Bereavement: addressing challenges faced by advanced cancer patients, their caregivers, and their physicians

Physicians who work with advanced cancer patients need to be aware of the process of grief and bereavement not only in terms of how it may impact the patient and family, but in how it can affect their own emotions and behavior. There are a number of simple things that physicians can do to normalize and promote adaptive grieving in advanced cancer patients and their families. Patients facing the end of life face enormous physical and existential challenges. Yet from this challenge there is the potential for enormous growth and a "good death" for the patient as well as an opportunity for the family to strengthen their relationship with the patient and find positive meaning in their caretaking activities. In addition to caring for the patient and family, physicians must be attentive to their own needs, which include acknowledging feelings of grief and loss and pursuing healthy venues that promote adaptive coping and decrease the risk of detachment and burnout. Despite the physical, emotional and spiritual demands of working with end-of-life patients and their families, being open and willing to face these challenges can lead to positive growth and increased meaning for all involved.