How to care for a loved one who has advanced cancer

Advanced cancer may be the beginning of the end for a caregiver’s loved one, but it’s still a beginning. Each new beginning brings changes with it, and cancer is not the exception. Both caregiver and care receiver may have to make new decisions, and the former may have to shift his or her approach to care, as well as ask healthcare providers a new set of questions.

Advanced cancer

Questions to ask

Decisions to make

·         What’s the best that can be hoped for by trying another treatment?

·         Is this treatment meant to relieve side effects or slow the spread of cancer?

·         Is there a chance that a new treatment will be found while we try the old one? 

·         What are the possible side effects and other downsides of the treatment?

·         How likely are they?

·         Do the potential benefits outweigh the possible drawbacks?

·         Treatment goals.

·         When to consider using hospice care.

·         Financial decisions.

·         How to get support from relatives.


It goes without saying that these questions are asked with the care receiver’s best interests in mind, and that while the caregiver can and should provide his or her input, the patient should have final say regarding which decisions to make – unless they wish to bestow that power (of attorney or otherwise) on the caregiver. The point is, the wishes of the care receiver should be honored and respected even if they cannot speak for themselves anymore – in which case the caregiver should become their advocate and mouthpiece and do things the way their loved one would have wanted them.

Types of care

At advance stages, cancer may no longer respond to treatment and remission may seem unlikely. However, this doesn’t signify the end of care; rather, it may signal a different approach to care. For example, palliative care is aimed at relieving the symptoms of cancer and the side effects of treatment, as opposed to addressing the disease itself. Palliative care can help the patient enjoy his or her remaining days comfortably and pain-free. Other alternatives include clinical trials, hospice care, and home care (it is worth noting that no treatment at all is also an alternative; patients are free to refuse treatment at any point, and doctors have the right to stop aggressive treatment in some states, if they feel is not doing the patient any good).

Care alternatives

Palliative care

Some of the treatments and medications used to treat the cancer itself can be used as well to relieve pain and other symptoms. For instance, chemotherapy may be used to shrink a tumor that causes pain, or a mass that is pressing on certain nerves may be surgically removed.

Clinical trials

Patients with advanced cancer are not precluded from participating in clinical trials. Early-phase clinical trials designed to test the safety and effectiveness of a new treatment may help slow the growth of your loved one’s cancer, though that probability is low. Nonetheless, the person may want to join a trial regardless because it might help future cancer patients.

Hospice care

Hospice care staff is trained to address not only the physical but also the emotional, social, and spiritual needs or care receivers and caregivers. The latter may not realize that hospice care is not just a resource for the last days; patients may qualify when their doctor signs a statement saying they aren’t likely to survive beyond six months. Hospice care services include:

·         Doctor services.

·         Nursing care.

·         Medical supplies and equipment.

·         Drugs to manage cancer-related symptoms and pain.

·         Short-term inpatient care.

·         Homemaker and home health aide services.

·         Respite services.

·         Counseling.

·         Social work services.

·         Spiritual care.

·         Bereavement counseling and support.

·         Volunteer services.

Home care

Home care is basically hospital care – or as close to it as possible – at home. As such, it may include palliative care together with treatment for the actual cancer. Home care services may include:

·         Symptom management.

·         Monitoring care.

·         Physical and other therapies.

·         Home medical equipment.


Back to palliative care, this is very important for patients with advanced cancer because its effect on pain.

About pain

Cancer patients may not let on that they are in pain

They may believe they would be perceived as complaining just for the sake of complaining, or simply that pain is an inevitable aspect of cancer, and just get used to it.

Cancer-related pain can be managed

Contrary to the above, cancer and pain can be mutually exclusive. Treatment can help manage pain, but doctors are not mind readers; they should ask about levels of pain, but caregiver and care receiver should also come forth if the latter is in pain.

Managed pain allows cancer patients to enjoy life more

Pain can result in changes in personality, poor sleep, and inability to enjoy daily activities. It follows that managing pain will improve the quality of life of the person.


Letting doctors know about pain is one of the reasons that communication between the patient and the healthcare team – with or without the caregiver as intermediary – is so important. In order to keep the lines of communication open, caregivers may do the following:

·         Make a list of questions before each doctor’s appointment.

·         Take notes.

·         Ask the doctor if it’s okay to use a tape recorder.

·         Get the phone number of someone you can call with follow-up questions.

·         Keep a file or notebook of all the papers and test results and bring it to medical visits.

·         Keep records or a diary of all the visits listing drugs and tests.

·         Keep a record of any upsetting symptoms or side effects, noting the time and place that they occur. 

·         Find out what to do in an emergency, including who to call, how to reach them, and where to go.

The ebb and flow of people

When a person is first diagnosed with cancer, the family – including the caregiver – may be flooded with calls and visits to the point of being overwhelmed. In such a case the caregiver might want to consider:

·         Letting the answering machine get the messages.

·         Answering the phone and shifts.

·         Putting a polite ‘don’t disturb’ sign on the door of your home or hospital room thanking visitors for dropping by but letting them know that the patient is resting at the moment.

·         Asking a friend or relative to handle visits while you attend to your caregiving duties.  

·         Going somewhere you can’t be reached immediately.

In time, however, other people’s interest may wane. By the time the advanced stages of cancer arrive – and with them new challenges and concerns – the caregiver may find him or herself yearning for the initial influx of people. During the course of the disease, these may happen:

·         People who offer help before may not be available now.

·         Others who have helped before may want to help in different ways now.

·         People who haven’t helped before may start helping now.

·         Agencies that couldn’t help before may have become available now.

The trick is probably to accept help when it’s offered and ask for it when it’s needed. Some people’s offers may still stand in the long-run, while others’ may be only for limited time due any number of reasons. But you’d be surprised how many people might be willing to help if you’d just ask and let them know exactly what they could do, such as:

·         Helping with household chores like cooking, cleaning, shopping, yard work, and childcare or eldercare.

·         Talking and sharing your feelings.

·         Driving your loved one to medical appointments.

·         Picking up a child from school.

·         Picking up a prescription.

·         Looking up information you need.

·         Being the contact person and helping keep others updated.

Related: Caring for someone with cancer all day, everyday