Dealing with life-threatening illness

Donna’s* oncologist told her there was nothing more medical science could do to stop the spread of her cancer. He added she probably had three months to live. She went home and went to bed to await the inevitable.

Her daughter-in-law, distressed at her rapid descent into depression called the cancer support centre where I worked.

“Is there anything you can do?” she asked.  I suggested she bring her mother-in-law by for a cup of tea. Perhaps it would help just to talk.

I met them both at the door and ushered Donna into a quiet room where we would be undisturbed. She sat bent over and motionless in the chair, contracted with despair, unable to find the strength to meet my eyes.

I dropped to my knees, looked directly up into her eyes and quietly suggested that her oncologist didn’t know when he was going to die, much less when she was and that, at very least, there was a lot she could do to influence the quality of life she could have between now and the time of her death. And, I added, she might even live longer than he had predicted.

It was, for me, a rare departure from professional behaviour.  Health care professionals, for very good reasons, don’t contradict a doctor’s diagnosis. But what subsequently happened to Donna is a good illustration of the alchemy that can occur when the power of the human spirit comes up against even the hard data of medical science.

The depressed 65 year old who was given the prognosis of three months to live, actually lived more than three years longer.  She and her husband travelled, she enjoyed her grandchildren – and she was the first to credit programs like Helping Yourself (created by Princess Margaret Hospital’s Dr. Alastair Cunningham), yoga, and expressive art therapy in turning the tide of her physical decline.

All these years later, I still can’t find a randomized clinical trial that gives definitive proof that psychotherapy and skills such as guided imagery or meditation have a positive effect on survival of people who have been diagnosed with cancer. However, there is no question that these practices can help someone dealing with a serious illness manage pain, difficulty with sleeping, fatigue, or high blood pressure as well as improving concentration and mood, reducing depression and boosting the immune system (see Cancerresearchuk.org).

Still, Donna was not the only cancer patient I have met who credited “inner work” with extending her life.  Another patient, Vicki, was convinced that yoga, meditation and swimming with dolphins in Florida had kept her alive, again for several years past her prognosis. James said it was tai chi and all the love he got at the centre. Millie said it was because she was ornery. In the almost 10 years I was program director at HopeSpring Cancer Support Centre in Waterloo there were many, many more.

Great strides have been made in medical treatments and these days an increasing number of patients are successfully treated by medical science alone. In many cases, support from family, friends, medical, and health care practitioners, such as social workers, is sufficient to help them meet the challenge of a cancer illness and to ensure that they will not face cancer alone. But no matter how much support is available, a person hit with diagnosis of a life-threatening illness ultimately has an enormous amount to come to terms with, especially if, as with Donna, the diagnosis is terminal.

The “end of life” questions raised when we finally get around to considering the fact of our own mortality are difficult enough for a healthy 60-year-old who in today’s society can expect to live another 10, 20 or even 30 years.  But a person facing catastrophic illness is forced to confront the joys, the sorrows, and the regrets of their life, as well as the imminent loss of life itself, in the most immediate way. Already stressed by decisions about treatments, changes in future plans, changes in relationships as loved ones grapple with the diagnosis, and potentially debilitating treatments, the person can experience overwhelming levels of emotional, spiritual and physical discomfort.

There’s an expression in the trade – “nobody likes chronic.”  Caregivers, family members and friends may burn out. Notwithstanding their devotion, there may be times when they just can’t muster the compassion to hear again what they have heard so many times before. Further, their own needs or perspective may get in the way of their being able to “be there” for the person they care about. As time goes on and deeper issues emerge, they may suddenly feel in over their heads.  At the end of life, each of us is called to bring closure to our unique and precious time on earth.  The greatest lesson I have learned in being with people who are dying is that it is never too soon to begin.

Australian nurse Bronnie Ware has written a book called The Top Five Regrets of the Dying in which she shares what she learned during many years of sitting with people in their last 12 weeks of life. Most prevalent among the men was that they wished they hadn’t worked so hard, but all spoke of wishing that they had been true to themselves, that they had had the courage to express their feelings and that they had let themselves be happier.

A skilled practitioner can support the client in healing old wounds:  forgiving themselves and others, making amends when possible, and in deepening self knowledge and awareness of what their unique human life has held. Typically, people are left with both a greater appreciation of the life they have lived and a clearer sense of what is important to them in however many more years they may have.

Nancy Leach is a therapist who supports individuals with chronic or life-threatening illness through counselling, body therapy and meditation. She is the author of The Body Means Well: Empowered Healing.


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