Finding out that you are near the end of life

Hearing the news

We all know that death will happen to us one day, but most of us hope it won’t be anytime soon. Learning that you may not have long to live can be a shock – even if you were in some way expecting it. You may already know that the cancer has spread, or you may have been feeling unwell, but hearing that you are dying can be extremely upsetting. It may take a while for the news to sink in.

For some people, being told that the cancer can no longer be cured or treated may feel frightening or seem hard to accept. For others, it may be a kind of relief.

There is no right or wrong way to react. Give yourself time and space to take in what is happening. Reach out to friends or family or seek professional help – especially in the early days. See Support and information or call Cancer Connect on 13 11 20.

You may have lots of questions. Our information may help you understand practical, physical and emotional matters. You could be focused on getting everything sorted and your affairs in order, or you might not want to think about it for a while. You may not take much information in right away, so try to avoid making big decisions in the first day or two after being told if you can.

It’s a hugely shocking thing, but we are all mortal and we all live as if we are not. And that’s one of the hardest things I think; we live as if life will go on forever and we’re so shocked when we find out that it doesn’t.

Susan

How you might feel

Most people have many strong emotions. After the initial shock, it’s common to have feelings of fear, denial, anger, despair, helplessness, anxiety or depression. Your emotions might change, sometimes from day to day or even from hour to hour. This is part of the process of making sense of what is happening.

How you respond to these feelings will vary. You may find it hard to think clearly at times. It’s natural to cry or feel completely overwhelmed; you don’t need to put on a brave face. Other times you may feel quiet and reflective – you may avoid people and not want to talk. You might get a burst of energy or anxiety and start making plans. People often say their fears are stronger when it’s quieter at night.

Some people compare these feelings to waves at the beach. The first wave may knock you off your feet, and then your footing becomes a little stronger. But, at any time, a large wave can suddenly come back and knock you off your feet again. There may also be calm periods between these waves. Your mood may fluctuate up and down.

It may help to talk

You may have your own ways to respond to these emotions. At first you may not feel able to share your feelings, but as you start to process things it may help to talk about them and find a path forward.

You may feel comfortable talking to a trusted family member or friend. Or you could consider seeking professional help through a palliative care specialist or nurse, general practitioner (GP), counsellor, psychologist, psychiatrist or spiritual adviser. Other people in a similar situation can offer a unique perspective, so you may want to join a support group.

Telling people

There is no easy way to start this conversation, but you may find it helps to practise what you are going to say.

• When you feel ready, decide who to tell and what you want to say. Think of answers to possible questions, but only respond if you feel comfortable. You don’t have to share every detail.
• Choose a quiet time and place.
• People react in different ways. They may be uncomfortable or not know what to say. If they get upset, you may end up comforting them, even though you are the one dying. Denial is a common reaction – they may be convinced there’s a cure or that the doctors are wrong.
• If you’d like help telling people, call Cancer Connect on 13 11 20. They can help you find the words that feel right for you. Another option is to ask your doctor or nurse about ways to help you share the news.

For ways to talk to people (including children) about dying, see Emotional and spiritual needs. Learn more about talking to kids about cancer.

Do people who are dying need to be told?

Sometimes family members learn cancer is terminal before the person who is dying. They may think the person is too young, old or sick to be told the truth. They may worry about the health or emotional impact on the person if they know they are dying. People who are dying usually have a sense of what is happening. Trying to keep it a secret may mean they feel alone when they most need support.

Ask the person how much detail they want to know and follow their wishes. Knowing they are dying can give them time to prepare for death. The healthcare team can help you have this conversation. They can also suggest ways to explain the situation if the person has dementia, memory problems or issues understanding.