s only offered to people close to death, this type of care can improve quality of life from the time of diagnosis. Palliative care also offers support to families and carers.
After a diagnosis of advanced cancer, some people want to find out how long they have left to live, while others don't.
As everyone is different, a doctor can give you an estimate based on what usually happens to people in your situation, but can’t say exactly what will happen to you. The actual time could be longer or shorter.
Not all people with advanced cancer die from it – for some people, improved treatments can keep the disease under control for months or years. Other people find that different health issues become more serious than the cancer.
Asking your doctor questions will help you make an informed choice about your treatment and care. You may want to include some of the questions below in your own list. Palliative Care Australia also has recommended questions to ask your treating team.
- What type of cancer do I have?
- How far has the cancer spread? How fast is it growing?
- What is my prognosis? How long am I likely to live?
- What treatment do you recommend and why?
- Are there other treatment choices for me? If not, why not?
- Are there any clinical trials I can join?
- Are there any complementary therapies that might help?
- What treatment do you suggest for any pain or discomfort?
- What are the risks and possible side effects of each treatment?
- What will happen if I don’t have treatment?
- Can I have palliative care?
- Can I call the palliative care team at any time?
- Does the palliative care team inform my GP and other specialists about my care?
- Do I have to pay for any palliative care services?
- Can you help me talk to my family about what is happening?
Facing the end of your life
Some people find the uncertainty of having advanced cancer the most challenging aspect. When faced with the possibility of dying, people often think about what they’d like to achieve in the time they have left. They may begin to live day by day, or take control of their life by completing practical tasks, such as preparing a will or planning the funeral.
Listen to the podcast, The Thing About Advanced Cancer , or call our trusted cancer nurses on 13 11 20 for support.
Living with Advanced Cancer
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Expert content reviewers:
Prof Nicholas Glasgow, Head, Calvary Palliative and End of Life Care Research Institute, ACT; Kathryn Bennett, Nurse Practitioner, Eastern Palliative Care Association Inc., VIC; Dr Maria Ftanou, Head, Clinical Psychology, Peter MacCallum Cancer Centre, and Research Fellow, Melbourne School of Population and Global Health, The University of Melbourne, VIC; Erin Ireland, Legal Counsel, Cancer Council NSW; Nikki Johnston, Palliative Care Nurse Practitioner, Clare Holland House, Calvary Public Hospital Bruce, ACT; Judy Margolis, Consumer; Linda Nolte, Program Director, Advance Care Planning Australia; Kate ReedCox, Nurse Practitioner, National Clinical Advisor, Palliative Care Australia; Helena Rodi, Project Manager, Advance Care Planning Australia; Kaitlyn Thorne, Coordinator Cancer Support, 13 11 20, Cancer Council Queensland.
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The information on this webpage was adapted from Living with Advanced Cancer - A guide for people with cancer, their families and friends (2019 edition). This webpage was last updated in September 2021.