Cancer: end of life care

Around 50% of people diagnosed with cancer live for more than five years after their diagnosis. Even so, roughly a quarter of the population of the UK will die from cancer. There isn't any universal advice on how to come to terms with a life-threatening illness, but having a positive attitude towards the time you have left, whether it's a month, a year or longer, can really affect your quality of life.

Each person will deal with their situation in their own way. Some people take on high-profile activities and challenges For example, Jane Tomlinson raised money for charity through long-distance running after she was diagnosed with terminal breast cancer. Other people prefer to spend their time quietly with family, friends or alone.

A terminal diagnosis is an overwhelming shock for most people and their families. Even if you're surrounded by people who care about you, you may find it difficult to cope.

Where to get support

• Cancer charities. Organisations such as Macmillan Cancer Support have cancer helplines. Specialist cancer nurses provide information about cancer, its treatments, practical advice and support. Call Macmillan free on 0808 808 0000. 
• Therapy services. Depending on where you live, you may have access to free therapy. A health professional, such as your GP, cancer specialist or healthcare worker, can refer you for therapy. If you live in London, you could be referred to the Nafsiyat Intercultural Therapy Centre, an organisation that specialises in therapy for people from ethnic minorities. The Cancer Counselling Trust offers free telephone counselling to anyone affected by cancer, wherever they live. Your doctor or cancer specialist may be able to recommend a suitable therapist. To find a therapist in your area, go to the British Association for Counselling & Psychotherapy website.
• Hospices. These can offer treatment of physical symptoms, psychological and spiritual support, and bereavement care. They can also provide a wide range of other services, including complementary therapies such as acupuncture or massage, art and music therapy and beauty treatments. They can care for people in a hospice building, care home or at home. Their services are usually free.
• Self-help groups. Ashley Riley, spokesperson for end-of-life charity Dignity in Dying, says: "We advise our members to join a local self-help group. These groups unite people in similar situations who can share experiences and offer support to one another. It's often helpful to speak to people outside the family who are going through the same experience as you." To find a self-help group in your area, visit the Macmillan Cancer Support website.

Practical considerations 
You may want to think about putting your affairs in order. "More and more people are planning how they want to be buried and taking care of their finances, because they don't want their families to be burdened with it after they've gone," says Stuart Danskin, senior cancer information nurse at Macmillan.

• Making a will could be the most positive thing you can do for your family. Anyone who's dependent on you could face financial difficulties if you die intestate (without making a will). The best way to make a will is through a solicitor, which helps prevent any legal problems arising later on.
• Some people have clear views on their treatment or care. The Mental Capacity Act gives you several ways to prepare for the future, either by setting out certain decisions in advance or by letting people know what you'd like to happen if you lose the capacity to make decisions.    
• You can also write down or tell people your wishes and preferences for your future treatment or care. This is not legally binding in the same way as advance decisions (often compared with living wills, which are made by people before they are unable to make those decisions), but health professionals must take them into account when considering your treatment. These preferences can be about anything, including treatment, things that are important to you such as dietary preferences if you're a vegetarian, or personal preferences such as wanting to sleep with the light on.
• You can appoint someone to make decisions for you in the future, and one or more attorneys to make decisions about financial matters or about your health and personal welfare, or both. Find out more from the Office of the Public Guardian.

Getting financial help
Macmillan offers advice on help with prescription costs, travel to hospital, childcare and many things people do not immediately think of. Call Macmillan free on 0808 808 0000.

More information
For more information on end of life care, including sources of support, making the most of the time you have, your rights and choices, bereavement, pain relief and where you can die, see End of life care.