How do doctors know when a person with cancer is about to die?
Im caring for a friend 72 year old man with advanced prostrate cancer I was told today he only has weeks or months at the most to live . He has tumors throughout his body. How do Doctors know when a perso is about to die?
Doctors do not know for sure when someone will die. We have no crystal balls. From our experiences, we can have some idea and so the "weeks to months" which gives a general idea without being specific. There are many patients who will say that "my doctor said I had (some amount of time) to live and I am long past that. The purpose of the doctor's statement is not to be exact but instead to prepare the patient and family to think about what needs to be done in the time left (however much there is); a will, advanced directives, important conversations and other things that the patient may wish to do. These are crucial activities at the end of life and it is important to think about and do them while there is time to act.
Your friend's doctor has given him, and you, a gift - an opportunity to turn from a pursuit of aggressive, expensive, often painful, but clearly futile care, toward the pursuit of the best that life has to offer in the time that your friend has left. Many doctors are reluctant to share the news that they have run out of viable options for treating a progressive disease. People who are very ill often know they're dying long before doctors or family members are willing to acknowledge it. Loved ones beg for just "one more medicine to try," and often patients go along just to avoid causing their loved ones any more distress, even when they suffer from these futile attempts.
But now, with this gift of truth that your friend's doctor has given him, together you two can focus on making the most of every moment! In fact, it's very common for people who discontinue treatment to actually feel better for awhile, because they aren't taking so many medications, and the stress of having to "fight" so hard is relieved.
Now is a great time for your friend to enroll in hospice. Hospice care will help keep him as physically, emotionally, and spiritually as comfortable as humanly possible. The nurses, social workers, chaplains, and ancillary care staff will work with him and you to make the very most of every day. Studies show that the earlier people enroll in hospice care, the greater the benefit. For many, survival time actually increases beyond what would be expected for their disease.
Making the adjustment to discontinuing treatment is emotionally difficult for some patients and for most loved ones. I hope that you and your friend have an opportunity to talk about what this means for both of you. Spend this precious time seeking fun and adventure as his condition allows, and treasure every moment.
Bonnie Crawford, MSW Clinical Director My Health Care Partner, LLC
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