Despite everyone’s best efforts, cancer may spread or come back after a remission, making a cure no longer possible. When cancer reaches this stage, it may be referred to as advanced, terminal, or end-stage cancer. There are steps you can take to prepare you and your loved ones for your final days.
If you are living with advanced cancer and cure is unlikely, you may feel anger, fear, grief, and regret. It’s normal to grieve the decline of your strength, mobility, and independence. You may feel robbed of the personal time that the illness and treatments consume and the threat to your life. You may be grieving the prospect of leaving loved ones. Many people find that talking about their feelings and concerns with family, friends, and caregivers provides comfort. Learn more about grief and loss.
Putting legal, financial, and personal affairs in order
Although talking about dying is sad, it is wise to settle your affairs. Consider what you want your care to look like during the last days of life. And, share your wishes with your family and health care team. It helps to start early, even if you change your goals and plans as your situation or preferences change.
Completing your affairs may include finding and organizing important legal and financial documents. These include your will, marriage and birth certificates, social security card, insurance policies, bank statements, investment summaries, and account passwords. If you have complicated finances or are concerned about leaving your family with high medical bills or debts, consider talking with a financial advisor or social worker. They can help you organize your finances and create a plan to lessen the stress for you and your family. Planning to settle legal, financial, and business affairs allows you and your family to spend more quality time with each other.
It is also very important to create (or update) your advance directives. Preparing these well ahead of time and talking about them with your family ensures they understand your wishes.
There are two kinds of advance directives:
A durable health care power of attorney is a person you select to make health care decisions for you if you are unable to do so. This person may also be called a health care proxy, agent, or surrogate. Appointing someone you trust and letting that person know you have given them this responsibility are important steps to take.
A living will is a document that lists the type of medical treatments you do or do not want at the end of life.
Some people also find it helpful to plan some aspects of their own funeral or memorial service. Create a set of written instructions or discuss your wishes with your family or close friends.
Accomplishing unfinished goals
As you approach the end of your life, you may wish to accomplish certain things in the time you have left. These tasks help bring a sense of meaning and completion to your life. They may include fulfilling a dream to travel somewhere or reconnecting with a friend or relative. Or, you may want to have simpler meaningful experiences. You may choose to reread a favorite book or spend time with people who are important to you.
Another step to bring closure is finding peace in important relationships. This may involve resolving conflicts, saying goodbye to special people, and telling family members how much you love them. If you cannot talk in person, consider writing, calling, or sending a message through a family member. But keep in mind that, despite your best efforts, people may not respond the way you want. Some people may not feel comfortable visiting you at this time, or they may fear saying the wrong thing. You should feel comforted knowing that you have done your best to heal a troubled relationship.
Reviewing your life
Consider taking time to reflect on and celebrate your life. This could include the things you have accomplished, the people you have loved, and the events and loved ones that have shaped you. Talk with your family and friends about the events and special times you have spent together. You will be honoring the life you shared and creating new memories for them to cherish.
Stories can become gifts to the people you will leave behind. As you review your life, you may want to write or record your memories or ask someone to write for you as you talk. Sharing your wishes and dreams for loved ones helps ease your regrets about leaving them. It also helps them feel connected to you at important times in their lives. For young children, you may leave videos and albums that remind them of your love and connection.
Religion and spirituality
For some patients, organized religion is a central part of life. And the support of faith and clergy members is a major source of comfort at the end of life. Others may find spiritual comfort in connections to nature or people. As you prepare for the end of life, seek spiritual experiences that bring a sense of comfort, meaning, completion, and peace. Studies show that patients who feel spiritually supported have a better quality of life. Patients and their families should feel comfortable asking members of the cancer care team for help finding spiritual support.
National Cancer Institute: Coping with Advanced Cancer
Jewish Healthcare Foundation: Closure.org