Facing an uncertain future

No one can predict how long you will live. Even if one of your doctors has told you that you have 6 months to live, (perhaps because you asked him or her directly), you need to remember that this is just an estimate, and that you may live longer, or unfortunately you may have less time than this. Even with modern scans and x-rays it is often difficult to tell exactly what effect the cancer is having on your body. This makes it very difficult for your doctors to predict when you are nearing the end of life.

You may find your need for company and activity varies from day to day. Some people find they gradually need fewer people around them. As your energy fades, you may only want your partner or closest family members around you. On the other hand, you may be scared to be alone and want someone with you all the time. Even if you are in a hospital or hospice it is usually possible to arrange this.

There is no 'right' way to die and no 'right' way to cope with the knowledge that you or a partner or friend is dying - only what is right for you. It is up to each person to try to come to terms with approaching death in their own way, at their own pace. Many people do eventually find a sense of peace and appear to be ready to 'let go' when the time comes. Tears are very natural and you don't have to put on a brave face. If you disguise your feelings, you and the people you love do not get an opportunity to say what is in your hearts.

Although death is the final loss, where you finally lose contact with all your family and friends, other losses happen slowly throughout your terminal illness, such as stopping work and stopping driving. Although this slow process may help in allowing you to get used to the idea of death and gradually disentangle yourself from life and commitments, it can also make you very sad and depressed. Although we have very supportive services for relatives who are bereaved, we often forget that the dying person also needs to spend time grieving for the things which are lost.

If you find that you need to talk about how you feel, and you find it difficult to talk to those closest to you (perhaps because they are too upset), talking to a trusted friend or a counsellor may help.

Spiritual and religious comfort

Many people find that they become more aware of religious beliefs or spiritual feelings during this time. People with strong religious faith are often greatly sustained during illness. Others start to question a lifetime faith. Others again may find that, perhaps for the first time in their lives, they need to think about and discuss spiritual issues. You may start thinking about whether there is a life after death. You may find comfort in prayer or meditation. Many people gain a great deal of support from knowing that other people are praying for them.

Don't be put off talking to a chaplain, minister, priest, rabbi or other religious leader just because you have not attended services regularly, or because you are unsure about what you believe. They are used to dealing with uncertainty and with people who are distressed, and may be able to help you find peace of mind.

Unfinished business

Many people find that when they are told that they will not recover from their cancer, they are overcome by thoughts of all the things they still want to do and unfinished business which they need to sort out. The most important advice at this stage is to go ahead and do all the things which you are fit enough to enjoy. This is not a time for delaying - if you really want to do something, then do it and enjoy it now!

In addition to dealing with your practical and financial affairs, you may find that there are also emotional loose ends you want to tie up - for example old friends you want to see, wrongs you want to put right. If you would like to settle old quarrels, you could try writing or telephoning the person and explaining about your illness and asking them to visit or get in touch. Approached with this openness, old hurts can often be healed, and you can end up feeling much more peaceful.

You may find yourself thinking a lot about the past, talking about shared joys, fears and regrets, and going over old events in your mind or through photo albums. If you feel well enough, you may want to visit places again, such as somewhere you used to live. You may also find yourself thinking about the future, and grieving for a time when you are no longer there. You may like to write letters to people who are dear to you, or perhaps prepare a tape, to be given to them after your death. Some people like to write down some of their family history for the next generation or to prepare a scrapbook for their children or grandchildren, perhaps getting the children to help.

These are sad tasks but they can also be satisfying as they give you an opportunity to reflect on the kinds of things that have happened to you, both good and bad. They may even result in some laughter and light-hearted memories. The important thing is to do what feels right for you, when it feels right. This may even be ignoring or completely shutting out your impending death until you can do so no longer.