Cancer and Planning Your Medical Treatment

• Mechanical ventilation (a machine helps you breathe)

Where can I find out more about planning my medical future?
For more information about planning my medical future, including suggestions for taking action and a list of resources, visit the Lance Armstrong Foundation.

Why is knowing about planning my medical future important to being affected by cancer?
Planning for your health care future is important to ensure that your desires for your medical care are carried out according to your intentions. Although you may have only limited control over the progress of your disease, with proper planning, you can affect how decisions concerning your medical care will be made after you become unable to do so yourself.

What do I need to know about planning my medical future?
The cancer experience often includes making choices among a variety of complex medical decisions. One such decision is the kind of care you want to have in advanced stages of illness or prior to death. Because it is your life, you should be the ultimate decision maker about whether to continue medical treatment. Most doctors are trained to provide all reasonable life-sustaining treatment.

Throughout their lives, many cancer survivors are able to make decisions about their health care. However, cancer or a new medical condition may leave survivors physically or mentally unable to express their preferences. Because of this possibility, express your desires in advance.

What steps should I take to address planning my medical future?
Preparing a durable power of attorney for health care is the best way to ensure that you receive the medical care that you want. You can specify any type of medical care. Doctors can prolong life in many ways, including with surgery, medicines, respirators, tube feeding, IV fluids and kidney dialysis. The more specific you are, the more likely you will receive the care that you would have chosen.

Give detailed instructions concerning:
• Whether and under what conditions you should receive life-sustaining treatment
• Whether and under what conditions you should have a do not resuscitate (DNR) order
• Whether and under what conditions you should receive pain medication, artificial nutrition and hydration, or surgery
• Your preference for where you want to receive treatments (hospital, hospice or home)
• General language that covers unanticipated events in your health, finances or available medical treatment
• Your agents’ names and addresses

Avoid vague words such as hopeless, extreme and heroic. Be specific when using words such as terminal or irreversible. You may consider your cancer terminal if your doctor tells you that you are unlikely to live for more than two years; your doctor may consider your cancer terminal only when you are within days of death. Specify under what circumstances you would want your doctors to withhold certain care or stop treating you. For example:
• When your doctors agree that treatment would improve neither the quality nor length of your life
• When your doctor believes that you are likely to die within a certain number of days, weeks or months
• When you have exhausted all traditional medical treatment without success
Specify the type of treatment you want. For example:
• Artificial nutrition and hydration (being fed through a tube placed in the stomach, upper intestine or vein)