Are painless deaths real?

[AGreatUsername]

Sorry, this is a dark and triggering post so please don't read if it'll upset you.

I have incurable cancer. Currently doing well, with some luck I might even get 10 years and see my 50th.

But, something that is massively impacting on my life, my sleep, my anxiety is fear of death. Fear of pain more so. All I seem to see is stories of horror where loved ones suffer horribly until they die but surely there are more peaceful deaths? Surely these are the exception?

I just want to be heavily drugged as soon as I am ready and not be awake or suffer at all. Is this even a thing or have I only got horror to come?

If anyone can offer some comfort of any peaceful cancer deaths I would be so grateful.

My father died of cancer four years ago. He barely needed any pain relief near the end, and died peacefully. He gave a little sigh and was gone.

Hugs x

I lost my mum before Christmas from a combination of dementia and finally pancreatic cancer. She was basically asleep for most of the last week as her body shut down the morphine kept her comfortable. I slept next to her for the last 3 nights and she died peacefully whilst I was there. Not a funny noise, or anything. Just slowly stopped breathing. I w totally understand you being concerned about this and I'm really sorry you are in the situation you are in. X

Yes, I have seen a peaceful cancer death. The months of chemo were far more traumatic in that case, and it was a tricky cancer (horrible mets). The last thing my relative said to me was that he could hear the clock ticking too loudly - I wasn’t sure if it was some kind of metaphor (he had aphasia due to a metastatic brain cancer so it was hard to communicate) or just that he could hear a dripping tap nearby. The last thing I said to him was, I love you. He passed quietly in the night.

I am not sure an internet straw poll will give you the relief you need. It’s a bit like those threads where people ask about childbirth - there’s a whole range of experience. But being prepared for what might happen can make it less stressful and frightening - so make plans for various scenarios (eg support to be at home), please talk to family and friends and let them comfort you, lean on them - they will want to, and it will help them grieve if you let them in.

Also Can you find a counsellor or a support group to help you with these incredibly difficult feelings and thoughts?

I am so terribly sorry you are going through this, and I hope you find some peace of mind.

Yes- speak to your palliative care team. You should be able to have “breakthrough” medication to take yourself and “just in case” medication that you call for. As you (or indeed IF you) need more breakthrough or that increases, your JIC meds can also be increased or you could get a syringe driver which delivers a steady dose over 24 hours and can include pain relief, antisickness, stuff to stop rattling in the chest and relieve anxiety/panic.
This means a pain free death really should be the aim, although some people do worry about being too “out of it” so choose a little discomfort to prolong the time they're “with it”.

So sorry to hear this op. I strongly recommend you start listening to some podcasts on NDE's or Near Death Experiences. This has completely removed my quite intense fear of death and altered how I see life and death in a hugely positive way.

I recommend Dead Talks but maybe just see which ones/ if any appeal. Sending 💖♥️

Sorry to edit - I see on rereading it's the possible pain of death you are most worried about. Sorry, please see other responses regarding this xxx

Yes definitely, I'm a nurse and have been with lots of patients in their last days.

It is possible to have a very peaceful death surrounded by the people who love you.

A friend of mine got enough pain relief to dull the pain into a manageable ache as he wanted to be alert til the end. He actually died peacefully in his sleep which is exactly how he wanted to go. But you might not need to prep for a while yet. My aunt was diagnosed with stage 4 breast cancer (metastised to the liver) 20 years ago lol.

This.

OP

Definitely, my aunt died from cancer at home with morphine she just slipped away peacefully

Absolutely possible and 99% of the time achievable to have a pain free, comfortable and peaceful death.
As a nurse in a role where a large proportion of my patients are palliative, when the time comes we are really good at managing symptoms. There are lots of drugs we can use for every symptom there is. Lots of different pain relief options, anti seizure meds, anti anxiety, anti sickness, secretion management, and these can come in injectable form for when you can’t swallow, or in a continuous pump. You can have them in the pump and ‘top up’ with injections too.
Also lots of non drug therapies too, such as fans for breathlessness, familiar and comforting smells, gentle massage etc.
I am doing lots of work around advanced care planning at the moment and finding that the more in control of their treatment the patients are the more personal and peaceful their deaths are, all the little details and wishes are so important. If you have hospice nurses in your area they will be able to support you through this, no matter how long or short the prognosis.
Any questions, please ask

I'm sorry you are having to process this, I can only imagine how difficult it is and the paths your mind walks at times. I have worked and dealt with a lot of end of life and deaths in my work, there are so many variables as the PP has said but here's my experiences.

Painless deaths are absolutely possible. The types of end of life symptoms you may experience are somewhat interlinked with the type of primary cancer you have understandably. Some experience no pain symptoms at the end of life, for some pain is an inconvenience and for an extremely small amount of people it's tricky to get in top of but this is where your specialist palliative care teams/hospice/palliative care consultants come into their own, they really are experts and I have been amazed as some of the symptoms they manage over the years. But, most won't need this level of specialist input.

For me, I think the things that make the biggest impact at that stage in your life is the discussions you've had with your loved ones around your wishes, your thoughts and values around life and death in general, sharing these with your healthcare team, making and/or writing plans (in my area we have a website called 'deciding right' which is excellent for both patient and professional info on all things end of life if this would be useful for you). Engage with Maggie's centre if your lucky enough to be able to access one, access psychological input if you can or want to. You do not need to feel out of control at this stage of your life, it's still very much up to you how you live your life and where you receive your care and this is where these conversations (which I realise are not easy) come into their own.

