Rejecting cancer treatment: What are the consequences? | Science-Based Medicine (2023)

Rejecting cancer treatment: What are the consequences? | Science-Based Medicine (1)

These do not cure cancer

One of the points I’ve tried to emphasize through my contributions to Science-Based Medicine is that every treatment decision requires an evaluation of risks and benefits. No treatment is without some sort of risk. And a decision to decline treatment has its own risks. One of the challenges that I confront regularly as a pharmacist is helping patients understand a medication’s expected long-term benefits against the risks and side effects of treatment. This dialogue is most challenging with symptomless conditions like high blood pressure, where patients face the prospect of immediate side effects against the potential for long-term benefit. One’s willingness to accept side effects is influenced, in part, by and understanding of, and belief in, the overall goals of therapy. Side effects from blood-pressure medications can be unpleasant. But weighed against the reduced risk of catastrophic events like strokes, drug therapy may be more acceptable. Willingness to accept these tradeoffs varies dramatically by disease, and are strongly influenced by patient-specific factors. In general, the more serious the illness, the greater the willingness to accept the risks of treatment.

As I’ve described before, consumers may have completely different risk perspectives when it comes to drug therapies and (so-called) complementary and alternative medicine (CAM). For some, there is a clear delineation between the two: drugs are artificial, harsh, and dangerous. Supplements, herbs and anything deemed “alternative”, however, are natural, safe, and effective. When we talk about drugs, we use scientific terms – discussing the probability of effectiveness or harm, and describing both. With CAM, no tentativeness or balance may be used. Specific treatment claims may not be backed up by any supporting evidence at all. On several occasions patients with serious medical conditions have told me that they are refusing all drug treatments, describing them as ineffective or too toxic. Many are attracted to the the simple promises of CAM, instead. Now I’m not arguing that drug treatment is always necessary for ever illness. For some conditions where lifestyle changes can obviate the need for drug treatments, declining treatment this may be a reasonable approach – it’s a kick in the pants to improve one’s lifestyle. Saying “no” may also be reasonable where the benefits from treatment are expected to be modest, yet the adverse effects from treatments are substantial. These scenarios are not uncommon in the palliative care setting. But in some circumstances, there’s a clear medical requirement for drug treatment – yet treatment is declined. This approach is particularly frustrating in situations where patients face very serious illnesses that are potentially curable. This week is the World Cancer Congress in Montreal and on Monday there were calls for patients to beware of fake cancer cures, ranging from laetrile, to coffee enemas, to juicing, and mistletoe. What are the consequences of using alternative treatments, instead of science-based care, for cancer? There are several studies and a recent publication that can help answer that question.

Who uses CAM instead of medicine?

Surveys suggest the vast majority of consumers with medical conditions use CAM in addition to, rather than as a substitute for medicine – that is, it is truly “complementary”. But there is a smaller population that uses CAM as a true “alternative” to medicine. A study by Nahin et al in 2010 looked at data from the 2002 National Healath Interview Survey (NHIS), which is described as a representative sample of Americans. It examined the group that did not use “conventional care” in the past 12 months – no health professionals, no emergency room visits, no surgery, and no nursing care of any kind. It asked about alternative medicine, which included acupuncture, ayurveda, biofeedback, chelation, chiropractic, energy healing/Reiki, hypnosis, massage, naturopathy, homeopathy, specialized diets, high-dose vitamins, yoga, tai chi, qui gong, and meditation. The survey found that 19.3% of adults did not access any “conventional” health care in the past 12 months. Of this group, over one third (38.4%) had some health need (of which 23.8% considered a serious condition). In the population that did not use conventional care, one-quarter (24.8%) used some form of alternative medicine. And 12% (approximately 4.6 million Americans) were estimated to be using alternative medicine, and not conventional medicine, to treat one or more health issues. Barriers to accessing health care were explored and users of alternative medicine had poorer health and had more barriers to care, with about 20% noting the decision to use alternative care was based on cost considerations of conventional care. There were several limitations worth noting: Most importantly, the types of conditions treated with “only CAM” were not collected. And as some users cited the costs of conventional care as a barrier, different insurance schemes might be expected to change utilization patterns. Finally, there is no assessment of outcomes. But this survey suggests that there is a small population that will preferentially treat a medical condition with CAM and not medicine.

