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Dealing with chronic cancer

Description

Sometimes cancer cannot be fully treated. This means there is no way to get rid of the cancer completely, yet the cancer also may not progress rapidly. Some cancers can be made to go away but come back and are treated successfully again.

It may be possible to control the cancer for months or years. Doing so requires ongoing treatment to help keep the cancer from progressing for as long as possible. Therefore, it becomes more like a chronic illness.

Cancer That Won't Go Away

Certain types of cancer are or may become chronic and never completely go away:

• Chronic leukemia
• Some types of lymphoma
• Ovarian cancer
• Breast cancer

Often, these cancers have spread to other parts of the body (metastasized). They cannot be cured, but can often be controlled for a period of time.

Controlling Chronic Cancer

When you have a chronic cancer, the focus is on keeping it under control, not to cure the cancer. This means keeping the tumor from getting larger or spreading to other areas. Treatment for chronic cancer can also help manage symptoms.

When cancer is not growing, it is called being in remission or having stable disease. Your health care provider will keep a close watch on the cancer to look for any growth. You may need ongoing treatment to help keep the cancer under control. This is called maintenance treatment.

If your cancer starts to grow or spread, you may need a different treatment to try to make it shrink or stop growing. Your cancer may go through several rounds of growing and shrinking. Or your cancer may not grow at all for many years.

Since each person and each cancer is different, your provider may not be able to tell you exactly how long your cancer can be controlled.

Treatment for Chronic Cancer

Chemotherapy (chemo) or immunotherapy may be used for chronic cancers. There are many types of drugs from which to choose. If one kind does not work, or stops working, your provider may suggest using another one.

Sometimes, cancer can become resistant to all of the treatments approved to treat it. If this happens, talk with your provider about your options. You may want to try another treatment, join a clinical trial, or you may decide to stop treatment.

Whatever treatment you receive, it is very important to follow your provider's instructions for taking the drug. Got to your doctor appointments as scheduled. If you have any side effects, tell your provider. There may be ways to lessen side effects. Do not stop taking any drug without first talking with your provider.

How Long to Continue Treatment

There is no limit on how long you can continue treatment for chronic cancer. It is a personal decision you need to make with the help of your provider and loved ones. Your decision may depend on:

• The type of cancer you have
• Your age
• Your overall health
• How you feel after treatment
• How well the treatment works to control your cancer
• The side effects you have with treatment

If you do decide to stop treatment that is no longer working, you can still get palliative care or hospice care to treat the symptoms of your cancer. This will not help treat the cancer, but it can help you feel your best for the time you have left.

Living with Cancer

It is not easy to live with a cancer you know will not go away. You may feel sad, angry, or afraid. These suggestions may help you cope:

• Do things you enjoy. This might include going to see music or theater, traveling, or fishing. Whatever it is, make time to do it.
• Enjoy the present. Try to focus on enjoying the present instead of worrying about the future. Focus on the small things that bring you joy every day, such as spending time with family, reading a good book, or walking in the woods.
• Share your feelings. Sharing your feelings with others may help you feel better. You can talk with a close family member or friend, join a support group, or meet with a counselor or clergy member.
• Let go of worry. Feeling worried is normal, but try not to let these thoughts take over. Acknowledge these fears and then practice letting them go.

References

American Cancer Society website. Managing cancer as a chronic illness. www.cancer.org/treatment/survivorship-during-and-after-treatment/when-cancer-doesnt-go-away.html. Updated January 14, 2019. Accessed June 6, 2022.

ASCO Cancer.net website. Coping with metastatic cancer. www.cancer.net/coping-with-cancer/managing-emotions/coping-with-metastatic-cancer. Updated March 2019. Accessed June 6, 2022.

National Cancer Institute website. When cancer returns. www.cancer.gov/publications/patient-education/when-cancer-returns.pdf. Updated February 2019. Accessed June 6, 2022.

Byrd JC. Chronic lymphocytic leukemia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 174.

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Review Date: 1/6/2022  

Reviewed By: Richard LoCicero, MD, private practice specializing in Hematology and Medical Oncology, Longstreet Cancer Center, Gainesville, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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