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Is Cancer the 'Best Death'?

What I can remember about my mother's death from breast cancer certainly does not reflect Dr. Smith's romantic view of dying.
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When the cancer community read the British Medical Journal (BMJ) blog post "Cancer is the best death," written by Richard Smith, a doctor and former BMJ editor, it's not surprising that it was met with a negative response.

So death from cancer is the best, the closest to the death that [Luis] Buñuel wanted and had. You can say goodbye, reflect on your life, leave last messages, perhaps visit special places for a last time, listen to favourite pieces of music, read loved poems, and prepare, according to your beliefs, to meet your maker or enjoy eternal oblivion.

This is, I recognise, a romantic view of dying, but it is achievable with love, morphine, and whisky.

When I first read that, my jaw dropped. Did he describe dying of cancer, or was he paraphrasing a Nicholas Sparks novel he just read?

What I can remember about my mother's death from breast cancer certainly does not reflect Dr. Smith's romantic view of dying. My mother spent a lot of time in treatment, or at church or with her family, trying to get in as much time in with her young children that she could. She didn't go on some soul-searching journey or adventure to cross off all those items on her bucket list. She was in treatment for metastatic breast cancer and at the end, she died in a hospital, surrounded by her loved ones. My mom only lived six months after she was diagnosed with Stage 4 breast cancer. She didn't have time to visit any special places, unless you count doctors' office and hospitals as special places.

Janet Freeman-Daily, a metastatic lung cancer patient who writes at Gray Connections, responded (please read the entire blog):

The reality is that death from cancer often does not conform to Smith's vision. Death by cancer happens when tumors cut off your air supply, compress your heart so it can't beat properly, block your gut so you can't eat, cause organ failure, erode your bones, press on nerves, or destroy bits of your brain so you can't control your body or think properly. Sound painful? Without pain medication -- sometimes even WITH morphine and whisky -- it is.

As far as I know, Dr. Smith does not have metastatic cancer. Ms. Freeman-Daily does, and she writes, unsurprisingly, a realistic view and description of cancer. Ms. Freeman-Daily also points out:

Among the lung cancer patients I've come to know online through their own posts or those of their caregivers, death can claim patients before they have established financial security for their family, raised their children, finished college -- or even had time to recognize that they are dying. Many linger after they've lost the ability to do what they love, communicate, or think clearly. Most will eventually find themselves dependent on others for their basic needs while still aware of the emotional and financial stresses their illness imposes on their loved ones.

Some diagnosed with Stage 4 cancer may die within weeks or months of their diagnosis. Others may live with metastatic disease for years and die after all lines of defense have failed. I followed the blog of Vanessa T., who recently died of Stage 4 breast cancer. Her family loved her so very much, and watching her slip away because of the mets to her brain was horrible. How could anyone see anything romantic or ideal about her passing at such a young age?

Marie Ennis O'Connor also wrote a response to Dr. Smith's blog:

Not everyone who dies of cancer has this peaceful idealised death. My own mother's death from brain cancer was far removed from romantic. Both men write of a dignified and peaceful death, along the lines of our work here is done on earth -- but what of the young mother with metastatic cancer who desperately wants to be there for her children growing up? Is love, morphine and whisky enough to ease her pain?

The most offensive, mind-boggling part of Dr. Smith's blog post was this:

But stay away from overambitious oncologists, and let's stop wasting billions trying to cure cancer, potentially leaving us to die a much more horrible death.

I will contend that there are probably cancer patients out there who continue with various treatments, only to make their remaining weeks or months excruciating and painful. They might choose to do so because they feel pressure from their families to continue on, or they are relying on possible false hope given by medical professionals (possibly the "overambitious oncologists" Dr. Smith is referring to?). You know what, though? If a patient does make that choice and they are of sound mind, then their decision should be respected, not pitied or judged. To take away someone's hope, no matter how unrealistic it may be, would be cruel. Perhaps an oncologist may be overambitious, but what if the patient wants that type of attitude and approach?

Nobody knows what they will do when faced with the hard decisions that terminal cancer patients deal with during their treatments. As much as I loathe the word, I will use it here: Dying is very much an individual journey. I pray that those facing these decisions aren't pressured to keep going on if they want to just live out their remaining days without debilitating treatments. When terminal cancer patients decide it's time to stop, those decisions should also be respected. People should be allowed to die with dignity. These broad statements, like the one Dr. Smith makes, implies that terminal patients should just check items off their bucket list and die already.

I will never ever agree with the statement that we should stop "wasting billions trying to cure cancer." Nope. Cancer research has saved lives and will continue to save lives. The money being spent and used on cancer research is priceless to those with metastatic disease who don't have the gift of time or people like me, in remission, who pray to God that my disease doesn't come back.

But it's not like I have a choice in the matter. Cancer doesn't work that way.

This post was originally posted on Get Up Swinging.