Cancer Patients Cannot Postpone Death for Major Milestones
A father dreams of walking his daughter down the aisle. A mother looks forward to seeing her son accepting his high school diploma. A grandparent awaits the birth of his grandchild. Unfortunately, illness and death sometimes interfere, keeping loved ones from being present at these events.
But recollections of health care workers and some studies have shown that patients dying of cancer often defy expectations, surviving to a major event such as a wedding or anniversary, and then dying immediately afterwards.
In a large study published in the December 22/29 2004 issue of the Journal of the American Medical Association , researchers attempted to address this evidence by determining if more cancer patient died after Christmas, Thanksgiving, or their own birthdays, rather than before. It turns out they did not.
About the Study
Researchers analyzed the death certificates of 309,221 people who had died of cancer in Ohio between 1989 and 2000. The death certificates contained information including date of birth, date of death, gender, age, race, and ethnicity.
The scientists counted the number of deaths in the week before and after three events that had potential religious, secular, and personal significance—Christmas, Thanksgiving, and the individual’s birthday—to determine whether more deaths occurred in the week following the significant event, compared to the week before.
There was no significant difference in the number of cancer patients dying during the week after Christmas, Thanksgiving, or the individual’s birthday, compared with the number of people dying the week before those events. In other words, cancer patients were apparently not able to postpone their deaths until after these events.
This study is severely limited by its selection of significant events. The study authors chose Christmas, Thanksgiving, and birthdays as the significant events of their study. But these events may not have been meaningful for the individuals in this study.
How Does This Affect You?
This large, ethnically and racially diverse study showed that cancer patients are not able to postpone death until after Christmas, Thanksgiving, or their birthdays. The researchers, however, were unable to determine what significance these events held for the study subjects. While Christmas and Thanksgiving hold special significance for some, this is by no means a universal attitude. In fact, it is likely that many Ohioans had conflicting, or even negative, views of these holidays and would not consider making any special effort to live through them for yet another year. And unlike children, most adults view their next birthday with trepidation and would not necessarily assign it any positive significance.
So, while this study may show that cancer patients cannot will themselves to stay alive for these three events, it says nothing about their ability to forestall death in anticipation of events they find meaningful. More personally significant, or “once in a lifetime” events, such as a child’s wedding, birth of a first grandchild, or 50th wedding anniversary, may have had a greater impact on the timing of death.
This, however, remains an open question. Anecdotal evidence of successful postponements are suspect since caregivers are naturally more likely to recall those patients who survived to see their children marry or graduate from college, for example, than to remember the patients who did not.
American Cancer Society
National Cancer Institute
National Institutes of Health
Young DC et al. Holidays, birthdays, and postponement of cancer death. JAMA . 2004; 292:3012-3016.
Last reviewed Dec 29, 2004 by ]]>Richard Glickman-Simon, MD]]>
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