Asking Your Healthcare Provider About Palliative Chemotherapy

Chemotherapy is the use of drugs that can be taken orally, through intravenous (IV) infusion, or applied to the skin. Healthcare providers recommend it as a means of possibly doing one of three things: curing cancer, prolonging life, or improving the symptoms of cancer.

When cancer is considered incurable, the focus shifts from finding a cure to extending your life and promoting your comfort. This is known as palliative chemotherapy.

When considering if palliative chemotherapy is right for you, it’s important to ask your oncologist the following five questions.

How Effective Is This Particular Chemotherapy at Reducing Tumor Size?

You will want to know the response rate of the chemotherapy your oncologist is proposing. Response rates refer to the number of people whose tumors will either shrink or disappear (or remain stable) as a result of the drug or drugs that are given.

Response rates are established through research for each type and stage of cancer. For example, an advanced metastatic colorectal cancer might have a 70% response rate to a certain combination of drugs. This means that 70% of the people with this type and stage of cancer has a positive response to this combination of drugs. It also means that 30% of the people with this type and stage of cancer will not respond to the treatment or will have only a minimal response.

How Long Will It Take Before You Know It's Working?

You will want to know what you're in for and how long you're in for it. Chemotherapy regimens can vary a great deal. Some cancers are treated in as little as one to two months while others may be treated for a full year. It’s standard to try two full cycles of chemotherapy (a full cycle is usually 2-6 weeks) before deciding whether it's working or not.

What Are the Potential Burdens of Treatment?

Chemotherapy can have some highly undesirable side effects. We all know about the possibility of nausea or upset stomach, loss of hair, and weight loss, and each individual responds differently. There are other potentially serious effects, and you will want to know if you're at risk for developing them.

You will also want to know what the personal burden will be on you and your family. How often will you have to go to the clinic for treatment, tests, blood work, etc.?

Essentially, you are weighing out the potential benefits against the risks and burdens of treatment to determine whether it will cause more harm than good.

Will You Live Longer?

One of the primary goals of palliative chemotherapy is to extend life. You will want to know what the chances are that you will live longer. If the chances are low that you’ll increase your lifespan, you might decide to forgo it to focus more on comfort measures.

Will Your Symptoms Be Reduced?

Another desired effect of palliative chemotherapy is to improve the symptoms of cancer. By reducing the size of a tumor, the symptoms of cancer may be reduced. You have a right to know what the chances are that your quality of life will be improved.

Several reports have shown that patients who receive palliative chemotherapy didn't get clear or adequate information about survival rates and quality of life issues from their oncologists. Make sure you are not one of them. The only way you can make the decision that’s right for you is to have all the information that's available.

A Word From Verywell

Deciding to forego palliative chemotherapy is not an easy decision, even when it's the right decision.

Even when they are not giving you chemotherapy, your medical team has the responsibility to continue to care for you. Often, patients that take a comfort-oriented route for their care will experience an increase in energy, quality of life, and the gift of time; when your days are not spent at the chemotherapy suite, they can be spent with your loved ones.