To be fully alive. (Guest Editorial).

Patients with advanced cancer are typically offered surgery chemotherapy radiation-or "there is nothing we can do for you." The last option seems not to be a choice, and yet I have often observed that this realization is the most liberating news that a dying person can receive.

Of my terminal cancer patients, the ones who found the most joy and fulfillment in their final months were often those who were told that there was nothing else that could be medically done for them. Once the system had given up, these people looked beyond the traditional medical model, empowered themselves, and took charge of their lives.

There is a lesson for all of us in the observation: There is still life to be lived after "nothing else can be done."

Beyond relieving symptoms, we should be helping more patients to consider what it means to be fully alive until they die.

My wife Diane died of metastatic breast cancer this past July 6 years after her original diagnosis. For most of that time she was able to make choices that allowed her to remain fully alive until she died. She continued to teach until the end of the school year and she participated in a support group. She found options to sustain her sense of well being and comfort, using alternative and complementary therapies such as acupuncture, high-dose micronutrients, and energy readings. Most important of all, she continued living well. She kept involved with the people around her and active with her friends and family.

Patients living with advanced, terminal cancer typically say "I must do everything I can to beat this cancer." Most family members say "You must do everything you can to beat that cancer." Most physicians say "We must do everything we can to beat the cancer." Yet are we doing everything? Too often, everything is limited to the material and physical realms, often to the exclusion of the patient's emotional, social, mental, and ...