If your blood cancer does not respond (or is resistant) to treatment, it is known as ‘refractory cancer’. When cancer is refractory, it may not respond to treatment at the beginning of therapy, or it may respond to treatment initially but become resistant to treatment over time. If your blood cancer is refractory to a particular therapy, your specialist will explore other therapies, or salvage therapies, that may treat your cancer better.

For many blood cancers, there are a number of known therapies that can help to treat a person’s disease. These treatments may differ in intensity, how they are delivered, their side-effects, and the mode of action in treating the disease. Your doctor will consider each of these when deciding which subsequent treatments to offer you. Some of the newer treatments may be available only on clinical trials.

We know, from research, that there are people who will respond to various treatments, and others who won’t. It is not always understood why this is the case. Now, many researchers are looking at the genetic makeup of various cancers, and at patterns in the genes of people who responded to treatment, such as specific mutations, and those who did not respond.

Using this information, researchers will soon be able to help clinicians make informed decisions on the best therapies for each individual patient across a number of blood cancers. We are still in the early stages of this process, but progress is being made and for some cancers, this information is already available.

People may experience a range of emotions such as shock, disbelief, anger or fear when told their cancer is refractory. It is normal to have these feelings and to be very apprehensive about what the future holds. In some cases, people may experience more intense emotions than when they were first diagnosed and may worry about how they will cope with further treatment. Heightened emotions are also common among their family members.

Everybody wishes to be among those for whom the first treatment offered works and they go into remission. It is very disappointing when this does not happen and further treatments are required. Often, but not always, these treatments are more intense than the original therapy.

For some people, having a blood cancer that did not respond to the original therapy may heighten feelings about their mortality, and some people have increased fear as they perceive that they now have reduced treatment options in their search for a cure. For some, acknowledging this fear and moving on with the options they have ahead is achievable. For others, this fear can greatly affect their quality of life and sense of wellbeing.

For some people, there are no treatments that are known to treat their cancer after they have tried all known options. Palliative care specialists are experts who can help you in many ways to support you through this time. They can help provide support emotionally, physically and spiritually. Accessing palliative care is not the same as ‘giving up’. It is accessing specialists who can help you at a time that can be difficult for you and your family. It’s a time in life that many of us are not prepared for and we have not had the experience to deal with the complex nature of being in this situation.

If you experience strong feelings that are long-lasting and are affecting your daily functioning, or if your feelings seem to be growing in intensity, please advise your medical team and/or contact the Leukaemia Foundation for assistance.