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The changes that occur in the body are discussed in this section. It can be hard to understand how cancer can cause death. The changes it causes in your body will depend on the type of cancer you have and where it is in the body.
When death is due to cancer it’s normal for someone to gradually get weaker and more tired over several weeks or months. As it’s not possible to accurately predict what will happen, it’s helpful to do important things, such as getting your affairs in order, sooner rather than later. However, as with all other seemingly healthy people, there is a small risk that you may die suddenly.
Most cancers affect the body’s ability to use food to make energy. This can lead to you feeling exhausted and weak. Cancer cells can prevent the body from working normally, and they may cause a change in the chemical balance in the body and sometimes a build-up of waste chemicals.
These changes can make people lose weight, no matter how much they eat. Your appetite will gradually reduce. Your appearance may change, your muscles may waste away and you may also start to look more tired. Once a person stops eating, they usually only live for a couple of weeks.
As you become weaker and less able to do things, just carrying out ordinary daily activities such as getting up can make you feel exhausted. You will gradually feel more and more tired and will need to rest or sleep more during the day.
During this time, it’s common for people to lose interest in things that were previously important to them. It is sometimes as though people need to withdraw their attention from the world in order to prepare for death.
People may need quite a lot of physical help and support during this time as they get weaker and less able to do things. However, a lot of the time they may just want to lie still and have people sitting nearby, without necessarily talking to them.
Occasionally, a dying person stays aware and able to talk right up until very close to the end and can have a meaningful conversation with people around them. However, this is the exception rather than the rule, so it’s important to say all the things that you want to at an early stage.
There usually comes a time when people are not able to get out of bed at all. After needing to sleep and rest a lot, most people move into a phase where they become more and more drowsy and then become unconscious.
Some people may drift in and out of consciousness before becoming unconscious. During this time they may become confused, and not recognise family or friends. They may also hear or see things which are not there (hallucinations). Some may have thoughts or experiences which are like dreams, where they’re not sure what’s real or not. This confusion can be due to chemical changes that are happening in the body and the build-up of waste chemicals (toxins). Sometimes, a person may appear distressed and restless to those around them. If this is the case, a nurse or doctor will be able to give medicines to help them relax. These medicines can be given by injection or by a syringe driver|.
Your feet and hands may feel cold, or your skin may feel very sensitive to any touch. People looking after you may need to be very gentle when moving or touching you.
The drowsiness and sleepiness usually gradually develops into a phase where people become unconscious and can’t respond at all to anything around them. You may seem to be peacefully asleep or you may move, twitch or grimace occasionally as though you are dreaming. Although you won’t be able to respond to the people around you, it’s likely that you will be aware that they are there and able to hear them if they talk to you. This phase may last only a few hours or can continue for a few days.
At this stage, food and drink are not necessary as your body is no longer able to absorb or use them. Moistening your lips or mouth are all that’s needed. When a person who is near the end of their life stops drinking, they usually only live for a few days.
If a person isn’t moving around, the fluid normally produced by their lungs is not able to drain away and may collect in the air passages. This means that when they breathe they make a slight groaning (rattling) noise. Medicines can be given to help with this. Although noisy breathing can be upsetting for the people around, it doesn’t seem to be uncomfortable for the dying person themselves. Breathing may also become irregular, with long gaps between breaths.
For most people, the final moments of life are very peaceful. Usually, you will be deeply unconscious and unaware as your breathing becomes gradually slower and more irregular, before stopping. With some people this seems to take a long time, while for others it happens over a few minutes.
People who have survived a near-death experience tell very different stories about their experience. Although many describe moving towards a bright light and a welcoming environment which they find hard to resist, others describe sinking or floating into nothingness.
Many people feel that they don’t know exactly what will happen to their mind after their death. Some people feel that their soul or consciousness will live on (perhaps in a new form) or go to another place. Other people feel that once they have died that is the end and their mind just stops.
It can be difficult to pinpoint the exact moment of death. Often the person’s body will relax completely and their face will look very peaceful. Many people say that they can sense when the person’s consciousness has gone from the body.
In some cultures and religions, it’s believed that the person’s mind (consciousness) stays around the body for some time after death. In other cultures and religions it is thought that the consciousness moves on to another place quickly. Some people believe that once the person has died there is nothing left of their mind (consciousness).
If you have a faith where the moments leading up to death and the actual moment of death are important for your future, it’s important that the people who are looking after you are aware of your needs. Let them know beforehand if you need special practices to be done or if you don’t want to be touched or moved for some time before or after death.
The staff in hospital or hospices will try to find out what is appropriate for people of different cultures in their final hours. However, it may be easier if you or your family make the staff aware of your needs. This will allow them to make arrangements for your spiritual or religious adviser to visit, if you feel that this is helpful, and to make sure that your body is treated in the appropriate way after death.
This list of questions can help you think about how and where you would like to die|, so that you can talk it through with your relatives and friends, and feel confident that you’ll be cared for in the way that you wish.
Content last reviewed: 1 February 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
We have a booklet aimed at people who want to be looked after at home at the end of their life, explaining the physical and emotional changes that may take place during their last weeks and days. You can order a copy from our be.Macmillan website.
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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