Someone close to me is dying from stage four breast cancer. She has bone mets everywhere, many tumors are pressing on nerves generating throbing, horrible pain, she also has tumors in her liver and other soft tissue. She has been on chemo every week for three years, the side effects are too numerous to list here, all i can offer is that a once beautiful woman is hard to look at. She spends most dayd is extreme pain. Recently she has started talking of taking her own life, she's tired of the fight and the pain. What do you tell someone going through this, how do you offer words of encouragement?

I don't know. Maybe this is a time when you can't. I don't want to be rude, but "words of encouragement" seems like a Hallmark card throwaway phrase. This person is about to die and they are fully aware of this at all times. What can you say? Other than you don't know what to say?

It's tough. Wish her and you the best.

There's the rub, how do you encourage them on, to get up one more day, so that they can suffer yet again. What do you do if they ask for help leaving.

I don't know what to say. But I would ask that you share this verse. And let her know shes in my prayers.

2 Corinthians 4:16 - 18

16 Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. 17 For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. 18 So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal

Is she receiving services from hospice? She should not have to be in pain; The hospice movement perfected palliative care and pain management in the terminally ill more than a decade ago. Does she have access to pain management, or is she refusing adequate pain management under the delusion that it will impair her cognitive function? Does she have the physical support of family?

The most important thing hospice taught me when I worked for them was that terminally ill patients' should never be alone unless they specifically request it, because the diagnosis of a terminal illness is the most emotionally isolating thing a person can experience. You're being there WITH her is encouragement, even if you find it sad. Honesty and openness are important. Don't be afraid to converse with her about the future and ask her what her wishes are with regard to the present (are you thirsty? Can I get you an extra blanket? What would you like to talk about today?). Don't be afraid to let here talk about what might, should, or will happen when she is gone. Don't be afraid to let her talk about how low she feels. Terminal illness makes you helpless. Her talking about offing herself gives her back a small measure of control she feels she has lost. People will do a lot to get out of pain. If she could get her pain under control, she might not think about suicide as a way out, or a way to take her destiny out of the grip of cancer.

Elizabeth Kubler Ross's five stages of grief bears noting: Your friend is probably pissed off beyond measure right now. That makes everything worse for her. Let her talk about it even if it makes you uncomfortable. Ask her if getting her pain under control would make this cross bearable to afford her the opportunity to make the most of her time left. It's not fair that cancer is taking her life, but why let it take it that much sooner? Talking about suicide may be a way for her to vent her frustration and feelings of helplessness. Have you ever felt better after talking about a problem?

Would you want to be remembered when you pass away? Spending time with her is a way to encourage her that she will be remembered fondly. However you can impress upon her that she touched your life and that you will remember her, it will comfort her.

Does she like music? Music therapy can be very comforting. So can the presence of a therapy dog or cat.

Sounds like hospice might be in order.

if her doctors are worth a shit they made sure she had enough pain meds to OD...

i really don't get the idea of making sure people suffer as long as they can stay alive for.

Yes, when my MIL starting having extreme pain the hospice nurse put her on phenobarbital.  It eased her passing and sounds like it applies here too.

Look into it.

That's a great idea.

I also would definitely share with her my love, admiration and appreciation.

That occurs daily.

My grandma has stage 4 cancer. Shes still up and going now but the cancer is spreading. Im really not ready to see her wake up everyday in pain.

She's not "sick enough" for hospice yet.  Pain meds are are a constant battle to find the right mix, in between those times is agony. She's at one of the top three cancer centers in the US.  This is the point  where she continues to push on or she folds, I'd like her to push on. she's 45 with two young teens and they need to see as much of their mom as they can.

There are none

Wow, this is so tough. You must be upset right now.

