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A peaceful death

BMJ 1999; 319 doi: (Published 31 July 1999) Cite this as: BMJ 1999;319:327
  1. J O'Neill, consultant in palliative medicine
  1. Chester

    Six years ago at the age of 68 my father in law was diagnosed as having prostate cancer. A bone scan confirmed disseminated bony metastases.

    Hormonal treatment meant that he could enjoy my wedding five months later, and we hoped for several years of good quality existence for him Four months later, his backache became more troublesome, the disease was failing to respond to medical hormonal treatment, and his surgeon recommended orchidectomy. An anxious telephone call from his wife the day after the operation, telling us that he had weakness of his arms, set alarm bells ringing. Computed tomography confirmed spinal cord compression. During, or shortly after his operation, he had developed cervical compression of the cord, possibly precipitated by the necessary manipulation of the neck during intubation for the general anaesthetic. He was confined to strict bed rest, unable to sit up owing to the tenuous stability of his cervical spine. A course of radiotherapy failed to improve his condition. A neurosurgeon offered a …

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