at least in part. We all will die. We hope to take our leave in a timely fashion, with dignity. This doesn't always happen. I am much more afraid of living too long--as my mother and my husband's father and stepmother are doing. If any of them could have seen themselves even ten years ago, they would have cried, Spare me! My mother's worst fear was "losing her marbles." In the space of four months they are mostly gone, a sudden descent (at 96) into dementia. She still knows there is something wrong with her. A blessing will come when she has deteriorated into not knowing, as my mother-in-law did about six years ago. Both of them, and my father-in-law (in poor health, demented, and paranoid) would be better off dead, released from suffering and confusion.

I have breast cancer; I had surgery, chemotherapy, and radiation in 2003. It wasn't easy, but present-day medical care made it bearable. I still have frequent visits with doctors and tests and treatments that remind me that I am always at risk. But so are we all.

I'm just objecting, I guess, to the cheerleaders who keep saying, Win, win! We all lose in the end. It is no sin to concede with dignity, to accept death and experience it as the last part of living.

In my family, dear LW, we have the breast cancer gene. Although I have not yet had cancer, the generation preceding my mother's all had it. My mother, an aunt and my sister have had it. I thank the maker daily for my family, who tied me to my life when I was ready to let it go. You probably resent them for that now, but I think as your treatment progresses and you get through the painful part your perspective will change. Getting help from a counselor will help with this.

Here's some practical things my family has learned about chemotherapy:

"List of Coping Stuff for Cancer, in random order

(perhaps one day to be organized)

1. The hair goes away in about 18 days after your first chemo. It returns as short curls within about a year after your last chemo. Eyebrows take about a year and a half. Most people are nice and try not to stare, but there are assholes in this world. They will be mean and point and laugh. Wear a wig if it makes you feel better; I wore a really short skirt and a scowl.

2. All of the hair goes away—ALL of it. You will hear “At least you don’t have to shave your legs,” more than once.

3. You will no longer have eyebrows or nose hair—which means you will get sweat in your eyes and your nose will drip. Have several soft cotton bandanas—they make great impromptu hats, and when you start to drip you will be glad to have them.

4. Wash all of your clothes and bedding in non-scented laundry detergent, without fabric softener. The laundry smells will make you sick when you are under the influence of chemo.

5. Have someone else cook you simple, soft foods, or buy them ready made at a deli. I liked to start my post chemo diet with soft, carb heavy food like mashed potatoes and pudding. Keep them in the fridge, and microwave them to warmth, but not to fragrance. Add a couple of bites of soft protein, like tofu or stewed brisket, but don’t overdo it for the first weekend after chemo. As you start to recover, you can add heavier food, like scrambled eggs.

6. Spend the three days before chemo drinking water constantly, while minimizing intake of caffeine and taking absolutely no alcohol. If your kidneys are already in “flush mode” when you get to chemo, you’ll be better able to get the chemicals out of your body once they’ve done their job.

7. Things that you like will stink when you are under the influence of chemo. I couldn’t stand the smell of coffee or wine—they seemed to be reduced to the smell of their chemical contents. I switched to drinking Irish breakfast tea in the morning.

8. When you hair falls out, your scalp feels very tender. It’s good to have those seamless stocking caps when you go to sleep—they keep your head warm, and they ease the friction between your head and your pillow.

9. Get one or two resources on the disease, and read them thoroughly. DO NOT spend excessive time on the internet researching your disease—if you need to know what’s out there, ask someone else to look for you. Non-scholarly sources are likely to contain bad information, and online scholarly forums are written for researchers for whom your disease is a sort of a challenge. Reading their statistics on and assessments of your treatment is a good way to get the shit scared out of you. If you are concerned that you are not getting appropriate care, get a second professional opinion.

10. Ensure is surprisingly tasty. Drink it over ice, and use a bendy straw so you don’t have to smell it. (Even better, drink it froma covered cup)

Stuff to have around:

Bendy straw/covered cups

Cold pack

Heating pad

Hemmorhoid suppositories

Yeast infection treatments

Stool softeners (don’t use fiber laxatives SEE: hemmorhoid)

Tylenol

Unscented laundry detergent

Tea

Ensure

Tapioca

Potato ricer

Muscle relaxing bath

Cotton nightclothes (absorbent)

Paper fan

Pants and skirts with elastic waistbands.

Anti-itch spray

Teething gel (for mouth sores)

Extra soft toothbrushes

Books on tape

Crock pot for cooking brisket or pot roast outside, away from your nose.

Microwave oven

Lotion, either unscented, or something that isn’t supposed to smell like food, such as lavender or juniper. This is a place to really treat yourself—get the good stuff.

Good sunglasses.

Any makeup that makes you happy

Stuff to get rid of or hide:

Shampoo

Brushes

Hair doodads"

Hope that our experience can help you. Cancer truly sucks.

Sara

Stop hitting the "publish my letter" button already.

I think that there is a conflation going on here, overlapping the LW previous depression, with an urge to want to reject treatment, versus an active suicide.

What startles the reader is not that the LW wants to die, but it her conclusion that life is not worth living.

If the LW had written "I have had a great life, but now, with advanced breast cancer I want to forego treatment and enjoy my remaining days", then that is a life-affirming approach to death. But the LW is saying "Life is shit, this is my out. Let me die". The former we would all be comfortable supporting, the latter upsets us.

To the LW: Suffering, sadly, is part of life. That is not to diminish your suffering, but please know that we all at some point go through awful times. It may be that you are indeed going to die from breast cancer. Perhaps that brings you relief. If your diagnosis is poor, and the idea of chemotherapy in exchange for a bit more time, appalls you, then it is your choice whether to proceed with the treatment or let the disease take its course. You will cause pain to those around you. You are free to do as you wish with regards to treatment. But please don't kill yourself actively. Those who love you will be shattered and they will never recover from it. You are obliged to live until your body wears out on its own. Sorry, but your freedom does not extend to active suicide.

If you are indeed entering the end of your days, and if your time is limited, why don't you sell all of your property and go do something that would bring you pleasure. Take a dear friend on a trip of a lifetime. Write a heart-felt letter to a long-lost friend. Pick up a camera and go take photos. Go shopping and buy yourself beautiful clothes. Go to a child's year-end school concert and give them a standing ovation. Go give some of your money to a needy family, and watch the transformative power of your generosity (as opposed to bequeathing life insurance to a charity). They will always love and remember you. The end of your life is not yet written. The pen is in your hand. Pick it up.