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How do we decide when to stop chemotherapy that's not working?

26 answers | Last updated: Oct 22, 2014
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A fellow caregiver asked...
In our last conversation with my father's doctor, she suggested we consider stopping chemotherapy, because it is no longer effective and is causing so many side effects. However, my father says he wants to continue chemo because he wants to "keep on fighting." How do we decide when to stop chemotherapy, and how do I talk to my father about this?
 

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Redwing Keyssar coordinates the Palliative Care Program for Jewish Family and Children's Services of San Francisco.
87% helpful
answered...

This is a very hard conversation to have, when the doctor acknowledges that cancer treatment is no longer achieving results. You and your father have to weigh the negative aspects See also:
Cancer Treatment and Nausea: What You Can Do

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of treatment, such as uncomfortable and painful side effects, against your father's need to keep seeking a cure. It's one of the moments in care giving when the role reversal is very intense -- you're going to have to be the parent in this situation, and help your father decide what's the best thing to do, just as he did with you when you were young.

The fact that your father's oncologist raised the subject is a sign that she's a good doctor. Because oncologists are in the business of curing cancer, many times they feel such a sense of failure when a patient is getting sicker that they just keep treating even when it no longer makes sense.

You could start by suggesting to your father that the two of you talk to the oncologist again and ask a few specific questions, such as, "Is continuing treatment going to make a significant difference in the progress of the cancer?" You can also ask, "If we discontinue treatment, can we expect the nausea, pain, and other discomforts to diminish?" If the doctor answers that treatment at this point won't make a big difference, but discontinuing it will improve your father's quality of life, that may help clarify the decision for both of you.

You may find that your father is more ready to talk about these big issues than you think. So often for family members it's actually their fear of bringing up difficult issues that's getting in the way, not the cancer patient's refusal to talk about them. We as a culture are death-phobic, and family members are very fearful that stopping treatment will be perceived as "giving up" on the patient, when it can be just the opposite.

Sometimes this moment can be the catalyst for a really important conversation; you could ask your father, "If you only had six months or a year to live, what would be most important to you? What can we do to make it as wonderful as possible?" I always remind people that there's a difference between hope and what we call "expectations for outcome." Just because the treatment is no longer expected to bring about a cure doesn't mean it's time to give up hope. And as time goes on, hope can be about being out of pain and suffering.

 

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43% helpful
nina answered...

I just went thru this with my husband. I did not try to talk him out of it, he was terminal, but the treatments gave him some hope to cling to. In the end that was better for us and him.

 

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An anonymous caregiver answered...

My father was becoming more and more weak with each chemo treatment. While driving home one day I asked him what was more important to him? His quanity of life or his Quality of life? He thought it thru then asked me to rephrase the question, I said, Dad, I can tell that this gets more difficult on you with each treatment, his chemo wasn't effective enough and the doctor had told him this. I explained the differences, that quanity would mean more chemo, more weakness etc whereas quality would allow him to sleep in if he wanted, allow the nausea to go away, for his hair to grow back, and allow him to enjoy what time he had left. I assured him that whatever he decided that I would stand by him. I just wanted to make sure that he understood that he did have a choice. After thinking it thru he decided that he wanted to eat his favorite foods, feel strong enough to hold his grandchildren, work in his garden and sit on his porch. He passed away 5 weeks later. Our family had some great times in those last weeks!!

 

26% helpful
Hope I can help answered...

My sincere sympathy. For people with cancer fighting to stay alive I would hope that they are being encouraged to eat a raw food diet with NO MEAT and NO DAIRY PRODUCTS and NO CHEMO!!! This is will give their bodies the best fighting chance at killing off the cancer cells. They must have an alkaline inner body instead of acidic. Cancer loves an acidic body!!! There are many published works in books, dvd's, and scientific studies etc..... PROVING all of this! I sincerely hope this doesn't upset you but I really want your father to live too! It may be the best suggestion your doctor could have made for your father. If your father really wants to keep on fighting have him watch the dvd, 'Healing Cancer from Inside Out' by Mike Anderson......it may just save his life. This can be ordered online from amazon. I have two friends fighting for their lives as well and it breaks my heart to see them suffer through chemo but it is their choice and I must respect it. I hope you find this information helpful.

