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Treatment even if my cancer does not go away

​Sometimes, cancer may not go away despite the best of treatments. This is usually the case when the cancer has spread to other parts of the body, away from where it originally started. Although long-term cure is unlikely, treatments can still be useful, focusing on controlling the cancer, reducing symptoms from the cancer and / or extension of life. Like all decisions, there are always pros and cons and they depend on your personal circumstances and preferences. It is important to discuss you’re your treating team on the benefits and risks of treatment to make the best decision for yourself.

Finding Hope

Despite the disappointment in knowing that the cancer is unlikely to be cured, it is still important to find hope in your condition improving. This can be lessening of cancer symptoms, controlling the cancer and extending life. The importance of these goals can vary throughout your cancer journey. Reducing symptoms from cancer is important throughout your cancer journey, allowing you to have a better quality of life. A good example would be reducing pain with pain medications. You can expect to feel better and more motivated to achieve what is important to you when your pain is well controlled. On the other hand, controlling the disease and extending life allows you to spend more time with your loved ones and achieve your life goals. Although there will be ups and downs in your cancer journey, it is important to be open about your hopes, and to continue to do so especially when your situation changes.


Coping with uncertainty

It is common for people to feel uncertain about their future after being diagnosed with cancer. This can revolve around having to put life plans on hold, whether the treatment will work, how you might cope with the treatment, or even death. With uncertainty, you may feel anxious, sad and a sense of loss of control. This is normal and you are not alone. Coping with uncertainty starts with acknowledging that there are things that you can and things that you cannot control. Although difficult, it may help to let go of the ones that you cannot control and focus your energy on ones that are within your control. You may also realize by now that living with cancer is not about “getting back to normal” but establishing a “new normal” for yourself and your loved ones. The following are some questions that may help you refocus your thoughts when you are dealing with uncertainty:

  • What is important or meaningful to me now?
  • What do I enjoy doing?
  • What do I have that I can be thankful for?
  • What are the things I can change and those that are beyond my control?
  • What are my fears and their meaning to me?
  • How should I deal with my fears? Who can I share my worries or uncertainties with?
  • How does support look like to me?
  • What gives me inner peace?
  • What are the services and support available to help me and my family?

Sharing your uncertainties and feelings with your loved ones and healthcare team may also help you to cope better. Your healthcare team may also connect you with a counsellor or support group to better support you. Remember to be kind to yourself. Despite the changes and uncertainties, allow yourself to find some happiness in life. Treat yourself with the same amount of respect, appreciation, and love that you would towards others.


Coping with your emotions

When cancer progression or recurrence occurs, you may find yourself in a myriad of feelings. You may feel sad, angry or defeated when you discover that despite trying your best in undergoing treatments, the cancer did not go away. Many people grieve over their inability to do what they could before the illness, and also the loss of what they thought would be their future. It is normal to feel this way, but it is also important to not let this stop you from living life to the fullest. Whatever it is that you are feeling, it is helpful to share it with your loved ones and healthcare team. Being open with your feelings may help you to emotionally cope better.


Making Treatment Decisions

Discussions about treatment, whether it is starting a new one, continuing or stopping, is usually done over time with your doctor. Your choices are unique and dependent on your preferences, values and goals. There is no right or wrong decision. It is helpful to be open about your thoughts with your healthcare team and loved ones so they can support you in making the best decision for yourself. Below are some questions you may consider asking your doctor to help you come to decisions about treatment:

  • Is this treatment still benefitting me?
    - If so, how long can my treatment go on?
    - Does the side effect outweigh the potential benefit of treatment?
    - If not, are there any other treatment options?
  • What can I expect if I choose not to continue with treatment?
  • What is the best I can reasonably hope for?
  • What is the worst that I am likely to face?
  • What are the common complications faced by others in the same situation?

Supportive and Palliative Care

Supportive and palliative care focuses on the management of problems related to your cancer and its treatment. Your doctor may have already referred you to a supportive and palliative care team before or during treatment; or you may be newly introduced to this team. This does not mean that your doctor has abandoned or given up on you. In contrast, the supportive and palliative care team provides you with an additional layer of specialized support, care and attention.

Supportive and palliative care is a holistic approach to care which caters to a person’s physical, emotional, social and spiritual needs, and provides practical support to patients as well as their families and caregivers. This care is not exclusive to those who have advanced cancer or are at the end of life. It is about focusing on the person’s wellness and quality of life from the point of diagnosis to after treatment completion or the end of life. Read more about supportive and palliative care here.

When to call your cancer care team

If you find that it is difficult for you to make treatment decisions after your cancer has progressed or recurred, or if negative feelings are getting in the way of your daily life, ask your doctor for a referral to the Supportive and Palliative care team, or speak to a counsellor or social worker. If you are a patient with NCCS, you may call +65 6436 8417 or +65 64368088 to book an appointment to speak to an NCCS medical social worker or clinical psychologist. Always remember that you do not need to journey this alone; professional help is readily available for you.

Useful Resources:

  1. American Cancer Society: Managing Cancer as a Chronic Illness 

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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.   

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