Patient Education

How does one survive middle to advanced-stage cancer? If that thought has ever occurred to you, we’re here to help. Whether you're awaiting a prognosis, have recently been diagnosed with middle to advanced-stage cancer or are going through cancer treatment, let's take a look at ways to handle your journey. Let's be honest no one is ever mentally prepared for such a diagnosis and that's where we will begin.

Is Stage 4 Cancer Always Terminal?

Middle or advanced stages of cancer, often referred to as stage 3 or stage 4, indicate that cancer has spread significantly within the body, potentially to lymph nodes or other organs.

While stage 4 cancer is serious and often referred to as terminal, this does not mean it is always immediately life-ending. Advances in treatment that allow for less invasive procedures, as well as treatments that target cancer cells with more precision, have improved outcomes and, in some cases, can extend life significantly.

• CAR T-cell Therapy: This approach engineers a patient's T-cells (immune system cells) to recognise and attack their specific cancer cells. It has shown more positive results, particularly in some types of leukemia and lymphomas, by improving survival rates and, in some cases, helping to achieve about long-term remission.
• Tyrosine Kinase Inhibitors (TKIs): These drugs block specific proteins, known as tyrosine kinases, which are involved in the growth and spread of cancer cells. TKIs have been successful in treating several types of cancer, including chronic myeloid leukemia and certain lung cancers, by targeting cancer cells more precision and with potentially fewer side effects.
• Minimally Invasive Procedures: Techniques such as laparoscopic surgery allow for the removal of tumors with less damage to surrounding tissues. This approach aims to reduce recovery time and complications, making it a vital option for managing certain cancers even in advanced stages.

But can advanced cancer be cured? While the prognosis for middle to advanced-stage cancer can be daunting, the survival rate varies widely depending on the type of cancer and the extent of its spread.

* Numbers may vary.

Often, metastatic cancer isn't curable. In most cases, treatment of stage IV cancer is aimed at tumour growth control, prolonging survival and improving quality of life. Nowadays, with good medical care and treatment advances, it is possible to live in complete remission for 5 years or more.

How Long Can You Live With Advanced Stage Cancer?

With the survival rates of stage 4 cancer as they are, estimating how much time you have will depend heavily on individual factors. Factors such as the type of cancer, the extent of spread, the patient's overall health, and response to treatment all play critical roles. While some may live for many years with quality care, others may have more limited time.

Coping With The News of an Advanced Stage Cancer Diagnosis

Cancer can invoke a wide range of feelings that you're not used to dealing with and this may affect your mental and emotional health. Consequently, your feelings may be amplified and they may fluctuate on a regular basis. Another reality you will also have to deal with is being mentally and financially prepared to make lifestyle and financial changes during treatment as stage 4 cancer treatment costs in Singapore can be hefty.

Some feel they have to be strong and protect their friends and families as they are affected by the news too. Others seek support and turn to loved ones or other survivors of cancer for guidance in coping with it. Some may ask for help from other professionals and counsellors while others turn to their faith to help them cope. Whatever you do, it is important to do what's right for you and not to compare your situation with others.

Ways To Cope With Your Emotions

• Express your feelings; even if you prefer not to discuss them, you can still convey them by penning your thoughts.
• Think positively; focus on getting well and what you can do to stay as healthy as possible.
• Never blame yourself; a cancer diagnosis can happen to anyone.
• Decide when to talk about your cancer only when you are ready. Your loved ones may mean well but it might be difficult for some of them to know how to act or what to say. You can also ask them how they feel or what they think.
• Find ways to relax; choose an activity such as meditation, relaxation exercises, etc.
• Be as active as you can manage; get out of your home and do something to help occupy your mind.
• Do things you enjoy; a hobby such as photography, cooking, gardening, or watching a movie.
• Look at what you can control; for some, putting their lives in order helps or setting a daily schedule can provide a sense of control.

Family And Care Arrangement

Cancer will change the lives of both the newly diagnosed and the ones dear to them. Routines may need to be adjusted, responsibilities may need to be tweaked and roles and duties may change. Additionally, financial issues may arise, you may need to live with someone else or need assistance with errands and chores. Most people find if they and their loved ones talk about cancer and how it makes them feel, they feel closer to one another.

There may also be changes to roles in the family. For example, a child may be asked to do more chores or a spouse or partner might need to do the shopping or run errands instead. Adjusting to the new situation is tough and requires time to get used to.

Work Continuity

Nearly half of Singaporeans feel they are not financially prepared to handle a cancer diagnosis, according to a study published in Jan 2024. This means many patients might need continue working to support their treatment adequately. Suitable work arrangements and work retention throughout cancer treatment and post-cancer treatment have to be discussed with your current employer. While cancer is a very personal topic to discuss with your employer, it is important to find out the available options that can work for you, so that you can decide if work should continue after your diagnosis.

Planning For Time Spent With Family And Friends

While it is easy for you to become occupied with cancer treatment and everything else that comes along with it, keep in mind the importance of time that needs to be spent with friends and family. They are your primary circle of support for you to rely on. Many may be willing to spend time with you, help you through your journey, and be there for you in any way they can.

Will Planning

You may have drawn up wills previously but may need to relook at them given the current situation. Determine if there are any changes to be made and give yourself ample time to think through and make the necessary changes.

Change in Priority

You might need to accept the fact that you may not be able to function according to the kind of pace or lifestyle you used to have prior to your cancer treatment. This is where working out your priorities is important. As you discover your priorities, you’ll know where and when to focus your effort and time.

Planning for Loss of Income

Cancer treatments and the lifestyle and employment changes that come with it may cause a strain on your finances due to cancer treatment costs here in Singapore. You can mitigate this by doing some up-to-date financial planning and knowing your options to pay for such cancer treatments.

Costs Associated With Middle To Advanced Stage Cancer Treatments

Some factors to consider in terms of costs include length, type and complexity of treatment, biopsies, and surgeries if required.

Coping With The Cost Of Cancer Treatments

For patients with as-charged insurance plans, you can get cancer treatment and care at private hospitals and private cancer specialist clinics like OncoCare.

Integrated shield plans can also go a long way to offset the costs of cancer treatments and it’s useful to know how it works. Integrated shield plans typically cover the bills for cancer treatment in Singapore, such as biopsies, chemotherapy, and surgery. With changes in the IP MediShield Plan from April 2021, the co-pay component with insurance riders for patients of private clinics like OncoCare will be minimal as OncoCare doctors are panel specialists for all seven IP local insurers.

Financial planning is key to determining your lifestyle while coping with cancer and after your recovery. Our specialist team at OncoCare is well-versed in personalised cancer treatments, covering costs for various cancers, giving you access to breast cancer doctor and treatment of cervical cancer among many others. Find out more about the many insurance policies that cover cancer treatments offered at OncoCare.

“Expert knowledge means better care for cancer”

Written by:
Dr Wong Nan Soon
MBBS (Singapore)
M.Med (Singapore)
MRCP (United Kingdom)
FAMS (Medical Oncology)
MHsc (Duke, USA)