 

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An anonymous caregiver answered...

My mom was diagnosed with stage 3c ovarian cancer 7 years ago. At one point, although the chemo was working as evidenced by a greatly reduced ca125 tumor marker and improved ctscan, she was very weak and unable to walk. Her internist suggested stopping the chemo and 'get ready for the next stage of your life' I.e., get ready to die. Instead, we had mom's adrenal function tested by a board-certified endocrinologist and discovered that the large doses of steroids given with the chemo had rendered mom adrenally insufficient. Mom began taking small daily maintenance doses of cortef to replace the cortisol her body could no longer make. Almost immediately mom regained her strength and was able to walk again. The endocrinologist also prescribed vitamin D3, 1000 units per day. That was almost three years ago. Mom is still doing very well and has an excellent quality of life.

The point is: Get Second Opinions.

 

42% helpful
angelsbaby answered...

My Husband decided to stop chemo after the dr said there were to many big tumors and to call hospice he cried but he lived for 3 more months he died april 16 2009 and i miss him. he knew that the chemo would not work so he opted for the quality .

 

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An anonymous caregiver answered...

I am a RN in an inpatient chemotherapy unit. I went into nursing because I appreciated the holistic view it lends to healing and health. I also have a great passion for health education and truly believe in evidence based practices. That said, there are two main points I would like to add to these topics, the first is in reference to "Hope I Can Help". There is strong evidence to suggest the benefit of a more holistic approach to oncology i.e. including diet, exercise, progressive muscle relaxation, aromatherapy, pet therapy... and so on into the treatment process(I just wrote a graduate school paper on this!). Be very weary of the term PROVEN, as it should not appear in scholarly literature. Typically, "proven" statements are bias one way or another. Suggestive...correlated, NOT proven. I say this because in health, especially oncology, nothing is for sure. I, myself am a vegetarian and attempt to live in a healthy way, but have seen ALL KINDS of people live/ die from cancer. ALL kinds. In some ways, suggesting that being a meat eater or any other term villainizes individuals. You are suggesting they DID something to get cancer, and many time there is no clear cause for some cancers. That said, this brings me to my second point, if you or your family is dealing with cancer and reviewing your treatment options, remember, they are options. There is no right way to handle cancer. There is no right treatment. There are treatment plans that research and time have explored. Ask questions...LOTS of them. Write them down. Deciding to do "western" medicine does not mean you cannot incorporate other approaches to treatment, just discuss them with your oncologist as sometimes there are interactions or perhaps your oncologist can aid in your search (Yes, some do advocate for combined therapy.) Anecdotally, which of course is worth very little, I have seen little success in prolonging life without chemotherapy once cancer is progressive. From what I have seen (I'm just one person, though) the disease process progresses quickly after chemo or radiation is discontinued. That said, "success" of treatment does not just mean a longer life. Quality of life is a huge factor that you should discuss with family and your chosen health care team. Remember, there are risks associated with most treatment option (even all natural ones!)In the end, I have seen amazing things...many of them are not explainable. Ask for this a lot : SHOW ME THE LITERATURE. Good luck and live well :)

 

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Still-here answered...

