“Coming to terms” with the end of life means learning to accept it as a possible outcome. This is a process that people move through at different paces. Some are ready to begin as soon as they learn they have stage IV breast cancer. Others aren’t ready until they’ve been through several courses of treatment. Still others aren’t ready until it’s clear that there are no effective additional treatment options left. Whatever the timetable, this is an emotional process.
And it takes time, says Kelly Grosklags, L.I.C.S.W., B.C.D., a Minneapolis-based oncology psychotherapist and grief counselor who has lots of experience helping people with advanced cancer deal with end-of-life emotions. She advises people to give themselves enough time to come to terms with the end of life: “It’s very beneficial to the person if they have been doing the psychological work along the way, talking about how this is feeling, prepping for what it might be like, talking about things they would like to do. As humans, we need time to process things.”
She adds that one feeling is very common in this experience: People fear they are somehow “giving up” once they start contemplating the end of life. They think that they either can focus on treating the cancer or prepare to die — but not both. Grosklags recommends replacing this “either-or” thinking with what she calls a “both-and” mindset. You can both work on coming to terms with the end of life and devote your energies to managing the cancer and living well day-to-day: keeping up with treatment, eating well, reducing stress, and being active. You can focus both on keeping the cancer under control for as long as possible and preparing for what you’ll do if treatments stop working. If at some point you decide to stop cancer treatment, you can both seek treatment for symptoms in order to live well and prepare for the end of life.
In this section, we’ll talk about some of the emotions that people commonly experience and possible strategies for getting emotional support.