I guess if I were her, I would be encouraged to go on knowing that my friends were caring about me and looking after my two kids. The kids would be my biggest worry after dealing with the immediate pain of the disease and treatment. I think a lot of the daily grind on top of treatment is what wears patients down the worst. And because life is so topsy-turvy with it all, the little things that make life normal become so much more important. Having someone make dinner and help out with housework is really an awesome thing, as is taking the two kids out to see a movie or go do something they enjoy would take some of the worry off. The more you can relieve the nagging daily stress we all deal with, the more she can concentrate on her treatment and finding the right drug combinations/holistic stuff like physical therapy/massage/diet.

I don't know if anyone is interested, but I recommend this course on death from Yale:

http://oyc.yale.edu/philosophy/death/

It's from the point of view of a pessimistic atheist professor, which sounds off-putting, but it still raises a lot of difficult questions and really forces you to think about death and what it means to us. I found it comforting in a strange way by the time I finished listening to the lectures, despite disagreeing with the professor's conclusions.

She should not be suffering from pain.  In fact, at this stage, relief from pain is all we can offer.  Believe me, there are things worse than death.  I have seen it.  My thoughts and prayers are with you and your friend.

You get them Hospice, yesterday.  And then you stay there and hold her hand until the atavan does what it does.





And then life goes on.

 

Id opt for medical mj.


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I went through this with my very, very close friend and colleague in December.



There are no words that you can offer that can change her outcome.  You need to take this to heart and understand it - and come to peace with it.



Since you note that she is terminal:



All you can offer is your time.  Your time, your presence, your calm and your humor is the most valuable thing you can offer - and give.



She knows about the elephant in the room.  Her family can give you pointers if she wants to discuss it - or if she wants to know about her pace.



When you are in her position - time passes quietly.  A smile of a friend in the doorway is a beam of sunlight.  Even if you can only stay a short while.  Its what you have to give.



Walking into the room at peace with your own angst can be hard.  Keep it light.  Everyone on her course is different - and has different needs... and those needs and her abilities will change with time.  Try to sense them.  It can be a simple as encouraging her to eat.



Don't try to fake her out.  Be yourself.  She will see through you like glass.  Relax.  Yeah - I know.... easy for me to say.  Been there.



If it seems right - talk about a funny joint experience years ago.



Its also okay to just sit.  You don't need to talk all the time.  We tend to talk when nervous.  It can turn to babbling.



I said it before - but its my best advice.  Try to relax the best you can.  Don't forget to smile.  No-one wants to see a long face.



In later times - there will be less you can give.  But being there can help you as much or more than her.



Just be a friend.
CWO

Very good advice here. Just be a friend.

Indeed. JJ, pain can become simply intractable, but I can't help but wonder if her pain isn't being managed as fully as it could be. Does she have someone going to appointments and actively advocating for her?



My father made the decision she's contemplating at the end of his illness, and I respected his wishes. He didn't have teen kids though. I have a lot of respect for what you're doing. While I don't really have words for her, let me tell you that your handling this well now will be a great comfort to you later.



 

Been there done that about 9 years ago,nothing you can say just be there.From what I witnessed death is by far not the worst thing that can happen to a person.

I went through the same thing ten years ago with a best friend who got the news and 7 months later was dead. There is nothing to make a man feel weaker than not being able to fix someones health issues. I didn't know God like I do today, but we talked about Him. My friend left this earth looking forward to what lay ahead of him. I miss him still. Just be there for your friend. She will be in my prayers. Good luck to you too.





Here are some easy words to say out loud: I'm sorry. I want to help if I can. You're a wonderful friend. I love you.

My wife has been fighting and "winning" stage 3C ovarian cancer for 7.5 years... It is a War which must be fought, and is never really won.  





However every moment of life where joy and family and togetherness can be appreciated is a HUGE VICTORY for a cancer patient.  The cost on a personal basis is enormus, but life is not about material things, but seeing a sunrise or sunset and being moved by the Lords creation.  He will embrace us all sooner or later... When the Lord decides that it is time our cycle will be complete.  Know that He and He alone give us these gifts.





Your friends struggle will end in her rapture and joy at knowing she did her very best. The Lord is proud of her strength. Allow her her space to find her way to the next life.





I am enormously proud of my wife and hers.