Hello anonymous (the RN in an inpatient chemotherapy unit) -- I really appreciate this response on your part. I am 54 and have been living with breast cancer since I was 36 -- one third of my life, half of that time knowing it was metastatic. Though I have made the decision now to stop chemotherapy because the remaining options have such severe side effects and not real likelihood of success, I have been very, very lucky to live WELL this long. Every friend I have had with cancer of any kind has approached it in his or her own way. I don't mind when people tell me about some so-called miracle diet or treatment that they think worked for them or someone they care about; I love to hear others' stories. But the one MOST DIFFICULT aspect of living with cancer for me is dealing with people who try to pressure me into trying whatever miracle treatment they swear by. It is not helpful. It feels like pressure. It does not reflect good listening. It does not respect my ability to think for myself and my autonomy in making my own decisions. Yet I know they mean well, and I try to gently get them to stop. Sometimes, though, I have to be quite assertive to make it clear that I am not finding their well intentioned advice helpful.

Having lived so long with advanced breast cancer, I do not want to chase every chance at a little more longevity no matter what the cost. In fact, I have never used the verb "fight" with respect to my cancer, maybe because I am Quaker and I am a pacifist. Instead, I have chosen to "live with" the cancer, to "live well" with it, to learn from it. I am paraplegic as a side effect of bone mets, but honestly, there are gifts to be found in one's limitations. I am far less restless than I used to be. My life is full of joy. If these "helpful" people really would listen to me, they would realize I am doing well living the life I have chosen.

 

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sjaweha answered...

Using ones knowledge and or excercising the access to it (Internet especially, books), is so crucial and so very available to all in seeking guidiance and wisdom regarding health and healing. As the aformentioned RN I have seen so many succeses and to failures.

One women I read much about comes to mind, Dr. Lorraine Day, cancer survivor, used to be head of Osteopthic Surgery at UCSF, almost died of breast cancer, had a Divine Intervention in the 11th hr, a huge tumor growing out of her chest between the breasts. She changed her plan according to her Guidiance and she healed fully. She has alot to say Now.

Blessings to all of you especially to those survivors who endured to tell the story's and support others. As well those still sufferring with this awful disease.

 

29% helpful
Stilldreamin' answered...

To Still-here. Wow, glad to here you are still here and thanks for your comments. I need your advice. I too have never felt like I was fighting anything(my doctor says he is). I am living with metastatic breast cancer and I think I'm living with it well (considering the circumstances). Not to get too personal, if you wouldn't mind telling me(only looking for what to expect) what happened with the bone mets? I think what scares me most is not the cancer but the idea of being bedridden and not doing things I'd like to. And yes, I can really relate to "helpful" people that don't listen. Even if I make a casual comment about something I'd really like to do, I get "shush, don't say that" and then they change the conversation. I know they don't want anything to happen to me, but it feels like they don't take this very serious. My dog listens though. The sun is out here today and it's a gorgeous day, except a little chilly. Hope you have a great day and thanks for any answers you can help me with.

 

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researchnut answered...

There was a cure for cancer in the 1930s..Dr Max Gerson. You can go to the Gerson Institute or find a local Greson practitioner. Chemo is an outdated and barbaric treatment. Take responsibility for your own research and your own health.

 

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Hempangel answered...

Has anyone noticed that Chemo research hasn't progressed in the last 40 years.In fact people aren't even living as long as they used to after the treatments.Did you also know that there are large numbers of people leaving the US for cancer treatments.Cannabis oil will cure your cancers and about 200 other illness's.You won't get all tore down like you do on chemo and radiation.You can eat and sleep while you are doing the treatments and you can't on western treatments.If something is drove into your mind long enough some will believe it.Not all though.God gave us a plant to combat illness's and he wants us to use it because it does the trick.Where does chemo grow.There are still people looking for the chemo plant and can't find it.Our body's are not synthetic people,so stop expecting synthetic drugs to work for cures.Watch this video and live people.It's called Run From the Cure by Rick Simpson.Watch it before you jump down sombody's throat and i'm telling you wright now that there thousands of people finding out it works and they are being silent even after they are cured because everyone that is doing the chemo thing are violent ass all hell.It is hard for them to admitt that they have been wrong for so long.Some of us act like mice.

 

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researchnut answered...

