We had a conversation on a hike where I expressed my concern that if Tom had chemo he might waste his remaining good days feeling bad. His oncologist asked him what was most important to him–quality of life or quantity of life. Tom replied, “90% quality and 10% quantity.” Tom decided to refuse chemo and accepted medical treatment only for comfort, such as removal of fluid from his abdomen.

Tom was nearly symptom free for a long time, and we used that time to travel the world and enjoy our friends, family, and each other. He died at home on hospice care, surrounded by his wife, children, and grandchildren, almost 3 years after his diagnosis. He lived longer than most patients with this diagnosis do, including those who have surgery and chemo. I am grateful that we had the conversation and that he made the decisions he did. It was as good a death as anyone could hope for.

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