So how would a decision to accept no treatment, or to only use alternative medicine, compare to “conventional” cancer care (chemotherapy, radiation, and surgery)? And what about delaying conventional cancer care to allow a trial of alternative medicine – does it have a measurable effect? Answering this question isn’t straightforward. In cancer research, new drugs are typically added to, or follow, established therapies, so all patients receive standard treatment options as part of their care. So we can’t ethically randomize patients to nothing, when established treatments exist. But we can answer this question in a different way: Patients that voluntarily opt out of cancer treatment can be followed, and compared to patients that do take cancer treatment. While it isn’t a prospective randomization, which would be the gold standard, it’s the best we can get. But even this approach is difficult. Most patients who decide to opt-out of cancer treatment, also opt-out of any follow-up evaluation. So tracking down patients, and their outcomes, is essential.

The effects of treatment refusals and delay, and the effectiveness of CAM as a substitute, has been evaluated in several groups of patients with breast cancer. Breast cancer is well studied, frequently diagnosed, and if detected early, potentially curable. Conventional treatment for early (localized) breast cancer is surgical resection of the tumor, followed by radiation and chemotherapy to reduce the risk of disease recurrence, by killing any residual cancer cells that remain. The overall effectiveness of conventional treatment is strongly influenced by the extent of the disease at diagnosis. When treated early in the disease course, the long-term outlook for for women with breast cancer can be excellent. However, once the cancer has spread to the lymph nodes, or metastasized to other part of the body, the outcomes are much worse. The treatment focus shifts from curative to palliative. (An old study of untreated breast cancer suggest the 5 year survival rates are 18% at 5 years and 3.6% at 10 years.) Given the potential for treatment cures, very few women elect to reject conventional treatment, or substitute CAM. But some do, which can inform us of the effectiveness of conventional care, as well as that of CAM. I found 5 studies which look at this question:

1. Patients’ Refusal of Surgery Strongly Impairs Breast Cancer Survival

This was a Swiss study byVerkooijen et al, published in 2005 in the Annals of Surgery that looked at 5339 patients under the age of 80 with non-metastatic breast cancer. It didn’t examine CAM, just the decision to refuse breast cancer surgery. It compared patients who refused breast cancer with those that those that accepted surgery. Only 1.3% of women (70) refused surgery. Of that group, 37 had no treatment, 25 had hormone-therapy only, and 8 had other types of treatments. So only a small percentage refused all treatment. In this study, the five-year survival of women that refused surgery was 72% versus 87% of women who had surgery. Adjusting for prognostic factors, the authors estimated that women that refused surgery had a 2.1-fold increased risk of death from breast cancer compared to conventional treatment. The survival curves make this clear:

The bottom line in this paper was that a decision to forgo surgery for breast cancer is associated with dramatically worse outcomes and survival.

2. Outcomes of breast cancer in patients who use alternative therapies as primary treatment

This was a medical chart review by Chang et al, published in the American Journal of Surgery in 2006. It examined breast cancer patients who refused conventional chemotherapy, or delay its initiation, in order to use CAM. The authors calculated each patient’s prognosis at the time of diagnosis. In total, 33 women were included. (Notably, patients who refused treatment and did not return for follow-up were excluded from the analysis, possibly biasing the results.) The results were grim:

  • Eleven patients initially refused surgery. Ten of these patients experienced progressive disease. Five ultimately had surgery. In the six others, the cancer had already metastasized, so surgery would have offered no benefit.
  • Three patients refused to allow sampling of lymph nodes to evaluate disease spread. One of these patients developed recurrent disease in the lymph nodes.
  • Ten patients refused local control (surgery/radiation) of the tumor site. Two patients developed recurrences in the same location, and two developed metastatic disease.
  • Nine patients refused chemotherapy, raising their estimated 10-year mortality from 17% to 25%

Consistent with the study above, the vast majority of breast cancer patients who refuse surgical intervention developed progressive disease. Even delaying surgery increased risks and overall mortality. Outcomes were better for patients that accepted surgery, but refused adjuvant treatments, like chemotherapy. However, even this strategy significantly raised 10-year mortality estimates.

3.Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes

This study from Han et al was published in the Annals of Surgical Oncology in 2011, and may include some of the patients in the Chang analysis. This was a retrospective chart review of breast cancer patients who refused or delayed conventional treatments. 61 patients were identified. On average patients had Stage 2 disease at diagnosis, which is highly treatable and potentially curable. In patients that omitted or delayed surgery (26 women) 96.2% had disease progression with 50% dying of the disease. At the time of diagnosis, the median tumor size was 2.0cm. Upon follow-up, the median-size was 7.8cm. (The authors include this photo of a tumor in a woman who elected to use diet and herbal treatments, rather than receive surgery.)

