The diagnosis of cancer is almost always a shock.  Except for the unusual cases such as Angelina Jolie, where she knew she had a gene that made her a very high risk for breast cancer, most people are not expecting to hear that word when they go to see their doctor about “that little niggle”.


Depending on what stage the cancer is and what type of cancer will determine the treatment, which might be aggressive therapy or it might be palliative care or something in between.  Once the aggressive treatment phase has ended, the person is often in a lot of pain, so has high level pain relief to manage their symptoms.  This analgesia has side effects, as does the cancer, including any secondary cancers that may arise.


The palliate stage is hard for everyone, hard for the person, as they are dying and may not have accepted that their life is shorter than they had thought it was.  It is hard for the family carer, as they helpless watch their loved one suffer and slowly slip away.


Stage 0 is where there are abnormal cells, but it is not yet cancer.  Stage 1 cancer means that the cancer is small and only in one place.  Stage 2 cancer is larger and may have grown more into nearby tissue.  It might also have spread to the lymph nodes, but not to other parts of the body.  Stage 3 cancer is large or multiple cancer tumours which may have also spread to the lymph nodes.  Stage 4 cancer is where the cancer has spread from where it originally started to at least one other site or organ in the body, these are then known as secondary cancers.


Depending on the site of the cancer and the secondary cancer will depend on the symptoms of the cancer.  It will also have an impact on the pain level that the person is experiencing.  Palliative care is aimed at relieving the symptoms of the cancer, so that the person can live longer or more comfortably and can be instigated at any stage of cancer.  The person might have problems eating, swallowing, breathing or speaking, to name a few issues, depending on the cancer and where it is.


At some point, the person with cancer and their family will go through the stages of grieving and hopefully get to acceptance by the time the person dies, but this might not be the case and their family might be still at anger when they die, which then muddled into the bereavement mental processing that they will have to do.


The person with cancer is still a person, they still have all their characteristics of their personality, even if they are being tempered by their illness and symptom management.


The person will hopefully plan and manage their death and manage their affairs.  They should make Lasting Powers of Attorney, if their life expectancy warrants it.  They should make a Will, so their estate can be dealt with after they have gone and they should speak to their family and medical team to let them know how they want to die, for example at home with the dog under their bed or in a hospice with immediate access to medical support.  For after they have died, they should let their family know what they want for their funeral.  They can be healing moments to help those left behind move on from their bereavement.  A chance to say goodbye.