Cancer and Advance Care Planning – Speaking Up

Categories: Care.

On average, over 500 Canadians are diagnosed with cancer every single day. And while many of those individuals successfully beat this disease, 200 of them will not. The Advance Care Planning in Canada Project, in collaboration with the B.C. Cancer Agency, has developed two important guides to help cancer patients; their families and their health team have important conversations about wishes for end-of-life care.

“We know that cancer is one of the leading causes of death in Canada,” says Louise Hanvey, Project Director for the National Advance Care Planning in Canada Initiative. “We also know that the vast majority of Canadians have not heard of Advance Care Planning, and that over 80% do not have a written plan.”

Advance Care Planning is a process of reflection and communication about personal care preferences in the event that you become incapable of consenting to or refusing treatment or other care. The most important aspects of advance care planning are choosing one or more Substitute Decision Makers – someone who will speak on your behalf and make decisions for you if you are not able to do so yourself – and having a conversation with them about your wishes.

The two guides – one designed for patients and their families and the other designed for oncology professionals – outline steps for initiating conversations about end-of-life wishes, and also introduce terminology to help patients and families better understand treatment options.

Hanvey notes that the guide for oncology professionals is equally important, as research shows that health professionals often do not have these conversations with their patients. “A U.S. multi-site study in 2008 (citation) found that only 37% of patients with advanced cancer report discussion end-of-life care with their physician,” she says. “And a recent Canadian study (the ACCEPT study) of elderly, ill patients in 12 hospitals in Canada revealed that correct patient preferences for end-of-life care showed up in their charts only 30% of the time.”

The National Advance Care Planning in Canada Initiative has several valuable resources to help Canadians communicate their wishes, including a website ( with workbooks, wallet cards and links to provincial / territorial legislation and planning information. There are also tips and videos to help people begin these often-difficult conversations.  

 Ms. Hanvey notes that April, which is Daffodil Month, is the perfect time to release the guides – and for Canadians to have these important conversations. “We need to speak up about the care we want and deserve – with our families and our health care team.”


To download the ACP Cancer Tools, please click here.