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NCCN Guidelines for Patients


Adolescents and Young Adults with Cancer, Version 1.2017

It may be time to set up a plan.

Part 9 looks at advance care planning and

preparing your loved ones to cope with

the possibility of advanced cancer or even

death. Hospice care for incurable disease

is all about the quality of life.

Most people with cancer go into treatment determined

to “beat this thing.” And lots of them do—at any

given time there are millions of cancer survivors in

the U.S. alone. But sometimes beating cancer isn’t

an option. When cancer is diagnosed very late or

keeps progressing despite all treatment efforts, it may

be time to set some new goals. If it becomes clear

that cure is not possible, treatment becomes about

making the most of your time and assuring that you

can meet death on your own terms.

What is advance care planning?

Advance care planning is all about making sure that

your wishes are understood and respected. The focus

is on you receiving the best possible care at the end

of your life. Patients with incurable cancer can set up

an advance care plan early on to be prepared to cope

with their condition and the paths it can take.

The advance care planning process starts with

an open and honest discussion with your doctor

about your prognosis—what you may experience

in the coming months—and the medications or

therapies that may give you the best quality of life.

This discussion should include your partner and/or

other family members who love you and are likely to

be with you at the end. It’s important that everyone

understand the goals of your care and your personal

wishes about what should—and should not—be done.

Once you’ve made these decisions, you will fill out

a legal document that lays out what you want done

if you aren’t able to tell the doctors yourself. This

document is called an advance directive.


Thinking about the


74 What is advance care planning?

76 What can I do to cope when time is


77 What is hospice care?

77 Review