That’s a tough place to be. My husband has prostate cancer that’s metastasized to his bones. He’s made it very clear that he doesn’t want conventional chemo & I respect that decision. The effect on quality of life would be significant. For 13 years the cancer was held back by radiation, injections, and oral chemo meds. They have stopped working. He has had palliative radiation (will not do that again) & is currently getting monthly bone strengthening infusions (which he is tolerating very well). These last 2 treatments are just to try & reduce the tumors a bit & lower risk of painful bone fractures. They will not lengthen his life by much but should improve quality of life by keeping him out of a skilled nursing facility & contentedly living at home. Talk with your wife if she is still able to communicate. Discuss what is important to both of you - longevity vs quality of life. Ask her care team about the specific side effects & consider her ability to cope with them mentally & emotionally (not just physically). How would treatment affect your ability to care for her? Then make a decision that is right based on your lives & the goals you still share.