State Politics

From now on, choices will be very personal

With Thursday's announcement that her cancer has returned, Elizabeth Edwards must decide how to spend her days, or years, wisely.

People who have faced similar diagnoses say those decisions are intensely personal and challenging.

As of this week, Edwards has already made one decision: to fight her disease amid her husband's presidential campaign. Cancer survivors said they respected it.

"The point is, cancer is not a death sentence," said Ambrose Dudley, 67, of Raleigh, who was diagnosed with bone cancer 10 years ago. "You just have to live life."

Dudley, a retired Associated Press reporter whose cancer returned last summer, said he watched Thursday's news conference in which former U.S. Sen. John Edwards and Elizabeth explained her condition and their decision to continue campaigning. He found himself cheering:

"I said, 'Go on. Go.' "

Two kinds of courage

Those who study end-of-life care say there are no prescriptions for how to live out one's days. Patients make decisions that are as different as their personalities.

"Practical wisdom requires a reading of yourself and what you're able to take on," said William F. May, a medical ethicist and theologian at the University of Virginia's Institute for Practical Ethics and Public Life.

May said there were two kinds of courage for people in this situation: the courage of attack, which requires a willingness to fight the disease, and later, the courage of endurance, which comes when medical options run out.

He suggested Edwards may have both. She has already proved she has the courage to fight her cancer, first diagnosed in 2004, but she has also learned the courage of endurance in dealing with the death of her son, Wade, in a car accident in 1996.

One thing seemed certain Friday: Public perceptions of the Edwardses' decision would continue to be hotly debated along political lines.

"I am so proud of Elizabeth and John," wrote one person who posted messages with the Blue NC blog, a Democratic site. "What can we do, but redouble our efforts on their behalf."

Others sounded incredulous that John Edwards would continue campaigning while his wife battles late-stage cancer.

"What a chump that would try and take political advantage using his wife's terminal cancer!" one wrote on a blog.

Some who have confronted terminal illness or who study the issue took a more cautious view.

"She's a very independent woman," said Tomma Hargraves, 58, of Raleigh, who was diagnosed with lung cancer in November after feeling a lump in her neck. "Each of us is different. It's a very personal decision, and I don't think any of us -- unless we've been through something similar -- has the right to judge."

Indeed, just about the only advice experts on end-of-life care had to give Elizabeth Edwards was the obvious: form a community of support for the challenging times that lie ahead, and talk to loved ones about what makes life meaningful. Those kinds of conversations may be particularly helpful in making decisions as the days grow short.

Numbering days

They pointed out, while Edwards may be forced to confront her mortality now, everyone must eventually face up to it. In the words of the psalmist, "Teach us to number our days aright, that we may gain a heart of wisdom."

For some, that wisdom may mean a recommitment to family; for others it may be travel or a dedication to causes they hold dear.

In Edwards' case it may be the conviction that her husband is best suited to lead the country and that fighting for issues he has championed -- eliminating poverty, providing affordable health care -- is how she wants to be remembered.

"What would she do if she went home?" asked Julie White, 33, of Raleigh, who was diagnosed with breast cancer about the same time as Elizabeth Edwards. "I remember, I went home, and you start to think, and your mind wanders, and it's horrible."

(Staff writers Kristin Collins and Dan Kane contributed to this report.)