With breast cancer and colo-rectal cancer, the five year

With breast cancer and colo-rectal cancer, the five year survival rate—the point generally considered a cure—is steadily increasing,” Nettles noted.

In his year as part of MCV’s pilot program. Nettles worked primarily with young women, under 30, diagnosed as having terminal breast cancer. ‘‘1 also screened everyone coming through the breast clinic to get a handle on where they were emotionally. Did they need psychological resources? Most women, whether their tumor was benign or malignant, whether treatment was a success or noneffective, needed some type of help.”

In his counseling work with terminal breast cancer patients. Nettles watched the classic stages that all terminal patients go through repeated again and again.

“It’s a grieving process for themselves. First there’s the denial that anything is wrong—the diagnosis is a mistake. That’s a tremendous problem with women with breast cancer.

“Next, there’s anger. The ‘Why me?’ or 'How can life be so unfair?’. Then, it’s negotiation, bargaining—‘If this goes away. I’ll never yell at my kids again.’

“Finally comes acceptance, when the patient admits ‘I’ve got it. The doctors are going to do all that they can but I’ve got it.’ This is when patients must decide to make the most of the time that they have—make today count.”

As patients in this final stage of acceptance begin to focus on living in the here and now, one day at a time, they usually reach a point of isolation. according to Nettles. They don’t want friends or even family around. “They want to be left along to make their peace,” he said, adding that patients generally rejoin their loved ones after coming to terms with their mortality.

For the family members who are excluded from this gradual process of acceptance, for the wives, husbands, mothers, fathers and children who must make their own peace with the death of a loved one, there is