Perhaps its time we STOPPED fighting cancer. See Andreas Moritz-Cancer is not a disease. This wonderful book throws a new light on the subject. How to work with the toxic and malnourished body and nurture it back to health. There is never going to be a drug which can cure our western lifestyle diseases however much money we throw at research. Its time to start wondering if these invasive( treatments) are saving lives or taking them. Personally,I would rather use the Gerson treatment. Which has a better sucess record than chemo and radiation anyway.

 

50% helpful
Dyama answered...

My mom had a heart attack recently. It was her second attack. She was taken to the hospital by ambulance. Later I was asked by hospital staff if I would want doctors try revive her if her condition worsen. I was stumped but shortly replied like,' the first time you didn't ask but responded and brought her health back. Shouldn't the doctor go the same way again?' Later while next to mom, a doctor came by me and said,' mom lived a good life. If she needs to go, let her in peace, but we'll try our best to keep her'. Mom is 88 years old. She has later stage dementia. Doctors found several large tumors in her abdomen after she spoke of pain there during her second stay at the hospital. She is weak but sleeping at home on her bed as I write in her bedroom next to her. Awhile ago, she said to me that she wanted to go walking again when she gets better, and she wants to take a trip again to Japan. After reading the experience of others here, I come to think that there is no correct answer but surely a better one And though mine may be opposite to those ideal of other people, I should respect them and their feelings, because though our ways may differ, they come from the same place, our hearts.

 

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Hempangel answered...

It looks as though nobody is listening to what is going on with this cancer research thing.Still using chemotherapy and radiation are you.Have they told you that they are using generic drugs now for the treatment of cancer.Does anybody have any idea how dangerous it is to make chemotherapy drugs?There is a reason why it is not made in the states.Cannabis Science Inc has 4 cancers,4 different patients.All 4 patients self administered the drug and had outcomes way better than any chemo drug can do for the human body and with no side affects.This is probably to hard for some of you to swallow isn't it.How in the world can we be studorn for years but all of a sudden give a doctor complete control of our health.Chemotherapy is the most radical approach a person can do with their own healthWho in the world said that doctors cure? They treat.

 

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An anonymous caregiver answered...

I am so sorry to read about your dad, it is a very difficult time for all involved when the doctors tell you the treatment is no longer working, although you know this news is going to come, you can not get your head around it, when you are told. Your dad sound so much like my mam, she fought through to the bitter end, mam was also told treament was no longer working, both mam and our family had to come to terms with that news. When mam asked what time she had left, we were given a few months, but sadly two days later mam had to go into hospital andboth my dad and I were told mam had two week, mam passed away on the 10th August 12, it is very hard for you and your family, but what ever time you have with your dad, enjoy as those are the memories you will cherish. Tajkecare.

 

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MyHandy2012 answered...

To "hope I can help", there is no scientific basis to your theory of raw food, no dairy and no red meat. The doctors know what works. I will not even entertain the idea of a "macrobiotic or all natural die" to cure my cancer. Everyone is different but I have seen no cancer survivors from these methods. As to the original question, I think it is all up to the patient. It's THEIR life. It IS all about them.

 

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An anonymous caregiver answered...

One question - so many answers. How can we know what is best -it can only ever be what is right for the individual, in their mind, based on their needs at that time. I am looking after my terminally ill wife, my childhood sweetheart and best friend for nearly forty years. It tears me inside out to witness her slow and painful deterioration with metastatic breast cancer and to know their is nothing I can do to stop it. We can only keep going for as long as possible and build memories to look back on. This is my first time on a blog - I am so saddened to see so many hurting in the same way. God bless you all, maybe one day this monster will be tamed.

 

9% helpful
Hempangel answered...

