Advance Care Planning for People With Breast Cancer
No matter your stage of breast cancer, it’s a good idea to let the people around you know what you want to happen in case of a medical emergency. You can do this through advance care planning.
Advance care planning is a way to talk about — and document — your healthcare wishes if you’re not able to make decisions yourself. It also helps ensure those wishes are honored.
Since advance care planning often involves thinking through difficult decisions in an emergency or at the end of your life, it can be an unpleasant task. But many people prefer to get these conversations and choices out of the way early, and often feel relieved after completing advance care planning. After all, making your wishes known — and knowing that they’ll be honored should anything happen to you – allows you to not think about it anymore.
What is advance care planning?
Advance care planning is a way to think through and document your wishes for future medical care if an injury or illness leaves you unable to make decisions.
Advance care planning is focused on your goals and values. Since you can’t predict what treatment you’ll want in every possible scenario, you’ll document your goals and values around treatment and quality of life. These will guide your family to make healthcare decisions for you. For example, some people may want the most aggressive treatment possible in a hospital, while others would prefer to avoid invasive treatments and to focus on comfort and staying at home.
Communicating your goals and values is key to making sure you get the type of care you want. It’s important to talk with your family so they understand your wishes. But it can be helpful to fill out a legal form called an advance care directive to clearly lay out your preferences and state who should be responsible for communicating them.
Advance directives
Advance directives are legal documents that lay out your medical wishes. The forms you need to fill out may vary by state.
Advance directives are commonly made up of two forms:
A durable medical power of attorney: This is the person you name to make health care choices for you if you’re not able to. They are sometimes called a “health care agent” or “health care proxy.”
A living will: This gives your medical power of attorney and health care provider details on what type of care you want.
A living will details what type of medical care you want in the future. You can name common treatments you may want — and those you definitely do not want. You can also say under which conditions you want certain types of treatments. For instance, you may want CPR, a breathing tube, or a feeding tube if your brain is likely to be functional after treatment, but not if you’re likely to have debilitating brain damage. Unlike a will, a living will is not about finances, assets, or preferences for funeral services.
A living will is legally recognized, but not legally binding. Your healthcare providers will do their best to respect it. However, they may not always follow it exactly — for example, if it goes against accepted standards of care or the institution’s policy.
A durable power of attorney for healthcare designates the person you want to make healthcare choices for you if you’re unable to do so yourself. If you don’t have one in place, state law decides who that person is. Typically, your spouse is the first option, followed by your parents, then your adult children.
Who should do advance care planning?
All adults should do advanced care planning — not just people who are sick or have breast cancer. Accidents happen, and it’s wise to be prepared.
Of course, advance care planning is especially important for adults who are older or have a serious illness, like breast cancer. In addition to the many benefits, having an advance care directive is also important if there’s someone in your life whom you do not want to make decisions about your healthcare.
How to get started with advance care planning
To get started, talk to your primary care provider, your cancer team, or your cancer center’s palliative care team. Although coverage varies by state and by policy, advance care planning is usually covered by Medicare, Medicaid, and private insurance plans.
Before beginning the conversation, ask yourself the following questions about what you want at the end of your life or in case of a medical emergency:
Who do you want to make medical and financial decisions for you if you’re unable to? The person whose judgment you trust in these situations may not be the same as the person you’re closest to.
What kinds of care do you want — or not want?
What do you want the last few weeks of your life to look like — where are you and who is with you? What is most important to your quality of life?
Do you want invasive treatments if your health has declined and is not expected to improve?
When you’re ready to fill out your advance directive, you can get the forms from the social worker at your cancer center, or by contacting your state attorney general’s office or your local Area Agency on Aging.
After making your advance care plans, update them about once a year and after big life events, such as marriage or retirement. It may be helpful to remember that National Healthcare Decisions Day — an initiative to encourage people to fill out or revise their plans every year — is on April 16, the day after tax day.
Make sure both your healthcare proxy and your medical provider have a copy of your advance directive.
In addition to your state’s forms for a living will and healthcare agent, you may also want to consider some additional forms. Unlike an advance directive, the forms below are medical orders, and healthcare providers are legally required to follow them. Emergency technicians, for example, must follow a medical order but not necessarily an advance directive.
Do not resuscitate (DNR) order: You do not want CPR if you stop breathing or your heart stops beating. You may need both an in-hospital and out-of-hospital DNR order.
Do not intubate (DNI) order: You do not want a breathing tube to help you breathe. (You may still receive other treatments, like oxygen therapy.)
Do not hospitalize (DNH) order: You do not want to be brought to the hospital. You can name exceptions, like for injuries or to get help with pain. This type of order is most often used by people who live in nursing homes.
Physician orders for life-sustaining treatment (POLST): This describes what you want medical providers to do and not do in the case of a life-threatening emergency. It may contain orders like a DNR, but is more comprehensive. A POLST – which, depending on your state, may be called a MOLST or MOST — is only for people who have a serious illness, such as advanced breast cancer.
Where can I get help with advance care planning?
Advance care planning is something everyone should do. But it can be confusing and hard to think about it. Luckily, there are many resources out there that can help.
PREPARE for Your Care: This interactive online program walks you through each step of advance care planning. It’s available in English and Spanish.
The Conversation Project: A series of online conversation guides and advance care documents available in English, Spanish, and Chinese.
The Hello Game: A game available for purchase that guides families through conversations about advance care planning.
Triage Cancer’s Quick Guide to Advance Health Care Directives: More information about how to make advance care planning decisions.
This content is made possible by Gilead.
— Last updated on August 15, 2025 at 9:04 PM