The process of living with mortality begins when you are first told the diagnosis. A new cancer "victim" develops fear, despair, hope, depression, anxiety and determination to find answers. It doesn't matter if there is a 50 percent chance of a cure or 80 percent or 95 percent. As long as there is even a 5 percent chance that the cancer is incurable, the emotional turmoil persists and the need to learn how to go on living in a purposeful way, despite the fear and worry, remains.
Many people diagnosed as having a chronic potentially fatal disease react, think and behave in similar ways, following a similar pattern. Not everyone will go through all the stages described below. Some will skip one or two or even come back to an earlier stage if a new symptom or other significant event occurs. But it is useful to become aware of these common reactions, whether or not you experience all of them yourself. Understanding these experiences will help you face your own uncertainties and fears and help you put in perspective some of the decisions you will have to make.
When faced with the threat of death or dying, many patients and their families turn for understanding and guidance to the highly regarded work of Dr. Elisabeth Kübler-Ross. She illustrates five stages— denial and isolation, anger, bargaining, depression and acceptance—that occur during a terminal illness. But the Kübler-Ross model applies to death in the near future of weeks or months. These circumstances do not apply to cancer patients who have been told they have a potentially fatal illness and that they might die of it, but cannot know when, and, then again, may not die of it but may not know that for years to come.
Living with a chronic potentially fatal illness associated with a lifespan measured in years involves responses that differ in many important ways from those described by Dr. Kübler-Ross.