Everyone should be told about all the treatments,legal and illegal.Chemo and radiation were never mean to be used for the heathe of human kinds.Even Hitlers death doctors said this.There is no reason to use chemo and radiation when these same doctors have known about the oil from the resins of marijuana kill cancer cells.A pot head could never tell you about this oil killing cancers cells because they don't even have enough scence to get off the couch long enough to learn about anything new.Legalize pot and you will see how fast the government comes out with the real truth.As long as it is illegal they don't have to say a word and population control is in full motion.Legalize it and they will be stumbling over their own feet trying to informe the mutitudes.Look what happens when they legalize marijuana for medicine in a state.The government sends in growers and shop workers from all over the world to get the show on the road.Cannabis oil won't cause anyone to loose their hair and if you are sick from the cancer,just do a little more and the pain will stop.You will never have a problem eating.You can forget getting throwing up sick.Some people think the cannabis oil is the onointing oil and not just an ingreiadiant either,but the real onointing oil.

 

LhasaLove answered...

Self healing often occurs when the body gets rid of toxins and is provided with proper nutrition on a cellular level. Unfortunately, doctors do not offer us non toxic treatments as a viable choice before we begin chemo or when chemo has failed. I write about this topic because I am a ten year brain cancer survivor and when my cancer returned for the fourth time, I knew I had to abandon traditional treatments. Traditional treatments block proper mineral absorption. Here are my websites that provide free info. Blessings to all... www.LhasaLove.com www.occupycancer.info

 

ksatria answered...

it seems that the doctor has given up... my don't you give this a try. www.cacare.com my sister in law is diagnosed with nasopharing cancer, and we still cannot decide wheter to go here or to have chemo.

 

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An anonymous caregiver answered...

Before I take chemo, I will go to an interventional radio therapy clinic to see what they can do for my cancer. They have a more modern way of dealing with cancer which is less invasive! I trust them.

 

Geremia answered...

It all depends on the type of cancer. For some cancers, chemo is effective; for others, it rarely leads to remission or even cures. Multiple myeloma is an example of this latter case:

From the UpToDate article on multiple myeloma:

In most people, chemotherapy partially controls multiple myeloma; rarely, chemotherapy leads to complete remission.

In fact, it's so ineffective that my mom had to have a blood transfusion!

Also:

Transplantation, when successful, prolongs survival, leads to a remission, and, infrequently, cures multiple myeloma. However, transplantation has several limitations. The high-dose chemotherapy given before transplantation usually fails to kill all of the plasma cells, allowing the condition to relapse after transplantation. Such treatment also puts the patient at risk for serious infections and bleeding, which can be fatal.

UpToDate is used by 700,000+ physicians worldwide; it's not alternative medicine. Thus, if even mainstream medicine recognizes the relative ineffectiveness of chemo and transplantation for multiple myeloma, why do they do it?

 

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An anonymous caregiver answered...

Large dosages of Advanced Ambrotose from Mannatech really helps with intercellular communication.

 

Hempangel answered...

There has been a lot of science coming in from all over the world on how cannabis treats cancer.If you have to do chemo than you should be doing the cannabis thing at the same time because you will have a better chance of surviving the crap.Cannabis cause's cancer cells to commit suicide and there are no long term side affects like there is with chemo and radiation.As soon as becomes legal we can save more lives and people can use it for free or almost free.Believe me when I tell you that your doctors know about this cannabis but I don't think they make enough money off of it if you could do it for free.I'm not talking about smoking pot for cancer even though some do and it does help but nothing like ingesting the extracts of the stuff.I'm talking ingesting it or taking it by mouth and swallowing it.A person with cancer needs to ingest it at least 7 times a day and each dosage is the size of a grain of rice or two grains of rice.Rickie Lake is getting ready to make movie about how cancer can be cured with cannabis along with the use of chemo.That's good for her show and this is just me,but i'm going to take my chances with just using the extracts of cannabis if I get this terrible condition.I'm 65 now and am a viet nam vet that was drench with agent orange.So far I've been very luky or God has other plans for me.We'll see.

 

 
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