Ron Davis, president of the American Medical Association, himself suffering from pancreatic cancer, has made a passionate plea to fellow doctors to help patients lead healthy lives.
Davis, a doctor of preventive medicine, got the bad news eight months into his one-year term.
Like most of those diagnosed with the disease, Davis' cancer has spread beyond the pancreas, reducing chances for recovery. Surgery isn't an option.
"As a physician, I know the survival statistics for someone with stage 4 pancreatic cancer," he said. But if the five-year survival is 5 percent, that's not zero... So, never take away someone's hope," he told the AMA's annual meeting Saturday.
After his diagnosis, he has still managed to keep a dizzying pace of meetings and speeches. During one lecture, he walked on a treadmill to "walk the talk" on prevention of chronic illness through fitness.
He continues on chemotherapy, an aggressive regimen his doctors hope will halt the spread of cancer now in his liver. And though bald, he looks robust. He will turn 52 on Wednesday.
Davis told his listeners of pursuing the "noble cause" of raising awareness about pancreatic cancer, which afflicts 37,000 Americans a year, and kills 34,000. While it is the fourth leading cause of cancer death in the nation, "pancreatic cancer research accounts for less than 2 percent of the National Cancer Institute's research funding," he said.
He applauded the AMA for supporting stronger regulation of tobacco and for raising awareness about people who don't have health insurance. And he urged the group to press for even more, raising federal taxes on tobacco and working to avoid Medicare doctor payment cuts.
"So, whether we are ill or well, we should not waste any of that time before figuring out how to leave our mark on this planet," he said.
Davis has spent his career working to prevent disease and raise awareness about the risks of tobacco. His agenda as AMA president has included coverage for the uninsured and promoting health quality and safety.
Meantime a study has found patients do not get necessarily depressed when the news of the inevitable is broken to them by their doctors.
Only one-third of terminally ill cancer patients in a new, federally funded study said their doctors had discussed end-of-life care.
Those who had these talks were no more likely to become depressed than those who did not, the study found. They were less likely to spend their final days in hospitals, tethered to machines. They avoided costly, futile care. And their loved ones were more at peace after they died.
Doctors mistakenly fear that frank conversations will harm patients, said Barbara Coombs Lee, president of the advocacy group Compassionate Choices.
"Boiled down, it's 'Talking about dying will kill you,' " she said. In reality, "people crave these conversations, because without a full and candid discussion of what they're up against and what their options are, they feel abandoned and forlorn, as though they have to face this alone. No one is willing to talk about it."
The new study is the first to look at what happens to patients if they are or are not asked what kind of care they'd like to receive if they were dying, said lead researcher Dr. Alexi Wright of the Dana-Farber Cancer Institute in Boston.
It involved 603 people in Massachusetts, New Hampshire, Connecticut and Texas. All had failed chemotherapy for advanced cancer and had life expectancies of less than a year. They were interviewed at the start of the study and are being followed until their deaths. Records were used to document their care.
Of the 323 who have died so far, those who had end-of-life talks were three times less likely to spend their final week in intensive care, four times less likely to be on breathing machines, and six times less likely to be resuscitated.
About 7 percent of all patients in the study developed depression. Feeling nervous or worried was no more common among those who had end-of-life talks than those who did not.
James Rogers, 67 of Durham, North Carolina and diagnosed with advanced lung cancer last October, had only one question for the doctor who recommended treatment.
"I said 'Can you get rid of it?' She said 'no,' " and he decided to simply enjoy his final days with the help of the hospice staff at Duke.
"I like being told what my health condition is. I don't like beating around the bush," he said. "We all have to die. I've had a very good life. Death is not something that was fearful to me."