In patients that accepted surgery but rejected adjuvant therapy (chemotherapy/radiation), the initial 10-year relapse-free survival was estimated at 59.2%, which would have been 74.3% had the patients accepted these treatments. Actual outcomes were much worse than predicted. The actual observed relapse-free survival was only 13.8%. Some subsequently elected to take palliative chemotherapy and radiation to control their disease. From this study we can conclude that refusing or delaying conventional cancer care is associated with much worse outcomes.

4. Prognosis following the use of complementary and alternative medicine in women diagnosed with breast cancer

This analysis, by Saquib et al, was a secondary analysis of the Women’s Healthy Eating and Living (WHEL) study. It looked at 2562 breast cancer survivors and surveyed for rejection of systemic treatment (i.e., chemotherapy) and use of CAM following surgical resection. All women had to be aged 18-70 and had operable Stage I-IIIa breast cancer. In this group, 177 women were identified who declined systemic treatment. 80% of this group used CAM. Compared to women that took chemotherapy, women that declined systemic treatment had a 90% greater risk of an additional breast cancer event, and the risk of death increased by 70%. CAM use had no effect on this finding. In addition, the lack of effect was consistent between “high supplement users” (>3 per day) and low supplement users. The authors concluded that women that decline systemic treatment are at greater risk for subsequent recurrence and death due to breast cancer. The use of CAM had no measurable effect on the recurrence of breast cancer or on the risk of subsequent death.

5. Outcome analysis of breast cancer patients who declined evidence-based treatment

Here is the recent paper I referred to above, which studied women with breast cancer in Northern Alberta who refused standard treatments. It was also a chart review with a matched pair analysis (age, disease stage, calendar year) that compared survival with those that received conventional cancer care. Between 1980 and 2006 they identified 185 women (1.2%) that refused cancer care following diagnosis by biopsy. (Notably, cancer care is an insured service in Alberta, so there should have been no financial barriers in accessing treatment.) Women older than 75 were excluded from the analysis because this population is generally not included in clinical trials and active treatment regimens. In addition, women that accepted surgery, but rejected chemotherapy/radiation were excluded from the analysis. To qualify, women had to have rejected all conventional care. The final population studied was 87 women, most of whom presented with early (Stage I or II) disease. Most were married, over the age of 50, and urban residents. In this group, the primary treatment was CAM in 58%, and was unknown in the remainder. Some women in this group eventually accepted cancer care, and the average delay was 20-30 weeks due to CAM use.

The results were grim. The 5 year overall survival was 43% for women that declined cancer care, and 86% for women that received conventional cancer care. For cancer-specific survival (i.e., those that died of breast cancer) survival was 46% vs. 85% in those that took cancer care. The survival curves are ugly:

(a) All causes of deaths and (b) deaths due to breast cancer only

The authors compared the “CAM” group to those where treatment plan (if any) was not known:

(a) All causes of deaths and (b) deaths due to breast cancer only

Note that the difference is only statistically significant in (a) where all-causes of death were included and not (b), cancer-specific causes. So does that mean CAM helps? Probably not. The two groups are not well defined, and the “unknown” group could include CAM users – it is not a comparison of CAM versus no treatment. And as the types of CAM used was not documented, this is a heterogeneous group. The key point this comparison illustrates is that CAM users did dramatically worse than women that took conventional cancer care. Even delaying surgery to allow for CAM first significantly decreased the effectiveness of subsequent conventional care. The authors conclude, correctly, that there is no evidence to support using CAM as primary cancer treatment.

Effectiveness evaluations

The data show that avoiding or delaying conventional cancer care is associated with negative outcomes, and CAM used does not seem to modify this risk. But have any specific CAM interventions shown any benefit? Probably the most comprehensive single review is a systematic review by Gerber et al, published in Breast Cancer Research and Treatment in 2006, which looked at CAM effectiveness for early breast cancer. It concludes:

There is no compelling evidence that any of the numerous complementary treatments available is sufficiently effective in breast cancer patients to justify its use. It should be the responsibility of those who claim efficacy for CAM to support these claims with acceptable evidence, rather than the responsibility of those who criticize CAM to prove its non-efficacy.

