The signs of death being near can be different for each person. No one can really predict what may happen at the end of life, how long the final stage of life will last, or when death will actually happen. Sometimes death comes quickly due to an unexpected event or problem. Other times the dying process moves slowly and the patient seems to linger.
Medicines and treatments people receive at the end of life can control pain and other symptoms, such as constipation, nausea, and shortness of breath. Some people remain at home while receiving these treatments, whereas others enter a hospital or other facility. Either way, services are available to help patients and their families with the medical, psychological, social, and spiritual issues around dying.
Signs of approaching death
Death from cancer usually occurs after a person has become weaker and more tired over several weeks or months. It is not always possible to predict how long someone will live. But some common signs and symptoms show that a person is entering the final weeks and days of life. Knowing what to expect helps relieve anxiety and allows better planning.
The following are signs and symptoms that suggest a person with cancer may be entering the final weeks of life:
- Worsening weakness and exhaustion.
- A need to sleep much of the time, often spending most of the day in bed or resting.
- Weight loss and muscle thinning or loss.
- Minimal or no appetite and difficulty eating or swallowing fluids.
- Decreased ability to talk and concentrate.
- Little interest in doing things that were previously important.
- Loss of interest in the outside world, news, politics, entertainment, and local events.
- Wanting to have only a few people nearby and limiting time spent with visitors.
- As the last days of life approach, you may see the following signs and symptoms:
- Breathing may slow, sometimes with very long pauses between breaths.
- Noisy breathing, with congestion and gurgling or rattling sounds as the person becomes unable to clear fluids from the throat. These sounds may concern others, but the person who is dying is not aware of them.
- Cool skin that may turn a bluish, dusky color, especially in the person’s hands and feet.
- Dryness of mouth and lips.
- Decreased amount of urine.
- Loss of bladder and bowel control.
- Restlessness or repetitive, involuntary movements.
- Confusion about time, place, and identity of people, including family members and close friends.
- Seeing or hearing people or things that are not there. This is common and usually normal. It is not a cause for concern unless these hallucinations scare or upset the person who is ill. These dream-like experiences often include traveling, preparing for travel, or being welcomed by people who have died.
- A tendency to drift in and out of consciousness and gradually becoming less and less responsive to touch or voice.
Of course, every person is different. The signs and symptoms that people experience vary. And the order in which signs and symptoms occur may differ.
Emotional support to a person who is living with and dying of cancer?
Everyone has different needs, but some worries are common to most dying patients. Two of these concerns are fear of abandonment and fear of being a burden. People who are dying also have concerns about loss of dignity and loss of control. Some ways caregivers can provide comfort to a person with these worries are listed below:
- Keep the person company. Talk, watch movies, read, or just be with him or her.
- Allow the person to express fears and concerns about dying, such as leaving family and friends behind. Be prepared to listen.
- Avoid withholding difficult information. Most patients prefer to be included in discussions about issues that concern them.
How does cancer cause death?
Every patient is different, and the way cancer causes death varies. The process can depend on the type of cancer, where it is in the body, and how fast it’s growing.
For some people, the cancer can’t be controlled anymore and spreads to healthy tissues and organs. Cancer cells take up the needed space and nutrients that the healthy organs would use. As a result, the healthy organs can no longer function. For other people, complications from treatment can cause death.
During the final stages of cancer, problems may occur in several parts of the body.
Digestive system: If cancer is in the digestive system (e.g., stomach, pancreas, or colon), food or waste may not be able to pass through, causing bloating, nausea, or vomiting. If the cancer prevents food from being digested or absorbed, patients can also become malnourished.
Lungs: If too little healthy lung tissue is left, or if cancer blocks off part of the lung, the person may have trouble breathing and getting enough oxygen. Or, if the lung collapses, it may become infected, which may be too hard for someone with advanced cancer to fight.
Bones: If cancer is in the bones, too much calcium may go into the bloodstream, which can cause unconsciousness and death. Bones with tumours may also break and not heal.
Liver: The liver removes toxins from the blood, helps digest food, and converts food into substances needed to live. If there isn’t enough healthy liver tissue, the body’s chemical balance is upset. The person may eventually go into a coma.
Bone marrow: When cancer is in the bone marrow, the body can’t make enough healthy blood cells. A lack of red blood cells will cause anaemia, and the body won’t have enough oxygen in the blood. A low white blood cell count will make it hard to fight infection. And a drop in platelets will prevent the blood from clotting, making it hard to control abnormal bleeding.
Brain: A large tumour in the brain may cause memory problems, balance problems, bleeding in the brain, or loss of function in another body part, which may eventually lead to a coma.
In some cases, the exact cause can’t be pinpointed and patients simply decline slowly, becoming weaker and weaker until they succumb to the cancer.
When we determines that the cancer can no longer be controlled, medical testing and cancer treatment often stop. But the person’s care continues, with an emphasis on improving their quality of life and that of their loved ones, and making them comfortable for the following weeks or months.