Advance care planning: What patients and caregivers should know
February 02, 2026
Medically Reviewed | Last reviewed by Ryan Huey, M.D., and Melanie Cavazos on February 02, 2026
Advance care planning can seem daunting, but it’s a necessary process to make sure that your health care preferences are honored if you become too sick to speak for yourself.
“I define advance care planning as an ongoing process of communication about your goals, values and wishes in terms of your health care decisions,” says senior social work counselor Melanie Cavazos.
She and gastrointestinal medical oncologist Ryan Huey, M.D., spoke about the importance of advance care planning on the Cancerwise podcast. Here’s what they want patients and caregivers to know.
Why advance care planning is important
When you’re diagnosed with cancer or another serious illness, you can be faced with a lot of uncertainty.
Is this curable?
What will my treatment look like?
What if I become too sick to make important decisions?
How do I let my family know how to proceed if my condition worsens?
Advance care planning helps you prepare for these situations.
Most of the time, the first thing people think about when they hear ‘advance care planning’ is advance directive documents, such as medical power of attorney, living will and out-of-hospital do not resuscitate documents.
“In my opinion, the conversation about what’s in those documents is just as important – if not more important – than the documents themselves,” says Cavazos.
Why? Because it gives patients a voice and control during a time when they feel like they lose control in many aspects of their lives.
“There may come a time when you can’t communicate your wishes to your family or care team anymore,” she says. “And if you haven’t had these conversations, your doctors and loved ones have to guess what you want in certain scenarios.”
Advance care planning takes out the guesswork, so your preferences are known and can be implemented.
Featured Podcast:
How to talk to your loved ones about advance care planning
View all Cancerwise podcast episodesWhen should you have conversations about advance care planning?
The earlier you can start having these conversations, the better. And remember: communication should be ongoing. As things change with your health or in your personal life, you can update your advance care plans.
“Certainly, you want to discuss what’s important to you when you receive a new cancer diagnosis, if the cancer gets worse or if you’re hospitalized,” says Huey. “But you don’t have to have a big moment in order for these conversations to be appropriate.”
Advance care planning is for everybody, not just people with a cancer diagnosis, adds Cavazos.
“If you were to get sick suddenly or unexpectedly, what would you want done?” says Huey. “We all like to think that we can be really thoughtful and methodical about decision-making. But sometimes things happen very quickly. So, it’s important to have some hypothetical conversations ahead of time, so everyone is prepared.”
How to start conversations about advance care planning
Cavazos likes to start conversations with patients by asking, ‘Have you done your advance directive documents?’
“That will typically lead to a conversation of, ‘No, you haven’t done them? OK, well, let’s talk about it,’” she says. “That initial question is a gateway for me to be able to have longer conversations with them in which we identify their health care goals.”
What to consider during advance care planning
Here are some questions to ask yourself as you begin your advance care planning:
- Whom do I want to make medical decisions for me if I’m no longer able to?
- Does that person know that I want them to make these decisions?
- If I become really sick, do I want to have life-sustaining treatments performed on me?
- If I’m near the end of life, do I want to spend that time in a hospital or at home?
“Some people have the misconception that advance care planning is talking about how they want to die. But that’s not true,” says Cavazos. “In reality, advance care planning is talking about how you want to live.”
It’s important to account for family dynamics as well. For example, if you have a big family with relatives who live out of town, there might be one person who’s local who typically makes all the decisions.
“It can be challenging getting everybody on the same page, so those conversations tend to be a bit more involved,” says Cavazos. “We want everybody involved, including the patient, their loved ones, doctors, social workers, nurses and APPs. We’re all part of the team.”
Huey agrees.
“The most important thing is we always want the patient to be in charge,” he says. “All of us are here to support you.”
If you’d like to learn more about advance care planning, contact your social work counselor or call Social Work at 713-792-6195.
Request an appointment at MD Anderson online or call 1-877-632-6789.