Based on the current evidence, there is nothing to suggest that any specific CAM treatment has any meaningful clinical effects.

Conclusion: Alternative medicine isn’t real medicine

Despite widespread claims, there is no evidence to support the use of any CAM treatment as a replacement for conventional cancer care. As the studies in breast cancer show, delaying treatment or substituting CAM for conventional cancer care dramatically worsens outcomes.The results of these studies will hopefully provide patients and health providers with a better understanding of the risks and consequences of CAM for cancer. CAM is no alternative to science-based cancer care.


1. Verkooijen HM, Fioretta GM, Rapiti E, Bonnefoi H, Vlastos G, Kurtz J, Schaefer P, Sappino AP, Schubert H, & Bouchardy C (2005). Patients’ refusal of surgery strongly impairs breast cancer survival. Annals of surgery, 242 (2), 276-80 PMID: 16041219

2. Chang EY, Glissmeyer M, Tonnes S, Hudson T, & Johnson N (2006). Outcomes of breast cancer in patients who use alternative therapies as primary treatment. American journal of surgery, 192 (4), 471-3 PMID: 16978951

3. Han E, Johnson N, DelaMelena T, Glissmeyer M, & Steinbock K (2011). Alternative therapy used as primary treatment for breast cancer negatively impacts outcomes. Annals of surgical oncology, 18 (4), 912-6 PMID: 21225354

4. Saquib J, Parker BA, Natarajan L, Madlensky L, Saquib N, Patterson RE, Newman VA, & Pierce JP (2012). Prognosis following the use of complementary and alternative medicine in women diagnosed with breast cancer. Complementary therapies in medicine, 20 (5), 283-90 PMID: 22863642

5. Joseph K, Vrouwe S, Kamruzzaman A, Balbaid A, Fenton D, Berendt R, Yu E, & Tai P (2012). Outcome analysis of breast cancer patients who declined evidence-based treatment. World journal of surgical oncology, 10 (1) PMID: 22734852

  • Scott Gavura

    Scott Gavura, BScPhm, MBA, RPh is committed to improving the way medications are used, and examining the profession of pharmacy through the lens of science-based medicine. He has a professional interest is improving the cost-effective use of drugs at the population level. Scott holds a Bachelor of Science in Pharmacy degree, and a Master of Business Administration degree from the University of Toronto, and has completed a Accredited Canadian Hospital Pharmacy Residency Program. His professional background includes pharmacy work in both community and hospital settings. He is a registered pharmacist in Ontario, Canada.Scott has no conflicts of interest to disclose.Disclaimer: All views expressed by Scott are his personal views alone, and do not represent the opinions of any current or former employers, or any organizations that he may be affiliated with. All information is provided for discussion purposes only, and should not be used as a replacement for consultation with a licensed and accredited health professional.

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What happens when a cancer patient refuses treatment? ›

Connect with Supportive Care

Your loved one may still refuse treatment, in which case the conversation needs to shift from conventional treatment to supportive care. Talk with the oncologist sooner, not later, about hospice and palliative care. Also, talk to your love one about his or her values and wishes.

Can you refuse medical treatment for cancer? ›

You don't have to have treatment.

People with very advanced cancers sometimes find they'd rather treat the pain and other side effects of their cancer so that they can make the best of the time they have remaining. If you choose not to be treated, you can always change your mind.

What happens if you refuse chemotherapy? ›

Can you refuse chemotherapy? Yes. Your doctor presents what he or she feels are the most appropriate treatment options for your specific cancer type and stage while also considering your overall health, but you have the right to make final decisions regarding your care.

What happens if you can't tolerate chemo? ›

Other options. If cancer does not respond to chemotherapy, radiation therapy, or other treatments, palliative care is still an option. A person can receive palliative care with other treatments or on its own.

What is it called when a patient refuses treatment? ›

Informed refusal is where a person has refused a recommended medical treatment based upon an understanding of the facts and implications of not following the treatment. Informed refusal is linked to the informed consent process, as a patient has a right to consent, but also may choose to refuse.

Can you be forced to take medication? ›

If you are an involuntary patient

You still have the right to accept or refuse medication, unless you are an immediate and substantial danger to yourself or others. If you are an immediate and substantial danger to yourself or others, the hospital staff may give you emergency medication.