You also don't need to decide on anything right now. I have hand of heart found that the vast majority of people come to a point of acceptance, almost as if their body signals to their brain that it's ok, it's time. This doesn't mean you may no longer feel sadness, anger, regret, why me.........you can feel this but accept your fate simultaneously and do it in the way you want to. Empower yourself by letting all around you know what you want, what's important to you, and what your worries are. Remember any healthcare professional involved in your palliative care process is there to ensure you ultimately have the death you want. Some people know what this is immediately, others have to process. It's your journey, you walk that path how you want and need to.

Wishing you all the best with everything x

My gran woke to see her family all there at once and joked that it must be serious then appeared to fall asleep during the night and just stop breathing. It did seem very peaceful.

Yes my Dad, he had renal cell cancer, he had paracetamol sometimes when he was palliative which worked well, then a couple of days before he died (he was asleep most of the time) the team put in a syringe driver to support his comfort. He died from pneumonia in the end and the medication in the driver - helped with breathing and secretions. He was comfortable and pain free throughout ❤️❤️

I'm so sorry you're in this situation OP and I hope the prognosis will be better than you're expecting.

To echo the others, the answer to your question is yes, in my experience.

I was with my mum through her struggle with metastatic breast cancer (she had lung, bone and liver mets) and stayed in the hospice with her the last few days

She lived for 7 years after her stage 4 diagnosis and many of those were really good years where largely you would not have known she has cancer. She was going downhill with fatigue and some pain from bone mets in the year before she died but was pretty well eg able to potter around in the house and go out in a wheelchair until a week before she died.

In the last week she got liver failure and went downhill fast. She didn't want to eat, couldn't walk, was often sleepy and felt cold so she was bedbound but she was bright and alert (when not asleep) and not in pain. She went to the hospice for the 48 hours before she died and they were amazing with pain relief and making her comfortable

In the last 24 hours she got confused and didn't always know who we were which was upsetting for us but I don't think it was for her. There was a very short period where she got really distressed, agitated and confused so we got the nurse and she asked mum if she wants to sleep now and she said yes and the nurse put up the sedation and she was then unconscious and stayed like that until she stopped breathing a few hours later. She passed away very peacefully with her family around her and my dad holding her hand.

Honestly I think it was only a matter of minutes when she seemed at all distressed. Mum chose to die in the hospice, which she knew because she had been to a day programme there for a few years, and I think that was a very good decision as they had all the equipment and expertise to make her really comfortable. It felt very respectful and that she was in control of how she wanted to pass.

I hope that is helpful.

I’m a senior nurse and I also have stage 4 breast cancer. Incurable but containable.
I have seen a lot of death in intensive care and Hospice care. I have no fear of death after what I’ve seen and experienced. Peaceful death is possible. I have seen and heard amazing things as patients have passed. You have nothing to fear. I hope I have been able to convey some reassurance to you. Thinking of you as you battle on. Sending love. ❤️

I’m very sorry for your diagnosis and yet you sound upbeat and positive about death. Would you share some of the amazing things you have seen? If you felt comfortable enough?

I was with my Nan. She opened her eyes and said "Bill" (her late husband) and closed her eyes again and just stopped breathing

My mum wasn't responsive at all, her breathing was a little rattling but no discomfort. Again she just stopped

I'm in my 40s with stage 4 breast cancer. I've also been terrified of dying in pain so thank you for the question and responses, which have been really reassuring.

Definitely possible in my experience as a nurse working on an oncology/pall care ward. It does depend somewhat on your diagnosis, how proactive your team is and whether there is a palliative care team who conducts the end of life palliation.

@AGreatUsername , I’m so sorry how difficult for you this must be. I feel the fear in your post.
Are you assigned to a hospice? A hospice nurse will be able to reassure you. Please if you are not assigned to a hospice speak to your GP about arranging this.
My DIL’s grandmother has recently died from cancer. She was chatting very close to the end and tired but in no pain. Her passing was by all accounts very peaceful.
X🙏🏻

Just to ask - do you know about the Stage 4/ Incurable chat in Life Limiting Illness. We are all at different stages of being incurable- I’m well just now, others are further along the road. I don’t post much, but read it a lot.
There’s some good advice/ insights, there’s also a lot of humour - sometimes dark. It may be worth a look.

In real life I’m part of a group of people with cancer- a couple are already attending the local hospice, and say it’s lovely.
It does give me confidence that the palliative care people know what they are doing.

I’ve worked as a nurse for 17 years in a hospice . In all that time I can think of only a few patients who had a lot of pain at the end of their lives and these patients all had drug or alcohol issues which meant that pain relief worked differently and sadly wasn’t as effective. You can certainly ask to be sedated in the last few days. Specialist hospice care makes a huge difference - we use drugs differently from a hospital or GP to better effect generally. Please don’t fear hospice input - quite a few of our patients are admitted for end of life care or wanting to die as have had enough but with excellent hospice input go home and spend more time with loved ones .

My grannie died very peacefully. No pain.