How to have a good death

Is cancer a kinder way to die than Alzheimer's disease as best-selling author, Terry Pratchett claims? 

Which would you rather die from: Alzheimer’s or cancer?   That’s the question posed by bestselling author Terry Pratchett  who at 59,  has early-onset Alzheimer's disease,.   The disease, he says,  ‘strips away your living self a bit at a time’  - he has already lost the ability to touch-type -  and it has left him with ‘a sense of loss and abandonment’.

And the author made what is perhaps the cruellest comparison for the 50 plus age group to consider: the slow degeneration of Alzheimer’s compared to the  appeared what he says sometimes seems to be ‘the heroic glamour of cancer’.

‘I'd like a chance to die like my father did - of cancer, at 86,’ Pratchett told the Arthritis Research Trust conference last month.  ‘Before he went to spend his last two weeks in a hospice, he was bustling around the house. He talked to us right up to the last few days, knowing who we were and who he was. Right now, I envy him.’

It’s a point that echoes the argument put forward by leading scientist, Dr Guy Brown in his new book The Living End (Macmillan).  The Cambridge biochemist argues that cancer and heart disease currently receive hundreds of times more research investment than Alzheimers – yet is  should receive less research funding as both cancer and heart disease bring about quicker deaths and are therefore relatively 'desirable'; ways to die. 

His point is that there is a gap opening up between life expectancy and healthy life expectancy, and increasing numbers of us can expect to be treated successfully for cancer or heart disease only to spend the last decade or so in a long painful descent to death from dementia.

‘A disproportionate amount of funding goes to cancer and heart disease, whereas stroke and dementia get much less. These are skewed priorities. We need to switch dramatically but that would mean stopping government funding for cancer and cardiovascular disease, and that would cause screams in the medical research establishment,’ he said in a recent interview.    ‘We are driving up longevity and creating more and more people with a very low quality of life.’

The statististics seem to bear out this view. The World Health Organisation calculates that, when it comes to disability in the over-60s, dementia is responsible for about 11 per cent, cardiovascular disease for about 5 per cent, and cancer for 2.4 per cent.

In January, the House of Commons Public Accounts Committee also called for dementia to be accorded the same status, in terms of national health priorities, as cancer and heart disease. The committee was told that dementia costs the UK economy £17 billion a year, more than stroke, heart disease and cancer combined.

Both Terry Pratchett and Dr Brown have put their money where their mouths are.  Pratchett has donated £500,000 to arthritis research while Brown has switched the focus of his clinical research from heart disease to Alzheimer’s.  And to pay attention now to the process of death is not  necessarily depressing –especially if its results in successful research to beat dementia and a greater awareness of the value of a healthy life. 

‘Leave something really worthwhile behind you,’  says Dr Brown.   ‘Build that dream, write that novel and.have lots of sex.’ 

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