Do patients have the right to refuse medical treatment? ›

Right to Refuse Treatment

Patients usually have the right to refuse medical care, even if this could lead to death. For example, patients can refuse life-saving treatment like respirators or blood transfusions. Refusals must be free and informed.

Who is the oncologist who refuses treatment? ›

Dr Ezekiel Emanuel is one of America's leading public health experts. He's an oncologist, bioethicist, an architect of Obamacare, and a former member of President Joe Biden's COVID advisory board. But when he turns 75, he's vowed to completely change his approach to health care.

Can you survive without chemo? ›

Some had chemotherapy and some did not. Among those who did not have chemotherapy, the five-year survival rate without distant metastasis was 94 percent.

What are the hardest cancers to cure? ›

Some of the most difficult cancers to treat are those that develop in the:
  • liver.
  • pancreas.
  • ovaries.
  • brain (glioblastomas)
  • cells that give your skin color (melanomas)

Is it better not to have chemotherapy? ›

Because of chemotherapy's possible risks and side effects, it is not always recommended. Your oncologist may recommend avoiding chemotherapy if your body is not healthy enough to withstand chemotherapy or if there is a more effective treatment available.

Can you refuse to have chemotherapy? ›

Voluntary and informed decisions

Voluntary: you must make your decision to consent to or refuse treatment alone, and your decision must not be due to pressure by healthcare professionals, friends or family.

When do oncologists stop chemo? ›

Both the American Society of Clinical Oncology Quality Oncology Practice Initiative and the National Safety Forum include the discontinuation of chemotherapy within 2 weeks before death as a quality indicator of poor EOL care.

What is the most life threatening side effect of chemotherapy? ›

Infections. Chemotherapy can reduce your body's ability to fight infection. This makes you more likely to get infections that could make you seriously ill.

How many patients refuse medication? ›

Across all the studies, the average treatment refusal rate was 8.2 percent. Patients who were offered pharmacotherapy alone were 1.76 times more likely to refuse treatment than patients who were offered psychotherapy alone.

Why would hospice deny a patient? ›

Hospices are seeing denials for the six-month prognosis in recertification benefit periods, according to the medical review denial reasons, because documentation did not demonstrate the patient's current condition and/or an acute change in the patient's medical condition to support a life expectancy of six months or ...

What are the 10 rights of the patient? ›

Let's take a look at your rights.
  • The Right to Be Treated with Respect.
  • The Right to Obtain Your Medical Records.
  • The Right to Privacy of Your Medical Records.
  • The Right to Make a Treatment Choice.
  • The Right to Informed Consent.
  • The Right to Refuse Treatment.
  • The Right to Make Decisions About End-of-Life Care.
Feb 25, 2020

Can a doctor force you off medication? ›

Can a physician refuse to treat a current patient? Yes, but the physician needs to follow appropriate guidelines.

Do I have to take prescribed medication? ›

Taking your medicine as prescribed or medication adherence is important for controlling chronic conditions, treating temporary conditions, and overall long-term health and well-being. A personal connection with your health-care provider or pharmacist is an important part of medication adherence.

Why doctors should not be allowed to refuse treatment? ›

Nor should a physician withhold treatment from patients simply because they fail to adhere to his or her personal standards of morality. Rather, a physician's duty is to promote patients' wellness and flourishing through the application of evidence-based medicine to the best of his or her professional ability.

Can doctors drop you as a patient? ›

When dismissal is not an option. Even though physicians retain the legal right to dismiss patients in many situations, there are some circumstances when it's not only unadvisable but unethical and, depending on the state where it occurs, illegal and punishable both by law and by censure.

What are the 7 patients rights? ›

Patients' Rights Charter
  • Healthy and safe environment.
  • Participation in decision-making.
  • Access to health care.
  • Knowledge of one's health.
  • Insurance/medical aid scheme.
  • Choice of health services.
  • Treated by a named health care provider.
  • Confidentiality and privacy.
Jan 4, 2022

What percentage of patients refuse treatment? ›

Studies have reported rates of less than 1% for patients who refused all conventional treatment [4] and 3%–19% for patients who refused chemotherapy partially or completely [5–9]. We tend to think that refusing therapy leads to a poorer quality of life as the disease progresses without treatment.

What happens if I refuse radiation treatment? ›

Missed Radiation Therapy Sessions Increase Risk of Cancer Recurrence. Patients who miss radiation therapy sessions during cancer treatment have an increased risk of their disease returning, even if they eventually complete their course of radiation treatment, according to a new study.

