NCCN Guidelines for Patients® | Multiple Myeloma - page 66

NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
7.2 Parts of a treatment plan
Advanced care
Talking with your doctor about your prognosis can help
with treatment planning. If the cancer can’t be cured,
a care plan for the end of life can be made. However,
such talks often happen too late or not at all. Your doctor
may delay these talks for fear that you may lose hope,
become depressed, or have a shorter survival. Studies
suggest that these fears are wrong. Instead, there are
many benefits to advanced care planning. It is useful for:
Knowing what to expect,
Making the most of your time,
Lowering the stress of caregivers,
Having your wishes followed,
Having a better quality of life, and
Getting good care.
Advanced care planning starts with an honest talk
between you and your doctors. You don’t have to know
the exact details of your prognosis. Just having a general
idea will help with planning. With this information, you can
decide at what point you’d want to stop chemotherapy, if
at all. You can also decide what treatments you’d want for
symptom relief, such as radiation, surgery, or drugs.
Another part of the planning involves hospice care.
Hospice care doesn’t include treatment to fight the
cancer but rather to reduce symptoms caused by
cancer. Hospice care may be started because you aren’t
interested in more cancer treatment, no other cancer
treatment is available, or because you may be too sick for
cancer treatment.
Hospice care allows you to have the best quality of
life as possible. Care is given all day, every day of the
week. You can choose to have hospice care at home or
at a hospice center. One study found that patients and
caregivers had a better quality of life when hospice care
was started early.
An advance directive describes the treatment you’d want
if you weren’t able to make your wishes known. It also
can name a person who you’d want to make decisions for
you. It is a legal paper that your doctors have to follow. It
can reveal your wishes about life-sustaining machines,
such as feeding tubes. It can also include your treatment
wishes if your heart or lungs were to stop working. If you
already have an advance directive, it may need to be
updated to be legally valid.
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