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No one can be sure how long you will live and your doctors or nurses may be reluctant to give you a timescale. This uncertainty can be difficult to cope with.
Even if one of your doctors has suggested that you may have six months to live, perhaps because you asked them directly, it’s important to remember that this is just an estimate. You may live longer, or unfortunately, you may live for less time than this.
Even with modern scans and x-rays, it’s sometimes difficult to tell exactly what effect the cancer is having on your body. This makes it very difficult for your doctors or nurses to predict exactly when you are nearing the end of your life. However, there are some physical changes that can happen to the body that may indicate when someone is nearing the final days or hours of life. These changes are explained in more detail in our section called At the end of life|.
You will probably have good days when you feel well and positive about life and bad days when your energy reserves are lower. It’s important to plan for this and appreciate the days you feel well.
As you become more unwell you’ll find that you get weaker and feel more tired. You may gradually feel less able to do things and may also have less interest in doing activities that you enjoyed before. Your need for company and activity may vary from day to day.
You may sleep more and more during the day. Gradually you may lose strength and as this happens you may only want your partner or closest family members around you. Towards the very end of life you may feel your attention withdrawing even from them. 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’s usually possible to arrange this.
Although death is the final loss, other ‘losses’ happen gradually throughout a terminal illness. These can include stopping work, not being able to move around so easily and stopping driving. Although this slow process can be helpful in allowing you to get used to the idea of death, it can also make you feel sad and very low. A dying person often needs to spend time grieving for the things which are lost. This is a natural part of the process of dying.
There is no ‘right’ way to die and no ‘right’ way to cope with the knowledge that you, a relative or a friend, is dying. You can only cope in the way that is best for you. It’s up to each person to come to terms with death in their own way, at their own pace. Many people eventually find a sense of peace and appear to be ready to ‘let go’ when the time comes.
It’s natural to cry during this time and you don’t have to put on a brave face. Being open about your own feelings will make it easier for both you and the people you love to be able to say the things you want to.
If you find that you need to talk about how you feel, but find it difficult to talk to the people closest to you, perhaps because they are too upset, talking to a trusted friend may help. You may also find it helpful to talk to your district nurse or a palliative care nurse if you have one. They will always try to answer your questions and talk openly with you about dying. They can also tell you about counsellors or other people who you can talk to.
Many people find that when they are told they won’t recover from their cancer, they start thinking about all the things they still want to do. It’s important to go ahead and do the things you can while you are fit enough to enjoy them.
There may also be unfinished business that you need to sort out. As well as dealing with practical and financial affairs, you may find that there are emotional loose ends that you want to tie up - for example, old friends you want to see or wrongs you want to put right.
If you would like to settle old quarrels, you could try writing to or ringing the person, explaining your illness and asking them to visit or get in touch. This sort of openness can often heal old hurts and you’ll probably find you feel more at peace.
You may find yourself thinking a lot about the past, talking about shared joys, fears and regrets, going over old events in your mind or looking through photo albums. If you’re 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 will no longer be there.
You may like to write letters to people who are dear to you, or perhaps record a tape or video, to be given to them after your death. Some people like to write down their family history for the next generation or to put together a scrapbook for their children or grandchildren.
Memory boxes can also be very special mementos for loved ones. They can include messages and letters, a piece of jewellery, photographs, or a present to mark a special birthday. If the memory box is for a child, they may want to help with making it and filling it with special items.
We have more information about creating memory boxes|, which you may find helpful.
These are sad and perhaps difficult things to do, but they can also be satisfying as they give you a chance to reflect on the things that have happened to you, both good and bad. They may even make you laugh and have light-hearted memories. The important thing is to do what feels right for you, when it feels right.
Many people find that they become more aware of religious beliefs or spiritual feelings during this time. People with a strong religious faith often find this very supportive during illness. Other people may start to question their faith. Some may find that, perhaps for the first time in their lives, they feel the need to think about and discuss religious or spiritual issues. Spiritual issues cover the meaning of life and relationships with others and can be expressed in many ways, including through music, arts, nature, community, or family.
You may start thinking about whether there is a life after death. Some people find comfort in prayer or meditation. Many people gain a lot of support from knowing that other people are praying for them.
Some religions have very specific practices for when people are very ill or dying. If you want to follow a specific practice in a hospital or hospice, it’s helpful to discuss this with the staff. They will be able to help find the space and time for you to do this.
Don’t be put off talking to a chaplain, minister, priest, rabbi or other religious leader just because you have not attended services regularly in the past, or because you’re not sure about what you believe. Spiritual and religious leaders are used to dealing with uncertainty and with people who are distressed, and they may be able to help you find peace of mind.
You might find it helpful to watch our videos of Amanda's story of advanced cancer|, or Tracy's experiences of hospices|.
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)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
Our cancer information team have written a blog about approaching the end of life. Team member Debbie talks about her own experiences, and discusses sensitive topics such as choosing where to die and making advance decisions about your care.
If you have any questions about Macmillan we would love to hear from you| .
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© Macmillan Cancer Support 2013
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