How do oncologists decide treatment? ›

Because of this, your oncologist will review your full medical history before making any treatment recommendations. Learn more about what to know when cancer is not your only health concern. An oncologist will also consider a person's age when they recommend a treatment plan.

Is Stage 4 always terminal? ›

Is stage 4 cancer always terminal? Stage 4 cancer is not always terminal. It is usually advanced and requires more aggressive treatment. Terminal cancer refers to cancer that is not curable and eventually results in death.

Is Stage 4 curable? ›

However, remember that although stage 4 cancer can't be cured, it isn't necessarily terminal—in other words, it doesn't necessarily mean that the end of life is near. People with stage 4 cancer often live many years after diagnosis, which is why it's more accurate to describe it as "advanced" or "late-stage."

What shrinks tumors fast? ›

Radiation. This treatment uses high-energy rays to kill cancer cells or shrink tumors.

What are the top 3 deadliest cancers? ›

Lung and bronchus cancer is responsible for the most deaths with 130,180 people expected to die from this disease. That is nearly three times the 52,580 deaths due to colorectal cancer, which is the second most common cause of cancer death. Pancreatic cancer is the third deadliest cancer, causing 49,830 deaths.

What are the 4 deadliest cancers? ›

Most Dangerous Cancers Explained
  • Lung & Bronchus. Lung and bronchial cancer causes more deaths in the U.S. than any other type of cancer in both men and women. ...
  • Breast. The breast cancer death rate among women peaked in 1989. ...
  • Prostate. ...
  • Colon & Rectum. ...
  • Pancreas. ...
  • Liver & Intrahepatic Bile Duct. ...
  • Ovary.
Mar 3, 2022

Does chemo do more harm than good? ›

It is true that, while some people benefit, in some cases the side effects of palliative chemotherapy do more harm than good, and many patients would see more benefit from early access to palliative care as opposed to invasive medical interventions.

Which is harder on the body chemo or radiation? ›

Radiation therapy involves giving high doses of radiation beams directly into a tumor. The radiation beams change the DNA makeup of the tumor, causing it to shrink or die. This type of cancer treatment has fewer side effects than chemotherapy since it only targets one area of the body.

What percentage of chemo patients survive? ›

Around 13% of lung cancers are small-cell. Most people with this type receive chemotherapy. Approximately 83% of lung cancers are NSCLC. The remaining 3% are undefined.
Lung cancer.
NSCLC lung cancer stage
Chemo alone1%18%
Chemo plus radiotherapy without surgery6%35%
2 more rows

Who can skip chemotherapy? ›

After surgery, some cancer patients can safely skip radiation or chemotherapy, according to two studies exploring shorter, gentler cancer care. Researchers are looking for ways to precisely predict which cancer patients can avoid unneeded treatment to cut down on harmful side effects and unnecessary costs.

When is it too late for chemotherapy? ›

Late chemotherapy, defined as the practice of continuing an existing regimen within 14 days of death or beginning a new one within 30 days of death, has been named an indicator of quality of care and cited as a barrier to timely transition to hospice and other forms of palliative care.

Why do people deny chemotherapy? ›

Concerns About Chemo and Your Natural Defenses

A growing population of adults are choosing to refuse chemo is based on the way in which it works. Chemotherapy does not kill your immune system as claimed, but it can harm it temporarily.

What are the least survivable cancers? ›

Cancer survival rates by cancer type

The cancers with the lowest five-year survival estimates are mesothelioma (7.2%), pancreatic cancer (7.3%) and brain cancer (12.8%). The highest five-year survival estimates are seen in patients with testicular cancer (97%), melanoma of skin (92.3%) and prostate cancer (88%).

What to expect the last few weeks of life? ›

  • Why do changes happen at the end of life? When someone's dying, the body slows down and shows signs that the person is approaching the end of their life. ...
  • Losing weight. ...
  • Feeling weak and sleeping more. ...
  • Feeling hot or cold. ...
  • Eating and drinking less. ...
  • Bladder and bowel problems. ...
  • Breathlessness. ...
  • Noisy breathing.
Nov 25, 2022

How do doctors know how long you have left to live? ›

There are numerous measures – such as medical tests, physical exams and the patient's history – that can also be used to produce a statistical likelihood of surviving a specific length of time.

