Advanced cancer

Advanced cancer is cancer that has spread or come back. It is usually used to describe cancer that cannot be cured.

Doctors sometimes use other words to describe advanced cancer. For example, they may use metastatic or secondary cancer to describe cancer that has spread to other parts of the body. Depending on the cancer type, it may also be called stage 4 cancer.

Some people find out they have advanced cancer when they are first diagnosed. For others, the cancer may spread or come back after treatment.

You may have treatment to control the cancer. Sometimes, treatment can control advanced cancer for a long time. This can sometimes be years. During this time, you may be able to continue with your life and do the things that are important to you.

Sometimes it is not possible to stop the spread of the cancer. You will still have treatment to manage symptoms and help you feel as well as possible. This is called supportive or palliative care. This may include:

• medicines to help manage symptoms such as pain or sickness (nausea)
• radiotherapy to help reduce pain or bleeding caused by cancer
• emotional support to help you cope with any difficult feelings you have.

Treatment may help to control the cancer or manage its symptoms. Your cancer doctor or specialist nurse will explain what treatments may be helpful. This can depend on:

• the type of cancer
• the areas of the body affected
• any symptoms you have.

Treatment for advanced cancer may include:

• surgery
• radiotherapy
• chemotherapy
• hormonal therapies
• targeted therapies
• immunotherapies
• a combination of treatments

You may be offered some treatments as part of a clinical trial.

You may want to find out all your options before making treatment decisions. Your doctor can usually give you information on how well a treatment may work. They will consider what is important to you and how treatment may affect you. This will help you both decide the best treatment for you.

You may need to have treatment for a while to see if it is helping you. Sometimes, the treatment only causes side effects and has no benefits. In this case, you may want to think about if you want to continue with treatment. Making treatment decisions like this is always difficult. Before you decide what to do, it may help to talk to your cancer doctor, specialist nurse and family and friends.

If you decide not to have further treatment, your cancer doctor and specialist nurse will support you and make sure your symptoms are managed.

You may want to have an idea of how long you might live. This is called a prognosis or life expectancy. Or you may not want or need to know.

If you want to talk about this, your cancer doctor or specialist nurse can help. We have information about talking to your healthcare team about prognosis that may be helpful.

Knowing that your illness may not be curable might help you think about:

• what is important to you
• how you want to live your life.

You may want to focus on things you enjoy or want to achieve.

It might also make you think about planning ahead. If you feel ready to do this, you may want to write down your wishes. This might include:

• what is important to you
• how and where you would prefer to be cared for.

This is called advance care planning.

When someone finds out their cancer may not be cured, they may have questions about what will happen at the end of life. They may want to understand what to expect or want to know how to prepare. We have more information about practical and emotional support at the end of life.