<s>[INST] My husband was diagnosed with adenoid cycstic carcinoma 2-1/2 years ago. Had surgery and did about half of his radiation treatments. He was given 2 years. Where they came up with that I will never understand. He is starting to hurt again in his neck and throat area and is having to take more pain medication. He coughs up blood at times. Does this mean that the cancer is spreading rapidly now and that I should start preparing for health aide and hospice? [/INST] Hi, Thanks for writing in. He might be responding adequately to treatment till now and that is the reason he is managing with the disease. Throat pain and occasional bleeding might be due to the cancer. It will be important to make an assessment from his latest CT scan to know the spread of disease. If there is uncontrolled proliferation of the disease then he might require hospice care. Spreading cancer can cause throat pain and unexplained bleeding in cough. Please discuss pain relief with his doctor to keep your husband comfortable. Palliative care might be required for him. Pain relief medicines should be given as per his needs and for the pain he is having. Please do not worry. </s>