Why can't you touch chemo pills? ›

Chemotherapy drugs are considered to be hazardous to people who handle them or come into contact with them. For patients, this means the drugs are strong enough to damage or kill cancer cells. But this also means the drugs can be a concern for others who might be exposed to them.

Which cancers are most likely to recur? ›

Some cancers are difficult to treat and have high rates of recurrence. Glioblastoma, for example, recurs in nearly all patients, despite treatment. The rate of recurrence among patients with ovarian cancer is also high at 85%.

What is the most toxic chemotherapy drug? ›

Doxorubicin, an old chemotherapy drug that carries this unusual moniker because of its distinctive hue and fearsome toxicity, remains a key treatment for many cancer patients.

How do you help someone with cancer that doesn't want help? ›

Although each person with cancer is different, here are some general suggestions for showing support:
  1. Ask permission. Before visiting, giving advice, and asking questions, ask if it is welcome. ...
  2. Make plans. ...
  3. Be flexible. ...
  4. Laugh together. ...
  5. Allow for sadness. ...
  6. Check in. ...
  7. Offer to help. ...
  8. Follow through.

What is the most common cause of death in cancer patients? ›

Widespread metastases are the primary cause of death from cancer.

When should cancer treatment be stopped? ›

Some reasons why you might consider stopping include: Your cancer is advanced, and further treatment won't make a big difference in how long you live. You've tried multiple treatments that haven't worked. The risks or side effects of treatment outweigh the benefits.

Can terminally ill patients refuse treatment? ›

Every competent adult has the right to refuse unwanted medical treatment. This is part of the right of every individual to choose what will be done to their own body, and it applies even when refusing treatment means that the person may die."

What not to say to a cancer patient? ›

What Not to Say to a Cancer Patient
  • “Really you have cancer? ...
  • "Just live in the moment."
  • “I read about this new diet that cures cancer!”
  • “I know you will get better!”
  • “I know what you're going through. ...
  • “I can't stop worrying about you.” Please don't add another burden to my already heavy heart!
Mar 17, 2016

What do you say to someone with Stage 4 cancer? ›

Here are some ideas:
  • "I'm not sure what to say, but I want you to know I care".
  • "I'm sorry to hear that you are going through this".
  • "How are you doing?"
  • "If you would like to talk about it, I'm here".
  • "Please let me know how I can help".
  • "I'll keep you in my thoughts".
Jun 1, 2021

What are the emotional stages of cancer? ›

The Five Stages of Dealing with a Cancer Diagnosis
  • State 1: Denial. ...
  • Stage 2: Anger. ...
  • Stage 3: Bargaining. ...
  • Stage 4: Sadness and depression. ...
  • Stage 5: Acceptance.
Sep 25, 2018

What cancer kills the fastest? ›

1 in 4 people with pancreatic cancer die within a month, rapidly progressing to 3 in 4 dying within a year. This can be because they weren't treated in time.

What is the hardest cancer to cure? ›

Some of the most difficult cancers to treat are those that develop in the:
  • liver.
  • pancreas.
  • ovaries.
  • brain (glioblastomas)
  • cells that give your skin color (melanomas)

Which cancer is not curable? ›

Types of treatable but not curable cancer
  • Chronic lymphocytic leukaemia.
  • Chronic myeloid leukaemia.
  • Pleural mesothelioma.
  • Secondary brain tumours.
  • Secondary breast cancer.
  • Secondary bone cancer.
  • Secondary liver cancer.
  • Secondary lung cancer.
Mar 21, 2022

Why stage 4 cancer cannot be cured? ›

Stage 4 cancer usually can't be cured. In addition, because it's usually spread throughout the body by the time it's diagnosed, it is unlikely the cancer can be completely removed. The goal of treatment is to prolong survival and improve your quality of life.

What is the longest someone has lived with Stage 4 cancer? ›

“Stage 4 cancer for 18 years. Seventeen different treatments.

What hospice does not tell you? ›

What Does Hospice Care Not Include? Hospice care does not include curative treatment. The goal of hospice care is to provide comfort and support rather than to cure the disease. Hospice may not include medications you have grown accustomed to taking, such as chemotherapy or other medical supplements.

Can patients refuse treatment even if it means death? ›

Competent adult patients are entitled to refuse treatment even if that will result in their death or serious harm. – Patients cannot demand treatment that is not clinically appropriate. When is it necessary to seek patient consent?


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